活血化瘀法与氨基葡萄糖胶囊治疗创伤性膝骨性关节炎基质金属蛋白酶表达的影响

目的:观察活血化瘀法与盐酸氨基葡萄糖胶囊治疗创伤性膝骨性关节炎的临床疗效,检测创伤性膝骨性关节炎患者治疗前后基质金属蛋白酶的表达变化,探讨相关病理分子机制。方法:选取2015年1月至2017年12月陕西中医药大学附属医院收治的创伤性膝骨性关节炎早期患者60例,按照随机数字表法随机分为对照组和观察组,每组30例,对照组给予口服盐酸氨基葡萄糖胶囊治疗6个疗程;观察组给予活血化瘀协定方治疗6个疗程。2组治疗前后创伤性膝骨性关节炎的恢复情况比较、中医症候情况比较、记录膝关节症状分级量化评分、膝关节疼痛指数和中医症候积分,并抽取患者的关节液及血清检测基质金属蛋白酶的表达。结果:2组患者在治疗后第1周、第12周和第24周症状分级量化积分、膝关节疼痛指数、中医症候积分均较治疗前显著下降,差异有统计学意义(P 0. 05),2种治疗方法均能对创伤性膝骨性关节炎起到一定程度的恢复效果,并能明显改善中医症候情况,而口服活血化瘀中药汤剂对创伤性膝骨性关节炎治疗效果优于口服盐酸氨基葡萄糖胶囊(P 0. 05)。治疗后2组的MMP3表达均显著下降(P 0. 001),而MMP13在2组均无明显变化(P 0. 05),MMP1在观察组有明显下降(P 0. 001),但在对照组无明显改变(P 0. 05)。结论:2种治疗方法临床效果显著,治疗后基质金属蛋白酶MMP3表达水平均显著下降,可以临床推广应用。

Effects of Activating Blood Circulation to Resolve Blood Stasis and Glucosamine Capsules Therapy on the Expression of Matrix Metalloproteinase in Post-traumatic Knee Osteoarthritis

To observe the clinical effects of activating blood circulation to resolve blood stasis and glucosamine hydrochloride capsules therapy on post-traumatic knee osteoarthritis treatment,to measure the expression of matrix metalloproteinase in post-traumatic knee osteoarthritis patients before and after treatment,and to explore its relevant molecular mechanisms.Methods:A total of 60 patients with post-traumatic knee osteoarthritis in early stage in our hospital from January 2015 to December 2017 were selected and randomly divided into the treatment group(n=30)and the control group(n=30).The control group was given oral administration of glucosamine hydrochloride capsules for 6 courses of treatment.The treatment group was using the activating blood circulation to resolve blood stasis therapy for 6 courses of treatment.The recovery of traumatic knee osteoarthritis and the symptom of traditional Chinese Medicine(TCM)in 2 groups was compared before and after treatment.The symptoms and the quantitative assessment rating scale of knee osteoarthritis,the pain index of knee and the TCM symptom scores were recorded in both groups.And the synovial fluid and serum of patients were collected to detect the expression of matrix metalloproteinase.Results:The symptoms and the quantitative assessment rating scale of knee osteoarthritis,the pain index of knee and TCM symptom scores of the 2 groups in the 1st week,the 12th week and the 24th week after treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).Two therapeutic methods had certain therapeutic effects on the recovery from traumatic knee osteoarthritis,and could significantly improve the TCM syndrome.There were better therapeutic effects on oral decoction of traditional Chinese medicine than oral glycosaminoglycans hydrochloride capsules on treating traumatic knee osteogenesis(P<0.05).The expression level of MMP3 was decreased significantly in both groups(P<0.0001),while the expression level of MMP13 had no significant change in both groups(P>0.05).The expression level of MMP1 was decreased significantly in the treatment group(P<0.0001),but there was no significant change in the control group after treatment(P>0.05).Conclusion:Two treatment methods have been effective in this clinical study.We found that the expression level of MMP-3 was decreased significantly after treatment in 2 therapies,which can be clinically applied.