【作者】 张学祥；

【导师】 张世华；

【作者基本信息】 山东中医药大学 ， 中医骨伤科学， 2011， 硕士

【摘要】 目的观察补肾壮骨胶囊治疗膝骨性关节炎的疗效,并探讨其作用机理及补肾壮骨胶囊对膝骨性关节炎软骨细胞ADAMTS-4、MMP-1、TIMP-1表达的影响。方法实验研究将新西兰白兔40只分为A正常组、B模型组、C治疗组、D对照组,B, C, D三组按照Hulth造模方法造成兔膝骨性关节炎模型。C组给予补肾壮骨胶囊,D组给予壮骨关节丸。给药8周后行实验兔膝关节X光检查,动物处死后观察兔膝关节大体形态并测定关节软骨MMP-1、TIMP-1、ADAMTS-4阳性细胞数。临床研究应用补肾壮骨胶囊、壮骨关节丸治疗膝骨性关节炎患者各30例,对照观察临床总疗效。结果动物实验研究显示模型组膝关节软骨有明显退行性改变,HE染色光镜观察及软骨中MMP-1、TIMP-1、和ADAMTS-4的表达显示,治疗组和模型组比较有显著差异(P<0.01),治疗组和对照组相关检测指标没有显著差异(P>0.05),临床研究显示应用补肾壮骨胶囊治疗膝骨性关节炎总有效率和对照组相比有明显差异(P<0.05)。结论关节软骨中的MMP-1和ADAMTS-4是引起膝骨性关节炎的重要的酶,MMP-1和ADAMTS-4的过多表达可能是关节软骨退变的重要原因之一,补肾壮骨胶囊通过提高关节软骨TIMP-1的表达及抑制MMP-1和ADAMTS-4的表达保护软骨,改善膝关节功能。更多还原

【Abstract】 Objective :To observe the efficacy of Bushenzhuanggu capsule(BSZGC) for treatment of knee osteoarthritis(KOA) and its mechanism.To observe effects on knee osteoarthritis chondrocytes ADAMTS-4, MMP-1, TIMP-1 expression.Methods: In the experiment study ,40 New Zealand rabbits were randomly divided into 4 groups:Group A (the normal group),Group B (the model group),Group C(the treated group) and Group D(the control group).KOA models were created in Group B, C and D by Hulth’s operation methods. The rabbits in Group D were treated with Zhuangguguanjie pill (ZGGJP) and BSZGC was used in Group C. 8 weeks later, to make CR of the knee, Then to kill the rabbits and get the femoral condyle and measured MMP-1, TIMP-1, ADAMTS-4 positive cells. Clinical research applications BSZGC,ZGGJP treatment of KOA of the 30 patients in the control and the overall clinical efficacy observed symptoms and signs improve the situation.Results : The experiment study showed the model group significantly articular cartilage degeneration, HE staining and light microscopy MMP-1, TIMP-1, and ADAMTS-4 expression showed that the treatment group and model group were significantly different(P <0.01), treatment group and control group of related indicators no significant differences detected (P> 0.05), Clinical studies have shown that application of BSZGC of KOA total efficiency and the control group were significantly different (P <0.05).Conclusions :MMP-1 and ADAMTS-4 expression may be too much of articular cartilage degeneration is one of the important reasons, BSZGC articular cartilage by increasing the expression of TIMP-1 and inhibition of MMP-1 and ADAMTS-4 expression to effectively improve KOA in patients with clinical symptoms and restore knee function.更多还原