中药熏洗对膝骨性关节炎患者关节滑液中MMP-3和MMP-13的影响  

The Effect of Steaming and Washing with Chinese Medicine on the Level of MMP-3 and MMP-13 in Joint Synovia of Patients with Osteoarthritis

作　　者：何帮剑[1,2] 方针[1] 解光尧[1] 徐守宇[1] 

机构地区：[1]浙江中医药大学附属第三医院,浙江杭州310005 [2]浙江中医药大学,浙江杭州310053

出　　处：《中医药学报》2011年第4期61-64,共4页Acta Chinese Medicine and Pharmacology

基　　金：浙江中医药大学附属第三医院医药卫生科研计划青年项目(编号:ZS10YA03);浙江省"重中之重"学科(针灸推拿学)建设经费资助(浙教高科[2008]255号)

摘　　要：目的:观察中药熏洗治疗膝关节骨性关节炎的临床疗效和对关节滑液中MMP-3和MMP-13的影响。方法:膝关节骨性关节炎90例,分成治疗组和对照组。分别采用补肾活血汤熏洗和热开水熏洗加双氯芬酸钠乳膏外搽治疗,观察两组患者的临床症状、体征、Lysholm's膝关节评分以及关节滑液中MMP-3和MMP-13变化。结果:两组治疗后Lysholm's膝关节评分较治疗前明显升高(P<0.01),治疗组的评分值高于对照组(P<0.01),治疗组总体优良率为93.33%,对照组总体优良率为82.22%,治疗组疗效优于对照组(P<0.01),两组治疗后关节滑液MMP-3、MMP-13水平明显下降(P<0.01),治疗组MMP-3、MMP-13下降较对照组更为明显(P<0.01)。结论:补肾活血汤熏洗治疗膝骨性关节炎疗效显著,其作用机制可能通过降低MMP-3、MMP-13的水平,减轻滑膜炎症和关节软骨的破坏,从而发挥对骨性关节炎的治疗作用。Objective:To evaluate effects of fumigation and washing with traditional Chinese drug on the level of MMP-3,MMP-13 in joint synovia of patients with osteoarthritis.Methods:Ninety patients with knee osteoarthritis were randomized into treatment group and control group,45 patients in each group.The patients in treatment group were treated with fumigation and washing with Bushen Huoxue decoction,while the patients in control group only received fumigation and washing with boiled water and diclofenac ointment external application,clinical symptoms and Lysholm's knee score of each group were observed.The level changs in joint synovia of MMP-3,MMP-13 were measured by ELISA before and after therapy.Results:After the treatment,Lysholm's knee score was significantly increased than before(P<0.01).The score of treatment group was remarkably higher than that of control group(P<0.01),The total effective rate of treatment group(93.33%) was also markedly higher than that of control group(82.22%)(P<0.01).After the treatment,the level of MMP-3,MMP-13 was significantly decreased than before(P<0.01),the level of MMP-3,MMP-13 was remarkably lower than that of control group(P<0.01).Conclusion:The fumigation and washing with traditional Chinese drug is an effective method for knee osteoarthritis.The partial mechanism is attributed to its inhibition of the expression of MMP-3,MMP-13 inhibition of the inflammation of synovial membrane and destruction of the articular cartilage.

关 键 词：骨性关节炎 膝 基质金属蛋白酶-3 基质金属蛋白酶-13 中药熏洗 关节滑液 

分 类 号：R24[医药卫生—中医临床基础]