独活寄生汤对老年膝骨关节炎血清TLR4/NF-κB信号通路的影响  

Effect of Duhuo Jisheng Decoction(独活寄生汤)on Serum TLR4/NF-κB Signaling Pathway in Elderly Patients with Knee Osteoarthritis

作　　者：薛英[1] 田永祥[1] 刘峰瑞 郝耀 XUE Ying;TIAN Yongxiang;LIU Fengrui;HAO Yao(The First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学第一医院,山西太原030001

出　　处：《中华中医药学刊》2025年第4期201-205,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：山西省科技厅科研基金项目(201901D211481);山西省留学人员科技活动择优项目(20200037)。

摘　　要：目的观察独活寄生汤用于老年膝骨关节炎疗效及其对Toll样受体4(TLR4)/核转录因子κB(NF-κB)信号通路的影响。方法将118例老年膝骨关节炎患者按照随机数字表法分为观察组和对照组,各59例。对照组患者给予盐酸氨基葡萄糖片治疗,观察组在对照组基础上联合独活寄生汤治疗,4周为1个疗程,共治疗2个疗程。比较两组临床疗效,比较两组治疗前后中医证候积分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)量表评分及视觉模拟量表(VAS)评分,观察两组治疗前后血清白细胞介素-6(IL-6)、基质金属蛋白酶-1(MMP-1)、骨钙素(BGP)、I型前胶原羧基末端肽β降解产物(β-CTX)、I型前胶原羧基末端肽(PICP)水平及TLR4、NF-κB蛋白表达。结果治疗后观察组总有效率96.61%(57/59)高于对照组的83.05%(49/59),差异有统计学意义(P<0.05);治疗后两组各项中医证候积分较治疗前降低,并且观察组均低于对照组(P<0.05);治疗后,两组WOMAC评分及VAS评分较治疗前降低,并且观察组低于对照组(P<0.05);治疗后两组IL-6、MMP-1及TLR4、NF-κB蛋白水平较治疗前降低,并且观察组均低于对照组(P<0.05);治疗后,两组血清BGP、PICP水平较治疗前升高,并且观察组高于对照组,两组血清β-CTX水平较治疗前降低,并且观察组低于对照组(P<0.05)。结论独活寄生汤用于老年膝骨关节炎患者有利于提高临床疗效,减轻疼痛、乏力等症状,并改善关节功能,其作用机制可能与改善骨代谢指标、通过TLR4/NF-κB信号通路抑制炎症因子水平、减轻软骨损伤等因素有关。Objective To observe the effect of Duhuo Jisheng Decoction(独活寄生汤)on Toll-like receptor 4(TLR4)/nuclear transcription factorκB(NF-κB)signaling pathway in elderly patients with knee osteoarthritis.Methods A total of 118 elderly patients with knee osteoarthritis were divided into observation group and control group(59 cases in each)according to random number table method.The control group was treated with Glucosamine Hydrochloride Tablets and the observation group was treated with Duhuo Jisheng Decoction on the basis of the control group,4 weeks for 1 course of treatment,a total of 2 courses of treatment.The clinical efficacy of the two groups was compared,and the TCM syndrome scores,Western Ontario and McMaster University Osteoarthritis Index(WOMAC)scale score and visual analogue scale(VAS)score before and after treatment were compared between the two groups.Serum levels of interleukin-6(IL-6),matrix metalloproteinase-1(MMP-1),osteocalcin(BGP),carboxy-terminal peptideβdegradation product of type I procollagen(β-CTX)and carboxy-terminal peptide(PICP)of type I procollagen,and the protein expressions of TLR4 and NF-κB were observed before and after treatment in the two groups.Results After treatment,the total effective rate of the observation group was 96.61%,higher than that(83.05%)of control group,and the difference was statistically significant(P<0.05).After treatment,the scores of TCM syndrome in both groups were lower than those before treatment,and the score of the observation group was lower than that of the control group(P<0.05).After treatment,the WOMAC scores and VAS scores of both groups were lower than those before treatment,and the scores of the observation group were lower than those of the control group(P<0.05).After treatment,the levels of IL-6,MMP-1,TLR4 and NF-κB protein in two groups were lower than those before treatment,and the levels of the observation group were lower than those of the control group(P<0.05).After treatment,the levels of serum BGP and PICP of the two groups were h

关 键 词：膝骨关节炎 独活寄生汤 TOLL样受体4 核转录因子ΚB 炎症因子 

分 类 号：R274.984.3[医药卫生—中西医结合]