【作者】 吕海波；

【导师】 马少云；

【作者基本信息】 广州中医药大学 ， 中医骨伤科学， 2008， 硕士

【摘要】 研究目的旨在从膝骨性关节炎中医“证”的临床表现与现代医学一氧化氮和转化生长因子-β1的关系研究中,进一步探究膝骨性关节炎的病因病机;为继承和创新其临床规范标准,为提高本病辩证论治水平和疗效提供新的客观参考依据,进而为优化膝骨性关节炎手术及非手术治疗方案,减轻社会、家庭沉重经济、精神负担及提高患者生活质量贡献一份力量。材料与方法研究对象为广东省中医院珠海医院骨科门诊及住院患者,按膝骨性关节炎的中医证侯诊断标准,纳入肾虚髓亏型(1组)及瘀血阻滞型(2组)膝骨性关节炎病人各40例做为观察组。另设有正常健康人(45岁以上)40例做对照组(3组)。按实验室检测指标规定要求分别予严格抽取静脉血,治疗前及治疗后对标本中一氧化氮(NO)和转化生长因子-β1(TGF-β1)指标进行检测,所得数据用SPSS13.0 forWindows软件进行统计分析,组间比较当P＜0.05时为差异有统计学意义。结果治疗前,肾虚髓亏及瘀血阻滞两观察组中一氧化氮(NO)水平显著高于对照组(P＜0.01),且瘀血阻滞组高于肾虚髓亏组(P＜0.01);而转化生长因子-β1(TGF-β1)水平观显著低于对照组(P＜0.01),且瘀血阻滞组低于肾虚髓亏组(P＜0.01):NO和TGF-β1在1、2、3三组间分别做两两对比统计分析所得P值皆小于0.05(P＜0.05),其组间差异具有统计学意义。治疗后,观察组中NO水平均低于治疗前(P＜0.01),且瘀血阻滞组高于肾虚髓亏组(P＜0.01);TGF-β1水平均高于治疗前(P＜0.01),且瘀血阻滞组低于肾虚髓亏组(P＜0.01);NO和TGF-β1分别在1、2两组间对比分析所得P值皆小于0.05(P＜0.05),其组间差异具有统计学意义。结论本实验研究结果说明一氧化氮(NO)和转化生长因子-β1(TGF-β1)在膝骨性关节炎疾病过程中发生了明显改变,NO和TGF-β1与膝骨性关节炎的发病有关。治疗后,NO和TGF-β1水平发生了变化,其治疗可能在一定程度上是通过NO和TGF-β1水平的变化而起效的。膝骨性关节炎的中医证型(瘀血阻滞、肾虚髓亏)与一氧化氮(NO)及转化生长因子-β1(TGF-β1)有一定的相关性。治疗前后NO和TGF-β1水平在膝骨性关节炎瘀血阻滞组和肾虚髓亏组之间的变化差异具有统计学意义。这对在膝骨性关节炎治疗中进一步进行中医药临床研究提供客观观察指标有积极的意义,有助于关于KOA中医辨证分型的客观研究并为此提供微观指标,同时在骨性关节炎的药物研究及临床治疗中观察NO和TGF-β1水平亦具有一定指导意义。更多还原

【Abstract】 Objective:To study the Correlation between the clinical manifestation of TCM Syndromes of Knee Osteoarthritis and the level of Nitric oxide(NO)and Transforming growth factor -β1(TGF-β1)in modern medicine,further inquires into its cause of disease pathogenesis.In order to inherit and innovate the standard of clinical standard,to enhance the level of Syndrome Differentiation and Treatment of KOA and curative effect to provide the new objective reference,then to optimize the Knee Osteoarthritis surgery and the non-surgery therapeutic schedule,reduces the society,the family serious economy,the spiritual burden and improves the patient quality of life to contribute a strength..Materials and method:study object for Guangdong Province Chinese medicine hospital Zhuhai Hospital orthopedics outpatient service and in hospital patient.The standard of diagnoses according to TCM Syndromes of Knee Osteoarthritis,From integrates with manifestation of the kidneys-marrow deficiency(1 group)separately and the blood stasis(2 groups)of Knee Osteoarthritis patient each 40 examples to do for the observation group.In addition is equipped with the normal healthy persons(above 45 years old)40 examples to make the control group(3 groups).Extracts the venous blood strictly according to the laboratory examination target establish requirements before and after treatment.Examine the target of Nitric oxide (NO)and Transforming growth factor -β1 in the specimen,And analyze the obtained data with SPSS13.0 for the Windows,the group compares,when(P＜0.05)The difference has statistics significance.Results:Before treatment,the level of Nitric oxide(NO)of two Observer Group is significantly higher than the control group’s(P＜0.01),and blood stasis group is higher than kidneys-marrow deficiency group(P＜0.01).But the level of transforming growth factor-β1(TGF-β1)was significantly lower than that of the control group(P＜0.01),and blood stasis group is lower than kidneys-marrow deficiency group(P＜0.01);Compared NO and TGF -β1 among the three groups,all P values of statistical analysis are less than 0.05 (P＜0.05),The inter-group difference between the groups was significant. After treatment,the level of NO of two Observer Group is significantly lower than that before treatment(P＜0.01),and blood stasis group was higher than that kidneys-marrow deficiency group(P＜0.01);The level of TGF-β1 is higher than that before treatment(P＜0.01),and blood stasis group is lower than kidneys-marrow deficiency group(P＜0.01);NO and TGF-β1 in 1,2 comparative analysis between the two groups,the P values are less than 0.05(P＜0.05), The difference between the groups was significant.Conclusion:This study results show that nitric oxide(NO)and transforming growth factor -β1(TGF-β1)changed significantly in the disease process of Knee Osteoarthritis,The level of NO and TGF-β1 has relevance with knee osteoarthritis.After treatment,The level of NO and TGF-β1 has changed,its treatment may acts by the change of NO and TGF-β1 levels to a certain extent,The TCM Syndromes of Knee Osteoarthritis(blood stasis,kidneys-marrow deficiency)has certain relevance with Nitric oxide and Transforming growth factor -β1(TGF-β1).Before and after treatment, the changes of NO and TGF-β1 level in TCM Syndromes of Knee Osteoarthritis (blood stasis,kidneys-marrow deficiency)are statistical significant differences.This is positive for further clinical study of Chinese medicine in knee osteoarthritis treatment,and to provide an objective observation of the indicators as well,It is helpful’for TCM Syndromes of Knee Osteoarthritis and to provide micro-indicators,Meanwhile observing the level change of NO TGF-β1 in The drug research and clinical treatment of osteoarthritis is also a certain level of significance.更多还原