The effect of Jiegudan on the postoperative recovery after anterior cruciate ligament reconstruction by autologous tendon and the expression of TNF-α, IL-1β, and MMP-2

Abstract

Objective To investigate the effect of Jiegudan on the postoperative recovery after anterior cruciate ligament reconstruction by autologous tendon and the expression of TNF-α, IL-1β, and MMP-2 during the tendon-bone healing. Methods 60 patients with anterior cruciate ligament reconstruction in our hospital from June 2014 to May 2016 were selected. They were randomly divided into observation group and control group, 30 cases in each group. Within 2 weeks, the two groups of patients underwent routine knee rehabilitation exercise and oral Xiaozhong Huoxue herb. The observation group began to use Jiegudan from the third week after operation, and took the drug for 8 weeks with 1 week of interval in the middle. Results The Lysholm scores in the observation group before operation, 3 months after operation, and 6 months after operation were (38.37±1.10), (85.01±2.34), (93.37±1.30), and those in the control group were (38.90±1.27), (81.10±2.89), (93.87±1.57), the difference was statistically significant at 3 months after operation (P<0.05). The content of IL-1β in the synovial fluid in the observation group before operation, 1 month after operation, and 3 months after operation were (142.67±16.96) pg/nl, (99.81±17.53) pg/nl, (34.74±6.58) pg/nl, and those in the control group were (145.55±17.50) pg/nl, (110.24±18.04) pg/nl, (38.87±7.44) pg/nl, the difference between the two groups was statistically significant at 1 month and 3 months after operation (P<0.05). The levels of TNF-α in the synovial fluid in the observation group before operation, 1 month after operation, and 3 months after operation were (249.50±18.7) pg/nl, (122.13±19.81) pg/nl, (60.42±9.53) pg/nl, and those in the control group were (241.80±21.08) pg/nl, (135.61±17.70) pg/nl, (66.20±12.35) pg/nl, the difference between the two groups was statistically significant at 1 month and 3 months after operation (P<0.05). The levels of MMP-2 in the synovial fluid in the observation group before operation, 1 month after operation, and 3 months after operation were (102.36±12.10) pg/nl, (80.16±9.35) pg/nl, (63.28±13.74) pg/nl, and those in the control group were (98.29±11.13) pg/nl, (91.02±14.97) pg/nl, (67.81±16.36) pg/nl, the difference between the two groups was statistically significant at 1 month after operation (P<0.05). The content of IL-1β in the blood in the observation group before operation, 1 month after operation, and 3 months after operation were (213.46±18.31) pg/nl, (139.61±17.46) pg/nl, (103.88±17.92) pg/nl, and those in the control group were (211.60±15.02) pg/nl, (149.92±15.96) pg/nl, (100.96±13.32) pg/nl, the difference between the two groups was statistically significant at 1 month and 3 months after operation (P<0.05). The levels of TNF-α in the blood in the observation group before operation, 1 month after operation, and 3 months after operation were (352.44±24.70) pg/nl, (240.65±22.26) pg/nl, (131.80±17.27) pg/nl, and those in the control group were (354.18±21.20) pg/nl, (260.02±25.15) pg/nl, (149.63±24.42) pg/nl, the difference between the two groups was statistically significant at 1 month and 3 months after operation (P<0.05). The levels of MMP-2 in the blood in the observation group before operation, 1 month after operation, and 3 months after operation were (180.62±18.88) pg/nl, (119.82±15.96) pg/nl, (87.90±14.02) pg/nl, and those in the control group were (171.45±19.18) pg/nl, (129.80±20.17) pg/nl, (90.20±14.83) pg/nl, the difference between the two groups was statistically significant at 1 month after operation (P<0.05). Conclusion Jiegudan can improve the score of knee function after ACL reconstruction in a short period of time, reduce local inflammation, improve the symptoms of knee joint. Key words: Jiegudan; Anterior cruciate ligament; Reconstruction; TNF-α; IL-1β; MMP-2