目的:观察独活寄生汤治疗肝肾亏虚型膝骨关节炎(knee osteoarthritis,KOA)的临床疗效,并分析经独活寄生汤治疗前后关节液中小分子化合物的变化。方法:将73例天津中医药大学第一附属医院确诊的KOA患者随机分为观察组(42例)及对照组(31例)...目的:观察独活寄生汤治疗肝肾亏虚型膝骨关节炎(knee osteoarthritis,KOA)的临床疗效,并分析经独活寄生汤治疗前后关节液中小分子化合物的变化。方法:将73例天津中医药大学第一附属医院确诊的KOA患者随机分为观察组(42例)及对照组(31例),观察组给予独活寄生汤150 m L/次,2次/d,口服,对照组给予硫酸氨基葡萄糖胶囊0.5 g/次,3次/d,口服,两组患者均治疗1个月,以膝关节视觉模拟评分法(visual analogue scale score,VAS),西安大略麦马斯特大学骨关节炎指数评分(The Western Ontario and Mc Maste Universities,WOMAC),自制膝关节肿胀评分及综合疗效治疗反应评价作为临床疗效判定指标;所有KOA患者均在治疗前及治疗后抽取关节液,采用超高效液相色谱仪与主成分分析法(principal components analysis,PCA)分析两组患者治疗前后关节液代谢差异物,并用EZinfo 2.0软件进行PCA潜在差异生物标记物。结果:治疗1个月后,两组患者VAS,WOMAC,自制膝关节肿胀评分均较治疗前有明显改善(P<0.05);治疗1个月后与对照组比较,观察组患者VAS,WOMAC,自制膝关节肿胀评分、综合疗效治疗反应评价均明显升高(P<0.05);与治疗前比较,两组治疗后膝关节关节液中泛酸、犬尿氨酸、酪氨酸表达降低,苯甲酸、柠檬酸及脯氨酸表达升高(P<0.05);与对照组治疗后比较,观察组关节液中泛酸、犬尿氨酸、酪氨酸表达更低,苯甲酸、柠檬酸及脯氨酸表达更高(P<0.05),此外观察组关节液中牛磺酸,β-隐黄素及赖氨酸表达明显升高(P<0.05)。结论:独活寄生汤可减少肝肾亏虚型KOA患者关节疼痛、肿胀程度,增加活动范围,改善KOA患者生活质量;同时随着肝肾亏虚型KOA患者症状的改善,关节液中泛酸、犬尿氨酸、酪氨酸、苯甲酸,柠檬酸,脯氨酸,牛磺酸,β-隐黄素及赖氨酸表达出现变化。展开更多
Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. At present, the main therapeutic provision is to supply vitamin B 6, B 12 and folic acids, and the toxic and ill effect have been reporte...Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. At present, the main therapeutic provision is to supply vitamin B 6, B 12 and folic acids, and the toxic and ill effect have been reported. Homocysteine, taurine, hydrogen sulfide and metallothionein are metabolic products from methionine. Homocysteine induces necrosis of endothelium, proliferation of vascular smooth muscle cells, proliferation and activation of vascular fibroblast cells and mitochondrial structural destruction and dysfunction of myocardium cells. Taurine, an end metabolic product of homocysteine, obviously reduces cardiovascular injury induced by homocysteine. The possible mechanism of antagonism by reducing oxidative stress and endoplasmic reticulum stress has been proved. Hydrogen sulfide, another end metabolic product of homocysteine, obviously reducing cardiovascular injury of homocysteine by scavenging oxidative radicals has been found. Metallothionein a derivant production of homocysteine metabolism, antagonism to homocysteine injury to cardiovascular system been discussed. Homocysteine, taurine, hydrogen sulfide and metallothionein, as a metabolic product of methionine, interactive antagonism and interactive biological influence have been reviewed. Induced endogenous or exogenous supply of taurine, hydrogen sulfide and metallothionein might resist cardiovascular injury induced by hyperhomocysteinemia. According to the methionine metabolic cycle, using endogenous antagonistic substances might be a new clinical preventive and treatment target of homocystinemia.展开更多
文摘目的:观察独活寄生汤治疗肝肾亏虚型膝骨关节炎(knee osteoarthritis,KOA)的临床疗效,并分析经独活寄生汤治疗前后关节液中小分子化合物的变化。方法:将73例天津中医药大学第一附属医院确诊的KOA患者随机分为观察组(42例)及对照组(31例),观察组给予独活寄生汤150 m L/次,2次/d,口服,对照组给予硫酸氨基葡萄糖胶囊0.5 g/次,3次/d,口服,两组患者均治疗1个月,以膝关节视觉模拟评分法(visual analogue scale score,VAS),西安大略麦马斯特大学骨关节炎指数评分(The Western Ontario and Mc Maste Universities,WOMAC),自制膝关节肿胀评分及综合疗效治疗反应评价作为临床疗效判定指标;所有KOA患者均在治疗前及治疗后抽取关节液,采用超高效液相色谱仪与主成分分析法(principal components analysis,PCA)分析两组患者治疗前后关节液代谢差异物,并用EZinfo 2.0软件进行PCA潜在差异生物标记物。结果:治疗1个月后,两组患者VAS,WOMAC,自制膝关节肿胀评分均较治疗前有明显改善(P<0.05);治疗1个月后与对照组比较,观察组患者VAS,WOMAC,自制膝关节肿胀评分、综合疗效治疗反应评价均明显升高(P<0.05);与治疗前比较,两组治疗后膝关节关节液中泛酸、犬尿氨酸、酪氨酸表达降低,苯甲酸、柠檬酸及脯氨酸表达升高(P<0.05);与对照组治疗后比较,观察组关节液中泛酸、犬尿氨酸、酪氨酸表达更低,苯甲酸、柠檬酸及脯氨酸表达更高(P<0.05),此外观察组关节液中牛磺酸,β-隐黄素及赖氨酸表达明显升高(P<0.05)。结论:独活寄生汤可减少肝肾亏虚型KOA患者关节疼痛、肿胀程度,增加活动范围,改善KOA患者生活质量;同时随着肝肾亏虚型KOA患者症状的改善,关节液中泛酸、犬尿氨酸、酪氨酸、苯甲酸,柠檬酸,脯氨酸,牛磺酸,β-隐黄素及赖氨酸表达出现变化。
文摘Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. At present, the main therapeutic provision is to supply vitamin B 6, B 12 and folic acids, and the toxic and ill effect have been reported. Homocysteine, taurine, hydrogen sulfide and metallothionein are metabolic products from methionine. Homocysteine induces necrosis of endothelium, proliferation of vascular smooth muscle cells, proliferation and activation of vascular fibroblast cells and mitochondrial structural destruction and dysfunction of myocardium cells. Taurine, an end metabolic product of homocysteine, obviously reduces cardiovascular injury induced by homocysteine. The possible mechanism of antagonism by reducing oxidative stress and endoplasmic reticulum stress has been proved. Hydrogen sulfide, another end metabolic product of homocysteine, obviously reducing cardiovascular injury of homocysteine by scavenging oxidative radicals has been found. Metallothionein a derivant production of homocysteine metabolism, antagonism to homocysteine injury to cardiovascular system been discussed. Homocysteine, taurine, hydrogen sulfide and metallothionein, as a metabolic product of methionine, interactive antagonism and interactive biological influence have been reviewed. Induced endogenous or exogenous supply of taurine, hydrogen sulfide and metallothionein might resist cardiovascular injury induced by hyperhomocysteinemia. According to the methionine metabolic cycle, using endogenous antagonistic substances might be a new clinical preventive and treatment target of homocystinemia.
