基于 SDF-1／CXCR4信号转导通路探讨补肾消痛方对骨性关节炎的作用机制

摘要

目的：观察补肾消痛方在治疗骨性关节炎方面的临床疗效，并借此探讨该方在SDF-1／CXCR4信号转导通路对骨关节炎的作用机制。方法：选取2015年8月至2016年1月收住我科的膝骨关节炎（Knee Osteoarthritis，KOA）患者90例，随机分成对照组和观察组，各45例。对照组服用双氯芬酸钠缓释片，2片／d，1次／片，治疗10 d，观察组采用内服和外敷补肾消痛方，治疗10 d后观察2组治疗的临床疗效、各临床功能评分、药物不良反应、血浆IL-6及MMP-9水平的变化等情况。结果：1）治疗后观察组有效率86.67％，对照组有效率68.89％，2组有效率比较差异具有统计学意义（ P＜0.05）；2）2组患者治疗前症各评分及屈曲度比较差异无统计学意义（P＞0.05），治疗10 d后，HHS、Feller、屈曲度均升高，但对照组升高更明显，WOMAC、VAS均降低，对照组降低更明显，差异有统计学意义（ P＜0.05）；3）不良反应中，对照组出现14例（33.00％），观察组4例（11.0％），观察组不良反应明显低于对照组（P＜0.05）；4）2组患者治疗前血浆IL-6及MMP-9水平比较差异无统计学意义（P＞0.05）。治疗10 d后，2组的IL-6及MMP-9水平均较治疗前下降，但观察组下降更明显（P＜0.05）。结论：补肾消痛方在治疗膝骨关节炎方面有显著的临床效果，且不良反应明显降低，值得推广，同时，该方可能通过目前热门的SDF-1／CXCR4信号转导通路，通过降低炎性反应水平，对OA起作用。%Objective:To observe the effect of the Reliving-pain Tonifying-kidney Formula in the treatment of osteoarthritis , and to discuss the party SDF-1 /CXCR4 signal transduction mechanisms of osteoarthritis .Methods: A total of 90 osteoarthritis pa-tients who were admitted to our department during August 2015 to January 2016, were randomly divided into control group and ob-servation group, 45 cases in each group.The control group were given diclofenac sodium sustained-release tablets, 2 /day,1 /piece, for 10 days, the observation group given oral and winnowing Reliving-pain Tonifying-kidney Formula, the clinical efficacy of the treatment was observed 10 days after treatment , all clinical scores , adverse reactions , IL-6 and other changes in plasma levels of MMP-9 and the case.Results:1) After treatment, observation group effective rate was 86.67%, the control group was 68. 89%, the differences were statistically significant (P<0.05);2)There were no significantly different on disease scores and flexion of patients in both two groups before treatment (P>0.05), but 10 days after treatment, HHS, Feller, flexion were increased in the two groups , but the control group increased more significantly , WOMAC, VAS decreased more significantly in control group , the difference was statistically significant (P<0.05);3)There were 14 cases (33.00%) of adverse reactions in the control group and 4 cases (11.0%) in the observation group, significantly lower than the control group group (P<0.05);4)There were no significant difference of plasma IL-6 and MMP-9 level before the treatment ( P>0.05 ) .But 10 days after treatment , IL-6 and MMP-9 levels decreased in both groups , but the observation group decreased more significantly ( P<0.05 ) .Conclusion: Reli-ving-pain Tonifying-kidney Formula can achieve significant clinical efficacy , with less adverse reactions , which is worthy to be pro-moted in the clinical practice .Meanwhile , the drug may work on OA through the currently popular SDF-1 /CXCR4 signaling path-way to reduce inflammation levels .