龜鹿二仙膠於足球運動員膝關節炎之影響

The influence of Guilu Erxian Gao on the knee of soccer players

李雅文(Ya-Wen Lee)

指導教授 ： 方麗雯

共同指導教授 ： 郭士民(Shyh-Ming Kuo)

義守大學/理工學院/化學工程學系暨生物技術與化學工程研究所/碩士(2017年)

摘要

退化性關節炎是最常見的關節疾病之一。退化性關節炎的發生與軟骨內細胞外基質纖維的立體架構被破壞有關，由於軟骨組織沒有血管及神經，且軟骨受傷後不會自行修復與再生，因此，在預防軟骨受傷或繼續惡化的食療或藥物治療就顯得相當重要。龜鹿二仙膠是中醫固有成方，中醫常用來治療關節退化性疾病且無不良副作用。龜鹿二仙膠是由鹿角、龜板、枸杞、人參四味藥所組成，可治精氣神血虛弱等症狀。本研究利用臨床上之IKDC(International Knee Documentation Committee IKDC)及WOMAC (Western Ontario and McMaster Universities Osteoarthritis index WOMAC)膝關節評估量表，主觀性評估受試者服用龜鹿二仙膠前、後對於關節軟骨之影響。另外，使用免疫層析尿液試紙檢測尿液中軟骨寡聚基質蛋白(Cartilage Oligomeric Matrix Protein COMP)生物標記物之存在或增減，藉由上述方式，期望能為龜鹿二仙膠作為退化性關節炎療效追蹤之應用。論文研究中針對10位退役足球運動員（關節軟骨未退化者3位，有退化者7位）於服用龜鹿二仙膠前、後（服用一個月及三個月）填寫IKDC、WOMAC膝關節評量表及收集尿液進行軟骨寡聚基質蛋白尿液試紙測試。初步結果顯示：未服用龜鹿二仙膠，其10位足球運動員IKDC問卷之有退化者平均分數為61.93分，無退化者平均分數為81.27分； WOMAC問卷之有退化者之平均總分為73.58分，無退化者之WOMAC問卷平均總分為74.43分，尿液試片測試結果顯示具有90%正確率。服用龜鹿二仙膠一個月後，其10位足球運動員IKDC問卷之有退化者平均分數為62.09分，無退化者平均分數為76.67分； WOMAC問卷之有退化者之平均總分為76.73分，無退化者之WOMAC問卷平均總分為92.27分；服用龜鹿二仙膠三月後， IKDC問卷之有退化者平均分數為61.24分，無退化者平均分數為78.17分； WOMAC問卷之有退化者之平均總分為84.63分，無退化者之WOMAC問卷平均總分為91.67分。初步結果顯示：1. WOMAC問卷較能有效反映出龜鹿二仙膠在治療關節退化上之療效在：「上下樓梯、僵硬程度、扭轉或旋轉膝蓋、彎曲膝蓋、上下交通工具、穿襪子或絲襪的時候、蹲坐馬桶或從馬桶上站起來的時候及從事粗重家事時」在服用龜鹿二仙膠三個月後對膝部的功能有改善的效用。2. IKDC及WOMAC問卷結合COMP免疫層析尿液試紙能夠成為退化性關節炎之檢測工具並評估服用龜鹿二仙膠於足球運動員之退化性關節炎療效應用。

關鍵字

退化性關節炎 ； 龜鹿二仙膠 ； 免疫層析尿液試紙

並列摘要

Osteoarthritis (OA) is the most encounted disease in cartilage. As known, cartilage degeneration or OA is caused by an imbalance between the synthesis and degradation of biomolecules of the articular cartilage and rarely generates spontaneously due to lack of blood vessel and nerves. Thus, it is very important to prevent the degeneration of cartilage by foods or drugs cures. The herbal drug Guilu Erxian Jiao (GEJ) is a multicomponent Chinese medicine that has been used for treatment of degenerative joint diseases without adverse effects. The components of the GEJ are Carapax, Plastrum Chrysemys, Cornu Cervi, Ginseng Radix Rubra and Lycii fructus. In traditional Chinese medicine, GEJ has been used to treat kidney deficiency (qi, ying, and yang) This study utilized a clinically proven "IKDC Score" and “WOMAC” evaluation questionnaires, combined with a non-invasive immunochromatographic strip for urine specimens to detect cartilage degeneration markers from degenerated cartilage, to evaluate the treating of Guilu Erxian Jiao on the health condition of joint cartilage of football players. Among 10 football players (from the X-ray diagnoses: 3 of them being healthy, whereas 7 found being with symptoms of degenerated cartilage), these healthy subjects scored an average IKDC of 81.27, yet those with degenerated cartilage scored 61.93, healthy subjects scored an average WOMAC of 73.58, those with degenerated cartilage scored 74.73 before took the Guilu Erxian Jiao. With the non-invasive immunochromatographic urine test strip analysis, the accuracy is 90.0%. After taking the Guilu Erxian Jiao for one month, the healthy subjects scored an average IKDC of 76.67, yet those with degenerated cartilage scored 62.09, healthy subjects scored an average WOMAC of 76.73, those with degenerated cartilage scored 92.27. After taking the Guilu Erxian Jiao for three months, the healthy subjects scored an average IKDC of 78.17, yet those with degenerated cartilage scored 61.24, healthy subjects scored an average WOMAC of 84.63. The preliminary results indicated that 1. WOMAC could effectively reflect the treatment response of the Guilu Erxian Jiao on the degenerated cartilage. Besides, many improved functions of articular cartilage were re-achieved after taking Guilu Erxian Jiao for three months; 2. Combined IKDC, WOMAC and urine test strip could be employed for quick screening of the treating of Guilu Erxian Jiao on the articular cartilage in football players.

並列關鍵字

Osteoarthritis ； Guilu Erxian Jiao ； immunochromatographic urine strip ； IKDC ； WOMAC questionnaires

參考文獻

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