芍灵消增贴对膝骨关节炎患者血清NO与外周血单个核细胞的金属蛋白酶9mRNA表达的影响

目的：观察芍灵消增贴对膝骨关节炎（OA）患者血清NO与外周血单个核细胞（PBMC）的基质金属蛋白酶9（MMP-9）mRNA表达的影响，探讨其疗效机理。方法：采用随机、双盲、安慰剂平行对照临床研究方法，并设立健康对照组。随机选择健康志愿者共21例，作为健康组；将门诊膝OA患者共60例，随机进入试验组39例（芍灵消增贴）和对照组21例（安慰剂），共治疗2周。治疗前后各采取空腹血清测定NO与PBMC的MMP．9mRNA表达，并采用Lequense指数作为疗效评分标准，观察治疗前后膝关节症状变化包括休息痛、运动痛、压痛、肿胀、晨僵、行走能力的改善程度。结果：试验组与对照组血清NO、PBMC的MMP-9mRNA基础值均高于健康组，且差异有统计学意义（P〈0．05）；治疗2周后，试验组血清NO、PBMC的MMP_9mRNA及Lequesne指数值低于基础值，且差异有统计学意义（P〈0．05），NO、MMP．9表达量与休息痛、关节肿胀、行走能力及总Lequesne指数呈显著正相关。结论：芍灵消增贴作用机理是通过各种途径下调血清NO的浓度和抑制PBMC的MMP-9mRNA表达，从而抑制软骨细胞凋亡和软骨基质的降解，达到治疗和缓解OA临床症状的目的。

Effects of Shaolingxiaozeng Tie on serum levels of NO and MMP-9 mRNA in peripheral blood mononuclear cell on knee osteoarthritis patients

AIM: To observe the effects of Shaol-ingxiaozeng Tie on serum levels of nitric oxide ( NO) and matrix metalloproteinase-9(MMP-9) mRNA in peripheral blood mononuclear cell ( PBMC ) on knee osteo-arthritis (OA) patients and further to study its mechanism. METHODS: Healthy group (n = 21) was established with a randomized, double-blind, placebo, clinical trial research method. Sixty outpatients with knee osteoarthritis were randomly divided into Shaol-ingxiaozeng Tie( n = 39) and placebo ( n = 21)groups. The treatment lasted for 2 weeks. The serum levels of NO and MMP-9 mRNA in peripheral blood mononuclear cell were measured before and after treatment. The changes of articular genu symptoms such as knee pain at rest and movement, tenderness, knee swelling, morning stiffness and the improvement of walking ability were scored by Lequesne' s index before and after treatment. RESULTS: The serum levels of NO and MMP-9 mRNA in PBMC in Shaolingxiaozeng Tie and placebo groups were higher than those in healthy group, there were significant differences ( P < 0.05 ) . After two weeks treatment, the serum levels of NO and MMP-9 mRNA in PBMC and Lequesne's score in Shaolingxiaozeng Tie group were lower compared with the foundmental values, there were significant differences (P < 0.05) . There was significant positive correlation between the serum levels of NO and MMP-9 mRNA in PBMC and the knee pain at rest and movement, tenderness , knee swelling, morning stiffness, the walking ability and total Lequesne's score. CONCLUSION: Decreasing the concentration of serum NO and inhibiting the expression of MMP-9 mRNA in PBMC by various ways may be the action mechanisms of Shaolingxiaozeng Tie, so the clinical symptom of osteoarthritis is improved and relieved by inhibiting the apoptosis of chondrocytes and the degradation of cartilage matrix.