青藤碱注射液电致孔透皮给药治疗老年继发膝关节创伤性关节炎疗效及对关节液中炎性因子水平的影响  

Effect of Sinomenine injection by electroporation transdermal delivery on senile secondary knee traumatic arthritis and on levels of inflammatory factors in joint fluid

作　　者：成国华[1] 蔡华安[2] 王星娜[1] 欧阳文湘[1] 袁雯静[1] 吴佳玲[1] 胡小明[1] 藤健 

机构地区：[1]湖南省长沙市第四医院,湖南长沙410006 [2]湖南省人民医院,湖南长沙410000 [3]湖南正清制药集团股份有限公司,湖南怀化418000

出　　处：《现代中西医结合杂志》2017年第22期2401-2404,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：湖南省中医药科研计划项目(2011116)

摘　　要：目的观察青藤碱注射液电致孔透皮给药联合尼美舒利缓释胶囊治疗老年继发膝关节创伤性关节炎的临床疗效及对关节液中炎性因子水平的影响。方法将64例老年继发膝关节创伤性关节炎患者随机分为观察组和对照组,每组32例。对照组给予尼美舒利缓释胶囊口服和扶他林乳胶剂外用治疗,观察组给予尼美舒利缓释胶囊口服及LHJ-X1型原道电致孔电子脉冲治疗仪配合青藤碱注射液透皮给药治疗,2组均以10 d为1个疗程,治疗2个疗程。观察2组治疗前后关节VAS疼痛评分、关节活动度(ROM)、HSS评分及关节液中一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)及护骨素(OPG)、核因子κB受体激活因子配体(RANKL)、OPG/RANKL、白细胞介素-17(IL-17)含量变化,统计2组临床疗效及不良反应发生情况。结果 2组治疗后疼痛VAS评分和膝关节液中NO、MDA水平均显著降低(P均<0.05),膝关节活动度、HSS评分及膝关节液中SOD水平均显著增加(P均<0.05),且观察组上述各项指标改善情况均显著优于对照组(P均<0.05);观察组治疗后膝关节液中OPG、RANKL、OPG/RANKL均明显高于治疗前及对照组(P均<0.05),IL-17水平均明显低于治疗前及对照组(P均<0.05),对照组治疗前后各项指标比较差异均无统计学意义(P均>0.05)。观察组临床总有效率显著高于对照组(P<0.05),2组治疗期间均未见明显不良反应发生。结论青藤碱注射液电致孔透皮给药联合尼美舒利缓释胶囊治疗老年继发膝关节创伤性关节炎可有效缓解关节疼痛,提高膝关节活动范围,改善膝关节功能,可能通过有效降低关节液中自由基的活性提高OPG/RANKI的比值,下调IL-17水平来减缓关节骨侵蚀和滑膜的炎症状态。Objective It is to observe the effect of Sinomenine injection by electroporation transdermal delivery combined with Nimesulide sustained-release capsule on senile secondary knee traumatic arthritis and on levels of inflammatory factors in joint fluid. Methods Sixty-four patients with secondary knee joint traumatic arthritis were randomly divided into observation group and control group,with 32 cases in each group. The control group was treated with Nimesulide sustained-release capsules by oral administration and external therapy with Votalin emulsion. 10 days as one treatment course,both groups were treated for 2 courses. The changes of joint pain VAS scores,joint range of motion（ROM）,HSS scores and the contents of NO,SOD,MDA and OPG,receptor activator of nuclear factor-κb ligand（RANKL）,OPG/RANKL,IL-17 in joint fluid before and after treatment were observed,clinical curative effect and adverse reactions were evaluated in both groups. Results After treatment VAS scores,the levels of NO,MDA in joint fluid significantly decreased（P〈0. 05）,ROM,HSS scores and SOD in fluid joint increased in both groups（P〈0. 05）,and the improvements in observation group were better than that in control group（P〈0. 05）; OPG,RANKL,OPG/RANKL in joint fluid were lower while level of IL-17 was higher in observation group than those before treatment and in control group after treatment（P〈0. 05）,no significant difference was found in control group（P〈0. 05）. The total clinical efficiency of the observation group was significantly higher than that in the control group（P〈0. 05）,and no obvious adverse reactions occurred during treatment. Conclusion Sinomenine injection by electroporation transdermal delivery combined with Nimesulide sustained-release capsule can effectively relieve joint pain,improve the knee joint activity range and the function of knee joint in the treatment of senile secondary knee traumatic arthritis,the mechanism may be that it can effectively reduce the activity of free radicals i

关 键 词：青藤碱注射液 电致孔透皮给药技术 创伤性关节炎 膝关节功能 

分 类 号：R684.3[医药卫生—骨科学]