补肾强筋胶囊对早中期膝骨性关节炎滑液中白细胞介素-1β、肿瘤坏死因子-α、前列腺素E2及血清前列腺素E2的影响

李慧　曾明珠　张瑜

[摘要] 目的 探讨补肾强筋胶囊对早中期膝骨性关节炎（KOA）患者滑液中白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、前列腺素E2（PGE2）及血清PGE2的影响。 方法 选取2018年1月～2018年8月广东省第二中医院收治的KOA患者103例。根据随机数字表法将患者分为对照组（n = 51）与研究组（n = 52），对照组给予氨基葡萄糖胶囊联合玻璃酸钠关节腔内注射治疗，研究组在对照组基础上联合补肾强筋胶囊治疗。比较两组治疗后临床效果，治疗前后滑液中IL-1β、TNF-α、PGE2、血清PGE2水平及膝关节功能恢复情况，记录两组患者治疗期间不良反应发生情况。 结果 研究组患者治疗后临床总有效率高于对照组患者（P < 0.05）。两组患者治疗后滑液中IL-1β、TNF-α、PGE2均低于治疗前，且研究组IL-1β、TNF-α低于对照组（P < 0.05），两组治疗后滑液中PGE2水平比较，差异无统计学意义（P > 0.05）。兩组患者治疗后血清PGE2水平均降低，且研究组低于对照组（P < 0.05）。两组患者治疗后关节功能、关节疼痛、肌力、活动度、屈曲畸形、关节活动度评分均升高，且研究组高于对照组（P < 0.05）。两组患者治疗过程中均未出现不良反应现象。 结论 补肾强筋胶囊治疗早中期KOA患者，效果显著，可有效改善滑液中IL-1β、TNF-α水平，及血清PGE2水平，且不增加不良反应发生率。

[关键词] 补肾强筋胶囊;早中期膝骨性关节炎滑液;白介素-1β;肿瘤坏死因子-α;前列腺素E2

[中图分类号] R684.3          [文献标识码] A          [文章编号] 1673-7210（2019）05（c）-0119-05

[Abstract] Objective To investigate the effects of Bushen Qiangjin Capsules on interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， prostaglandin E2 （PGE2） in synovial fluid and serum PGE2 of patients with knee osteoarthritis （KOA） in the early and middle stages. Methods From January 2018 to August 2018， 103 patients with KOA in Guangdong Second Hospital of Traditional Chinese Medicine were selected as the research subjects. The patients were divided into control group （n = 51） and research group （n = 52） according to random number table method. The control group was treated with Glucosamine Capsules combined with Sodium Hyaluronate Intra-Articular Injection. The research group was treated with Bushen Qiangjin Capsules on the basis of the control group. The clinical efficacy was compared between the two groups after treatment. The levels of IL-1β， TNF-α， PGE2 in synovial fluid， serum PGE2 and the recovery of knee joint function were compared between the two groups before and after treatment. The occurrence of adverse reactions during treatment were recorded in the two groups. Results The total effective rate of the study group was significantly higher than the control group （P < 0.05）. After treatment， the levels of IL-1β， TNF-α and PGE2 in synovial fluid of the two groups were lower than those before treatment， and that in the study group was lower than those in the control group （P < 0.05）. No significant difference in the levels of PGE2 in synovial fluid between the two groups after treatment （P > 0.05）. The serum PGE2 level of the two groups decreased after treatment， and the study group was lower than that of the control group （P < 0.05）. After treatment， the scores of joint function， joint pain， muscle strength， range of motion， flexion deformity and range of motion of the two groups were all increased， and those in the study group were higher than that of the control group （P < 0.05）. No adverse reactions was observed in the two groups during the treatment. Conclusion Bushen Qiangjin Capsules is effective in the treatment of KOA patients in the early and middle stages. It can effectively improve the levels of IL-1β， TNF-α in synovial fluid and serum PGE2 in synovial fluid without increasing the incidence of adverse reactions. It has certain clinical value.