鹿骨胶治疗膝骨性关节炎风寒湿痹兼肝肾亏虚证患者的疗效分析OA

Objective To observe the effect of clinical use of Lujiaojiao(Cervi Cornus Colla)in the treatment of patients with knee osteoarthritis of wind-cold-damp paralysis and deficiency of liver and kidney syndrome.Methods Ninety-four patients with knee osteoarthritis attending the Department of Orthopaedics of People's Hospital Affiliated to Shandong First Medical Univer-sity from March 2024 to June 2024 were selected and divided into two groups by simple randomisation method.In the Isogia group,47 cases(2 cases were dislodged and 45 cases were completed the trail)were treated with Glucosamine Sulfate Capsules(trade name:Isogia),and in the Lujiaojiao(Cervi Cornus Colla)group,47 cases(2 cases were dislodged and 45 cases were com-pleted the trail)were treated with Lujiaojiao(Cervi Cornus Colla)combined with Isogia.The efficacy and safety of the two groups were counted,and the joint fluid matrix metalloproteinase-3(MMP-3),metalloproteinase inhibitor-1(TIMP-1),numerical rating scale(NRS)score,knee score,ultrasound parameters and serum bone metabolism level were compared between the two groups.Results The total effective rate of the Lujiaojiao(Cervi Cornus Colla)group was 91.11％(41/45).The total effective rate of the Isojia group was 75.56％(34/45).The total effective rate of the Lujiaojiao(Cervi Cornus Colla)group was higher than that of the Isojia group,and there was a difference(P＜0.05).The comparison of knee joint score,ultrasound detection pa-rameters,NRS score and score of main symptoms and signs of knee osteoarthritis before treatment between the two groups showed no difference(P＞0.05).The knee joint scores were higher in both groups after treatment and the scores were higher in the Deer Bone Glue group than those of the Isojia group(P＜0.05).Knee osteoarthritis major symptoms and signs score,synovial thick-ness,NRS score and joint fluid depth after treatment in both groups were lower than those before treatment,and the scores were lower in the Lujiaojiao(Cervi Cornus Colla)group than those of the Isojia group(P＜0.05).The comparison of joint fluid MMP-3,TIMP-1 and serum bone metabolism before treatment between the two groups showed no difference(P＞0.05).The levels of joint fluid TIMP-1 and serum osteocalcin(BGP)and bone-specific alkaline phosphatase(BALP)were elevated after treatment in both groups compared with those before treatment,and the levels were higher in the Deer Bone Glue group than those of the Isojia group(P＜0.05).The levels of joint fluid MMP-3,MMP-3/TIMP-1 and serum anti-tartrate acid phosphatase isoform 5b(TRACP-5b)and collagen type Ⅰ C-terminal peptide(CTX-Ⅰ)were lower in both groups after treatment than those before treatment,and the levels were lower in the Lujiaojiao(Cervi Cornus Colla)group than those of the Isojia group(P＜0.05).A total of 5 cases of adverse reactions occurred in the Lujiaojiao(Cervi Cornus Colla)group,with an incidence rate of 11.11％(5/45);4 cases occurred in the Isojia group,with an incidence rate of 8.89％(4/45).There was no difference in the cumulative incidence of adverse reactions between the two groups(P＞0.05).Conclusion Lujiaojiao(Cervi Cornus Colla)can maintain the dynamic balance of MMP-3/TIMP-1 in synovial fluid,improve bone metabolism and enhance the efficacy in the treatment for knee osteoarthritis.