传统中医药补肾固筋方对中老年膝骨关节炎患者IL-1、iNOS水平的影响和临床意义  

Effect and clinical significance of reinforcing kidney and strengthening ligament prescription on the levels of IL-1 and iNOS in middle and elderly patients with knee osteoarthritis

作　　者：张冲[1] 高海燕[2] 黄芸[2] 王宁宁[2] 李双成[2] 刘玉杰[3] 

机构地区：[1]河北省中医院骨三科,石家庄050000 [2]河北医科大学,石家庄050017 [3]解放军总医院骨科,北京100853

出　　处：《中国骨质疏松杂志》2015年第7期780-783,共4页Chinese Journal of Osteoporosis

基　　金：河北省中医药科学指导性课题(2014172)

摘　　要：目的观察补肾固筋方治疗膝骨关节炎IL-1、iNOS水平的研究。方法实验分两组进行,每组病例各92例,治疗8周,中药组口服补肾固筋方,西药组口服美洛昔康胶囊。收集患者治疗前后关节滑液及空腹血清,采用酶联免疫吸附法检测IL-1、iNOS的水平,观察治疗效果和不良反应。结果治疗前中药组和对照组IL-1、iNOS水平较治疗前显著增高;治疗后中药组关节液和血清IL-1、iNOS相比对照组显著降低(P<0.05);治疗后两组均未见明显血常规和肝肾功能异常。结论补肾固筋方在治疗中降低了IL-1、iNOS的水平及比值,不良反应少见,提示中药补肾固筋方通过调节细胞因子的表达水平来调控细胞凋亡和减轻软骨破坏,改善膝关节骨关节炎发生及发展。Objective To observe the efficacy of reinforcing kidney and strengthening ligament prescription on the levels of IL-1and iNOS in knee osteoarthritis. Methods The experimental subjects were divided into two groups. Each group had 92 patients with the treatment for 8 weeks. Patients in Chinese medicine group received reinforcing kidney and strengthening ligament prescription,while patients in Western medicine group received oral Meloxicam capsules. The joint synovial fluid and fasting serum were collected before and after the treatment. The levels of IL-1 and iNOS were determined using ELISA method. The therapeutic efficacy and adverse reaction were observed. Re sults Before the treatment,the levels of IL-1 and iNOS in TCMgroup and Western medicine group were significantly higher. After the treatment,the levels of IL-1 and iNOS in serum and synovial fluid in the Chinese medicine group decreased significantly,comparing to those in the Western medicine group（ P〈0. 05）. After the treatment,routine blood test and liver and kidney function were normal in both groups. Conclusion Reinforcing kidney and strengthening ligament prescription reduces the levels of IL-1 and iNOS and the ratio,with little adverse effect. The results suggest that Reinforcing kidney and strengthening ligament prescription regulates cell apoptosis,reduces the damage of cartilage,and relieves the development of knee joint osteoarthritis by regulating the expression levels of IL-1 and iNOS.

关 键 词：补肾固筋方 膝骨关节炎 IL-1(白介素-1) iNOS(诱导型一氧化氮合酶) 

分 类 号：R681[医药卫生—骨科学]