Hou Pu-Wei, Liu Shan-Chi, Tsay Gregory J, Tang Chih-Hsin, Chang Hen-Hong
Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan.
Graduate Institute of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
Evid Based Complement Alternat Med. 2022 Feb 9;2022:5367494. doi: 10.1155/2022/5367494. eCollection 2022.
Knee osteoarthritis (KOA) is a chronic, low-grade inflammatory disease that affects knee joints and causes functional disability in the elderly. KOA is typically treated with oral NSAIDs, which are commonly associated with gastrointestinal side effects or cardiovascular complications. Traditional Chinese medicine (TCM) is widely used by patients with KOA in Taiwan; the Hu-Qian-Wan (HQW) formula is typically prescribed. We investigated the therapeutic role of a modified version of the HQW decoction in Sprague-Dawley rats with KOA induced by anterior cruciate ligament transection (ACLT) of the right knee.
Thirty rats were randomly assigned to five groups (six animals each): arthrotomy alone (sham surgery, controls), ACLT only, ACLT + low-dose (1,000 mg/kg) HQW, ACLT + high-dose (3,000 mg/kg) HQW, and ACLT + celecoxib (30 mg/kg). All study groups underwent weight-bearing behavioral testing, micro-computed tomography (CT), and histological examinations of the knee joint cartilage, as well as immunohistochemical analyses of levels of interleukin (IL) 1 and tumor necrosis factor (TNF) expression in articular cartilage.
At 6 weeks, compared with ACLT group only, ACLT rats administered high-dose HQW or celecoxib exhibited the fewest weight-bearing deficits, the greatest improvements from baseline in articular cartilage architecture, and the lowest amounts of TNF- and IL-1 staining in cartilage and synovial sections (all values were significant compared with the ACLT-only group). The only values that were significantly increased by ACLT + low-dose HQW compared with ACLT alone were bone mineral density and trabecular numbers.
Our findings suggest that high-dose HQW improves weight-bearing asymmetry, decreases bone loss, and reduces levels of TNF- and IL-1 in the affected joint in ACLT-induced KOA rats. More evidence is needed to support our findings.
膝关节骨关节炎(KOA)是一种影响膝关节并导致老年人功能残疾的慢性、低度炎症性疾病。KOA通常采用口服非甾体抗炎药治疗,这些药物通常伴有胃肠道副作用或心血管并发症。台湾的KOA患者广泛使用传统中医(TCM);通常会开虎潜丸(HQW)配方。我们研究了改良版HQW汤剂对右膝前交叉韧带横断(ACLT)诱导的KOA大鼠的治疗作用。
30只大鼠随机分为五组(每组6只):单纯关节切开术(假手术,对照组)、仅ACLT、ACLT + 低剂量(1000mg/kg)HQW、ACLT + 高剂量(3000mg/kg)HQW以及ACLT + 塞来昔布(30mg/kg)。所有研究组均进行负重行为测试、微型计算机断层扫描(CT)、膝关节软骨组织学检查以及关节软骨中白细胞介素(IL)1和肿瘤坏死因子(TNF)表达水平的免疫组织化学分析。
在6周时,与仅ACLT组相比,接受高剂量HQW或塞来昔布的ACLT大鼠负重缺陷最少,关节软骨结构从基线的改善最大,软骨和滑膜切片中TNF和IL-1染色量最低(与仅ACLT组相比,所有值均有显著差异)。与单独ACLT相比,ACLT + 低剂量HQW唯一显著增加的值是骨密度和骨小梁数量。
我们的研究结果表明,高剂量HQW可改善ACLT诱导的KOA大鼠患侧关节的负重不对称性,减少骨质流失,并降低TNF和IL-1水平。需要更多证据来支持我们的研究结果。