Srivastava Shobhit, Saksena Anil K, Khattri Sanjay, Kumar Santosh, Dagur Raghubendra Singh
Department of Pharmacology and Therapeutics, King George's Medical University, Chowk, Lucknow, 226003, India.
Department of Orthopaedic Surgery, King George's Medical University, Lucknow, India.
Inflammopharmacology. 2016 Dec;24(6):377-388. doi: 10.1007/s10787-016-0289-9. Epub 2016 Oct 19.
Curcuma longa L. (CL), an Indian herb, has been used to treat many disorders because of its wide spectrum of pharmacological activities. It has been shown to exhibit anti-oxidant and anti-inflammatory properties, and is being used as herbal remedy since ancient times. Osteoarthritis of knee (KOA) is a chronic painful disorder in which prolong use of non-steroidal anti-inflammatory drugs (NSAIDs) or steroids may result into many serious side effects; hence, there is a need to develop herbal drugs, having good analgesia without side effects. Therefore, we planned to evaluate the efficacy of CL in KOA.
The study was designed as a randomized, double-blind, placebo-controlled trial in patients of KOA. After obtaining ethical clearance and written informed consent, a total of 160 patients of KOA were randomly enrolled into two groups to receive either CL extract or placebo along with the standard drug regimen. The patients were assessed on day 0, day 60, and day 120. On the days of their visit, the clinical prognosis was assessed by visual analog scale (VAS) and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index. On these days, the radiographs were also taken for Kellgren and Lawrence grading and blood samples were collected for assessing the changes in levels of IL-1β and biomarkers of oxidative stress, such as reactive oxygen species and malondialdehyde (MDA).
Over all significant improvement was observed in the patients of CL extract group as compared to placebo group. Clinically, the VAS and WOMAC scores became better, and simultaneously, the levels of biomarkers, viz., IL-1β, ROS, and MDA, were also significantly (p < 0.05) improved.
It may be concluded that on chronic administration, CL suppresses inflammation and brings clinical improvement in patients of KOA, which may be observed by decreased level of IL-1β and VAS/WOMAC scores, respectively. At the same time, CL decreases the oxidative stress also.
姜黄是一种印度草药,因其广泛的药理活性而被用于治疗多种疾病。它已被证明具有抗氧化和抗炎特性,自古以来就被用作草药疗法。膝关节骨关节炎(KOA)是一种慢性疼痛疾病,长期使用非甾体抗炎药(NSAIDs)或类固醇可能会导致许多严重的副作用;因此,需要开发具有良好镇痛效果且无副作用的草药药物。因此,我们计划评估姜黄在KOA中的疗效。
该研究设计为针对KOA患者的随机、双盲、安慰剂对照试验。在获得伦理批准和书面知情同意后,总共160名KOA患者被随机分为两组,分别接受姜黄提取物或安慰剂以及标准药物治疗方案。在第0天、第60天和第120天对患者进行评估。在他们就诊当天,通过视觉模拟量表(VAS)和西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评估临床预后。在这些日子里,还拍摄X线片进行凯尔格伦和劳伦斯分级,并采集血样以评估白细胞介素-1β水平以及氧化应激生物标志物(如活性氧和丙二醛(MDA))的变化。
与安慰剂组相比,姜黄提取物组患者总体上有显著改善。临床上,VAS和WOMAC评分有所改善,同时,生物标志物水平,即白细胞介素-1β、活性氧和MDA也有显著(p<0.05)改善。
可以得出结论,长期给药时,姜黄可抑制炎症并使KOA患者的临床症状得到改善,这可分别通过白细胞介素-1β水平降低和VAS/WOMAC评分降低来观察到。同时,姜黄也降低了氧化应激。