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补肾活血法联合富血小板血浆治疗膝骨关节炎的临床疗效及其对 IL-1、IL-6、VEGF、PGE-2 的影响。

Clinical Effect of Bushen Huoxue Method Combined with Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis and Its Effect on IL-1, IL-6, VEGF, and PGE-2.

机构信息

Department of Traumatology (I), Yantaishan Hospital, Yantai 264000, China.

Department of Orthopedic, Qingdao Eighth People's Hospital, Qingdao 266000, China.

出版信息

J Healthc Eng. 2022 Mar 26;2022:9491439. doi: 10.1155/2022/9491439. eCollection 2022.

Abstract

OBJECTIVE

To observe the clinical efficacy of the Bushen Huoxue method combined with platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA) and its effect on serum and joint fluid interleukin-1 (IL-1), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), and prostaglandin E2 (PGE-2).

METHODS

A total of 64 cases of KOA diagnosed and treated from January 2020 to January 2021 were randomly divided into research group and control group, with 32 cases in each group. The control group was treated with PRP, and the research group took the prescription of the Bushen Huoxue method on the basis of the control group. The clinical efficacy was assessed according to the criteria in "the diagnosis and Treatment of osteoarthritis," osteoarthritis index score and pain visual analogue score (VAS). Serum and articular fluid VAS, IL-1, IL-6, VEGF, and PGE-2 levels were detected by the enzyme-linked immunosorbent assay (ELISA).

RESULTS

The clinical effective rate of the research group was 93.8%, which was significantly higher than that of the control group (90.6%). There was no significant difference in the scores of osteoarthritis index between the two groups before treatment, but the scores of both groups decreased after treatment and was lower in the research group than those in the control group. VAS was significantly decreased in two groups after treatment and it was lower in the research group than that in the control group. After treatment, the levels of IL-1, IL-6, and PGE-2 in serum and articular fluid all indexes were decreased, and the levels in the research group were lower than those in the control group.

CONCLUSIONS

PRP joint cavity injection combined with oral administration of Bushen Huoxue prescription, and PRP joint cavity injection alone can improve the efficacy of KOA, relieve knee pain, and promote the recovery of knee function. The mechanism may be related to the reduction of IL-1, IL-6, VEGF levels, and PGE-2 levels in the serum and joint fluid. However, the efficacy of combination therapy was superior to PRP alone.

摘要

目的

观察补肾活血法联合富血小板血浆(PRP)治疗膝骨关节炎(KOA)的临床疗效及对血清和关节液白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、血管内皮生长因子(VEGF)、前列腺素 E2(PGE-2)的影响。

方法

将 2020 年 1 月至 2021 年 1 月诊治的 64 例 KOA 患者随机分为研究组和对照组,每组 32 例。对照组采用 PRP 治疗,研究组在对照组基础上采用补肾活血法处方治疗。根据《骨关节炎诊治指南》标准评估临床疗效,采用骨关节炎指数评分和疼痛视觉模拟评分(VAS)评估疗效,酶联免疫吸附试验(ELISA)检测血清和关节液 VAS、IL-1、IL-6、VEGF、PGE-2 水平。

结果

研究组临床有效率为 93.8%,明显高于对照组的 90.6%。两组治疗前骨关节炎指数评分无显著差异,治疗后均降低,且研究组低于对照组。两组治疗后 VAS 均明显降低,且研究组低于对照组。两组治疗后血清和关节液中 IL-1、IL-6、PGE-2 水平均降低,且研究组低于对照组。

结论

PRP 关节腔注射联合补肾活血方口服,与 PRP 关节腔注射单独治疗 KOA 均可提高疗效,缓解膝关节疼痛,促进膝关节功能恢复。其机制可能与降低血清和关节液中 IL-1、IL-6、VEGF 水平和 PGE-2 水平有关。但联合治疗的疗效优于 PRP 单独治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc42/8976638/286d1b6b8424/JHE2022-9491439.001.jpg

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