膝骨关节炎中医证候血清生物标志物研究

目的：研究膝骨关节炎中医证候与生物标志物的相关性,为膝骨关节炎的证候提供新内容。方法：2012年5月-2013年12月收集膝骨关节炎病例120例：男57例,女63例;分为肝肾不足、筋脉瘀滞证,脾肾两虚、湿注骨节证,肝肾亏虚、痰瘀交阻证。整理临床特征资料,采用ELISA法用酶标仪测定I型和Ⅱ型胶原抗原表位C1,2C（C1,2C）、Ⅱ型胶原抗原表位C2C（C2C）、Ⅱ型前胶原C末端肽（PIICP）、硫酸软骨素846（CS846）、软骨寡聚基质蛋白（COMP）、血清透明质酸（HA）,整理KOA中医症候的生物标志物和临床症状特征,研究KOA中医症候与生物标志物的相关性。结果：BMI、WOMAC评分、关节活动度等指标肝肾亏虚、痰瘀交阻证和脾肾两虚、湿注骨节证明显高于肝肾不足、筋脉瘀滞证（P〈0.05）,并且CS846和HA在明显高于肝肾不足、筋脉瘀滞证。结论：血清蛋白多糖在肝肾亏虚、痰瘀交阻证和脾肾两虚、湿注骨节证明显高于肝肾不足、筋脉瘀滞证,关节活动度和生活质量低于肝肾不足、筋脉瘀滞证。

Study between Traditional Chinese Medicine Syndrome and Serum Biomarkers in Knee Osteoarthritis

Objective：To analyze the correlation between traditional Chinese medicine syndrome and serum biomarkers in knee osteoarthritis.Methods：All 120 patients of knee osteoarthritis admitted from May 2012 to December 2013 were involved（57male and63female）.All the patients were divided into 3types：Type 1,insufficiency of the liver and kidney,with stagnation of tendons and muscle;Type 2,insufficiency of the spleen and kidney,with dampness infusion into bone and joints;Type 3,deficiency of the liver and kidney,with inter-obstruction of phlegm and stasis.ELISA methods were use to detected type I and type II collagen epitope C1,2C（C1,2C）,type II collagen epitope C2C（C2C）,type II procollagen C terminal peptide（PIICP）,chondroitin sulphate 846（CS846）,cartilage oligomeric matrix protein（COMP）,serum hyaluronic acid（HA）.Results：The BMI,WOMAC score,and joint range of motion were higher in type 2and type 3patients than that in type 1patients（P〈0.05）.Serum proteoglycans,CS846 and HA were higher in type 2and type 3patients compared with type 1patients,while quality of life was lower.Conclusion：The level of serum proteoglycans in patients with the type of insufficiency of the liver and kidney,with stagnation of tendons and muscle,and the type of insufficiency of the spleen and kidney,with dampness infusion into bone and joints,is significant higher than that type of deficiency of the liver and kidney,with inter-obstruction of phlegm and stasis,but the joint range of motion and quality of life are lower.