摘要
目的:探讨川膝散通过TLR4/NF-κB信号通路对肾虚血瘀型膝骨性关节炎的作用机制.方法:纳入2021 年1 月—2022 年12 月至杭州市富阳中医骨伤医院就诊的膝骨性关节炎患者 90 例,随机分为对照组和观察组,每组各45 例.对照组接受股四头肌锻炼、外用消炎止痛膏及口服硫酸氨基葡萄糖治疗,观察组接受对照组治疗的同时增加川膝散治疗.治疗前和治疗1 个月后对两组患者进行膝关节疼痛VAS评分、JOA 评分、WOMAC骨关节炎指数评分并检测血清Toll样受体4(TLR4)、核因子κB p65(NF-κB p65)、白介素1b(IL-1b)、肿瘤坏死因子α(TNF-α)变化.结果:两组患者膝关节疼痛VAS评分、JOA评分及WOMAC评分治疗前比较无明显统计学差异(P>0.05);治疗1 个月后,两组患者VAS评分、JOA评分及WOMAC评分均较治疗前有改善,差异具有统计学意义(P<0.05);与对照组比较,观察组VAS评分及WOMAC评分更低,而JOA评分更高,差异具有统计学意义(P<0.05).两组患者治疗前血清TLR4、NF-κB p65、IL-1b、TNF-α水平比较无明显统计学差异(P>0.05);治疗1 个月后,两组患者血清TLR4、NF-κB p65、IL-1b、TNF-α水平较治疗前降低(P<0.05),观察组患者血清TLR4、NF-κB p65、IL-1b、TNF-α水平明显低于对照组,差异具有统计学意义(P<0.05).结论:川膝散可以通过肾虚血瘀型膝骨性关节炎患者TLR4/NF-κB信号通路的激活,减少促炎因子的释放,从而减轻膝关节疼痛症状,改善患者膝关节功能的作用.
Abstract
Objective:To explore the mechanism of Chuanxi Powder on knee osteoarthritis of kidney defi-ciency and blood stasis type based on TLR4/NF-κB signaling pathway.Methods:From January 2021 to De-cember 2022,90 knee osteoarthritis patients who visited Fuyang Chinese Medicine Orthopedics Hospital were en-rolled and randomly divided into control group and observation group,with 45 cases in each group.The control group underwent quadriceps exercise,external application of anti-inflammatory analgesic plaster and oral Glu-cosamine Sulfate,while the observation group received Chuanxi Powder on the basis of the control group.The VAS score of knee pain,JOA score,WOMAC osteoarthritis index score of the two groups patients were recorded,and serum TLR4,NF-κB p65,IL-1b,TNF-α levels were determined before treatment and one month after treatment.Results:Before treatment,there were no significant differences between the two groups on knee pain VAS score,JOA score,and WOMAC score(P>0.05),both groups showed significant improvement in VAS,JOA,and WOMAC scores one month after treatment(P<0.05),the VAS score and WOMAC score in the ob-servation group were lower than those in the control group,while the JOA score was higher than that in the con-trol group(P<0.05).There were no significant differences between the two groups on serum TLR4,NF-κB p65,IL-1b,TNF-α levels(P>0.05)before treatment,the levels of serum TLR4,NF-κB p65,IL-1b,TNF-α were significantly lower after one month treatment(P<0.05),which in the observation group were lower than those in the control group(P<0.05).Conclusion:Chuanxi Powder can regulate the activation of TLR4/NF-κB signaling pathway in patients with knee osteoarthritis of kidney deficiency and blood stasis syndrome,and reduce the release of pro-inflammatory factors,thereby alleviating knee pain symptoms and improving knee joint function.
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