摘要
目的 观察重骨颗粒对膝骨关节炎(knee osteoarthritis,KO A)患者临床症状及相关实验室指标的影响.方法 纳入60例KOA患者并分为治疗组和对照组,每组各30例.对照组予以口服盐酸氨基葡萄糖片,治疗组在对照组基础上口服重骨颗粒,两组均治疗12周.观察治疗前后疗效性评价量表和中医症状评分的变化,检测治疗前后C反应蛋白(CRP)、血沉(ESR)、IL-6、IFN-γ、骨代谢生化指标(尿Ca、尿P、BALP、TRACP-5b、IGF-1)、基质金属蛋白酶指标(MMP-1、MMP-13)、血清OPG、RANKL水平及OPG/RANKL比值.结果 两组均无脱落病例,与治疗前比较,两组治疗后临床疗效指标较前均有所改善.治疗后观察组的疗效性评价量表、中医症状评分、CRP、ESR、IL-6、IFN-γ、尿Ca、尿P、TRACP-5b、MMP-1、MMP-13、RANKL水平均显著低于对照组(P＜0.05或P＜0.01),BALP、IGF-1、OPG水平显著高于对照组(P＜0.05或P＜0.01).观察期间两组均未见明显不良反应.结论 重骨颗粒可改善KOA患者临床症状,改善炎症因子及骨代谢水平,其机制可能与影响OPG/RANKL/RANK信号通路的表达有关.
Abstract
Objective To observe the effect of Chonggu granules on clinical symptoms and related laboratory indicators in patients with knee osteoarthritis(KOA).Methods The 60 patients with KOA weredivided into two groups,with 30 cases each in the treatment group and the control group.The patients inthe control group received oral glucosamine hydrochloride tablets,patients in the treatment group receive Chonggu granules on the basis of the control group,and the treatment period was 12 weeks.The change of efficacy evaluation scale and TCM symptom score before and after treatment were observed.C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),IL-6,IFN-γ,and bone metabolism and biochemical indexes(urine Ca,urine P,BALP,TRACP-5b,and IGF-1),matrix metalloproteinase indexes(MMP-1,MMP-13),and serum OPG,RANKL level and OPG/RANKL ratio were detected.Results There were no case of exfoliation in either group.The clinical efficacy indicators in both groups after treatment were improved compared with those before treatment.The levels of efficacy evaluation scale,TCM symptom score,CRP,ESR,IL-6,IFN-γ,urine Ca,urine P,TRACP-5b,MMP-1,MMP-13,and RANKL in the observation group were significantly lower than those in the control group after treatment(P＜0.05 or P＜0.01),and the levels of BALP,IGF-1 and OPG were significantly higher than those in the control group(P＜0.05 or P＜0.01).No significant adverse effect was observed in either group.Conclusion Heavy bone granules effectively improve the clinical symptoms,inflammatory factors,and bone metabolism levelsof patients with KOA.The mechanism may be related to the expression of OPG/RANKL/RANK signalingpathway.
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