独活寄生汤联合结筋病灶点温针灸对膝骨关节炎患者氧化应激、软骨代谢指标和NLRP3炎症小体的影响  

Effects of Duhuo Jisheng Decoction Combined with Spot Warming Acupuncture and Moxibustion at Jiejin Focus on Oxidative Stress,Cartilage Metabolic Indicators and NLRP3 Inflammatory Bodies in Patients with Knee Osteoarthritis

作　　者：王闯 刘旭 崔亮[2] 陶世武 杨宗宇[2] WANG Chuang;LIU Xu;CUI Liang;TAO Shi-wu;YANG Zong-yu(Graduate School of Hebei University of Traditional Chinese Medicine,Shijiazhuang,Hebei,050091,China;Department of Orthopedics,Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou,Hebei,061000,China)

机构地区：[1]河北中医药大学研究生院,河北石家庄050091 [2]河北省沧州中西医结合医院骨科,河北沧州061000

出　　处：《现代生物医学进展》2024年第22期4240-4242,共3页Progress in Modern Biomedicine

基　　金：河北省中医药管理局中医药类科研计划项目(2022594)。

摘　　要：目的:分析独活寄生汤联合结筋病灶点温针灸对膝骨关节炎(KOA)患者氧化应激、软骨代谢指标和核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体的影响。方法:采用随机数字表法将135例寒湿痹阻型KOA患者分为对照组(67例,接受结筋病灶点温针灸治疗)、研究组(68例,接受独活寄生汤联合结筋病灶点温针灸治疗)。对比两组Lysholm膝关节评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、血清氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、血清软骨代谢指标[Ⅱ型胶原羧基端端肽(CTX-Ⅱ)、蛋白聚糖(PG)、软骨寡聚基质蛋白(COMP)]、外周血单个核细胞NLPR3炎症小体信使核糖核酸(m RNA)的表达。结果:两组治疗后Lysholm膝关节评分、血清SOD升高,且研究组较对照组更高;WOMAC评分、血清MDA、COMP、CTX-Ⅱ、PG、NLRP3 mRNA表达、凋亡相关斑点样蛋白(ASC)mRNA表达、半胱天冬氨酸蛋白酶1(caspase-1)mRNA表达下降,且研究组较对照组更低(P<0.05)。结论:独活寄生汤联合结筋病灶点温针灸治疗KOA患者,可减轻氧化应激,改善软骨代谢指标,抑制NLRP3炎症小体。Objective:To analyze the effects of duhuo jisheng decoction combined with needle warming moxibustion on oxidative stress,cartilage metabolism indexes and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome in patients with knee osteoarthritis(KOA).Methods:The random number table method was used,135 patients with KOA of cold-dampness obstruction type were divided into control group(67 cases,treated with warm acupuncture at the lesion point of the tendon),and study group(68 cases,treated with duhuo jisheng decoction combined with warm acupuncture at the lesion point of the tendon).The Lysholm knee score,western ontario and mcMaster universities osteoarthritis Index(WOMAC),serum oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)],serum cartilage metabolism indexes[type Ⅱ collagen carboxy terminal peptide(CTX-Ⅱ),proteoglycan(PG),cartilage oligomeric matrix protein(COMP)],and the expression of NLPR3 inflammasome mRNA in peripheral blood mononuclear cells were compared between two groups.Results:Lysholm knee score and serum SOD increased in two groups,and study group was higher than those in control group after treatment.WOMAC score,serum MDA,COMP,CTX-Ⅱ,PG,NLRP3 mRNA expression,apoptosis-related spot-like protein(ASC)mRNA expression,and caspase-1 mRNA expression decreased,and study group was lower than those in control group(P<0.05).Conclusion:Duhuo jisheng decoction combined with warm acupuncture and moxibustion at the focus of tendon knots in the treatment of KOA patients,which can reduce oxidative stress,improve cartilage metabolism indexes,inhibit NLRP3 inflammasome.

关 键 词：独活寄生汤 结筋病灶点温针灸 膝骨关节炎 氧化应激 软骨代谢 NLRP3炎症小体 

分 类 号：R684.3[医药卫生—骨科学] R243[医药卫生—外科学]