OBJECTIVETo evaluate the clinical efficacy of treating knee osteoarthritis (KOA, Bi syndrome of knee) by massage combined Chinese materia medica (CMM) footbath fumigation and washing, and to observe the changes of the Lysholm knee score (LKSS).

METHODSTotally 61 patients with grade I to III KOA were randomly assigned to two groups, the treatment group and the control group. Patients in the treatment group were treated with massage combined CMM footbath fumigation and washing, while those in the control group were treated with oral administration of meloxicam. They were treated for 20 days (times). The LKSS was assessed before treatment, 10 days of treatment, by the end of the treatment, and 1 month after treatment.

RESULTS(1) The therapeutic efficacy in the treatment group was superior to that in the control group (P < 0.05). Thirteen cases were clinically controlled, with 11 markedly effective, 6 effective, and 1 ineffective in the treatment group, while 5 cases were clinically controlled, with 11 markedly effective, 10 effective, and 4 ineffective in the control group. (2) The LKSS: The post-treatment LKSS was higher than that before treatment in the two groups. The LKSS at 10 days (times) of treatment was lower in the treatment group than in the control group, but with no statistical difference (P > 0.05). The LKSS by the end of the treatment was higher in the treatment group than in the control group (P < 0.05). (3) The case number of patients in need of receiving the treatment again within 1-month follow-up and the difference between the LKSS at follow-ups and that by the end of the treatment were lower in the treatment group than in the control group (P < 0.01).

CONCLUSIONMassage combined CMM footbath fumigation and washing had better clinical efficacy on patients suffering from KOA.

Balneology ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Massage ; Middle Aged ; Osteoarthritis, Knee ; therapy ; Thiazines ; therapeutic use ; Thiazoles ; therapeutic use ; Treatment Outcome

Meloxicam concentration in skin was determined following topical administration of meloxicam patches in hairless mouse. Samples were analysized by HPLC coupled with microdialysis sampling technique, in which in vivo recovery of probe was characterized by the retrodialysis method. It was indicated that the in vivo recovery of the probe was 14.0%. The range of steady state concentration of meloxicam in dialysate was 24-50 ng x mL(-1), and that was 170-360 ng x mL(-1) in the hairless mouse skin. Steady state concentration of meloxicam was reached shortly after the application of meloxicam patches, which was maintained during the period of experiment.
Administration, Cutaneous ; Animals ; Chromatography, High Pressure Liquid ; Cyclooxygenase 2 Inhibitors ; administration & dosage ; pharmacokinetics ; Isoenzymes ; antagonists & inhibitors ; Mice ; Mice, Hairless ; Mice, Inbred BALB C ; Microdialysis ; Skin ; metabolism ; Skin Absorption ; Thiazines ; administration & dosage ; pharmacokinetics ; Thiazoles ; administration & dosage ; pharmacokinetics

PURPOSE: Osteoarthritic pain is largely considered to be inflammatory pain. Sensory nerve fibers innervating the knee have been shown to be significantly damaged in rat models of knee osteoarthritis (OA) in which the subchondral bone junction is destroyed, and this induces neuropathic pain (NP). Pregabalin was developed as a pain killer for NP; however, there are no reports on pregabalin use in OA patients. The purpose of this study was to investigate the efficacy of pregabalin for pain in OA patients. MATERIALS AND METHODS: Eighty-nine knee OA patients were evaluated in this randomized prospective study. Patients were divided into meloxicam, pregabalin, and meloxicam+pregabalin groups. Pain scores were evaluated before and 4 weeks after drug application using a visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain scales among groups were compared using a Kruskal-Wallis test. RESULTS: Before drug application, there was no significant difference in VAS and WOMAC scores among the three groups (p>0.05). Significant pain relief was seen in the meloxicam+pregabalin group in VAS at 1, 2, and 4 weeks, and WOMAC score at 4 weeks, compared with the other groups (p<0.05). No significant pain relief was seen in the meloxicam only group in VAS during 4 weeks and WOMAC score at 4 weeks compared with the pregabalin only group (p>0.05). CONCLUSION: Meloxicam+pregabalin was effective for pain in OA patients. This finding suggests that OA pain is a combination of inflammatory and NP.
Aged ; Aged, 80 and over ; Drug Therapy, Combination/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee/*drug therapy ; Pain Measurement ; Thiazines/administration & dosage/adverse effects/*therapeutic use ; Thiazoles/administration & dosage/adverse effects/*therapeutic use ; gamma-Aminobutyric Acid/administration & dosage/adverse effects/*analogs & derivatives/therapeutic use

The purpose of this study was to evaluate the effect of meloxicam (MEL) on selected immune parameters of bovine CD25highCD4+, CD25lowCD4+, and CD25-CD4+ cells. Peripheral blood mononuclear cells (PBMCs) collected from 12-month-old heifers were treated with MEL at a concentration corresponding to the serum level of this medication following administration at the recommended dose (MEL 5 x 10(-6) M) and at a concentration 10 times lower (MEL 5 x 10(-7) M). After 12 and 24 h of incubation with the drug, the percentage of CD25highCD4+ cells decreased; however, this disturbance was quickly reversed. Furthermore, the absolute number of CD25highCD4+ cells in the PBMC populations treated with MEL 5 x 10(-6) M for 48 and 168 h was increased. Prolonged (168 h) exposure to the drug increased the percentage of Foxp3+ cells in the CD25highCD4+ cell subpopulation. The higher dose of MEL was found to significantly increase the percentage of IFN-gamma+ cells among the CD25-CD4+ cells. These results indicated that MEL does not exert an immunosuppressive effect by depleting CD4+ cells and suppression of IFN-gamma+ production by these cells. Furthermore, IL-10 and TGF-beta production was not changed following exposure to MEL.
Animals ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage/*pharmacology ; Apoptosis/*drug effects ; CD4-Positive T-Lymphocytes/*drug effects/metabolism ; Cattle ; Cytokines/metabolism ; Dose-Response Relationship, Drug ; Female ; Forkhead Transcription Factors/*genetics/metabolism ; Gene Expression Regulation/*drug effects ; Immune Tolerance/drug effects ; Interleukin-2 Receptor alpha Subunit/*metabolism ; Leukocytes, Mononuclear/drug effects/metabolism ; Thiazines/administration & dosage/*pharmacology ; Thiazoles/administration & dosage/*pharmacology

BACKGROUND/AIMS: The use of proton pump inhibitors or misoprostol is known to prevent the gastrointestinal complications of nonsteroidal anti-inflammatory drugs (NSAIDs). Rebamipide is known to increase the mucosal generation of prostaglandins and to eliminate free oxygen radicals, thus enhancing the protective function of the gastric mucosa. However, it is unknown whether rebamipide plays a role in preventing NSAID-induced gastropathy. The aim of this study was to determine the effectiveness of rebamipide compared to misoprostol in preventing NSAID-induced gastrointestinal complications in patients requiring continuous NSAID treatment. METHODS: We studied 479 patients who required continuous NSAID treatment. The patients were randomly assigned to groups that received 100 mg of rebamipide three times per day or 200 microg of misoprostol three times per day for 12 weeks. The primary endpoint of the analysis was the occurrence rate of gastric ulcers, as determined by endoscopy after 12 weeks of therapy. RESULTS: Of the 479 patients in the study, 242 received rebamipide, and 237 received misoprostol. Ultimately, 44 patients (18.6%) withdrew from the misoprostol group and 25 patients (10.3%) withdrew from the rebamipide group. There was a significant difference in withdrawal rate between the two groups (p=0.0103). The per protocol analysis set was not valid because of the dropout rate of the misoprostol group; thus, the intention to treat (ITT) analysis set is the main set for the efficacy analysis in this study. After 12 weeks, the occurrence rate of gastric ulcers was similar in the rebamipide and misoprostol groups (20.3% vs 21.9%, p=0.6497) according to ITT analysis. In addition, the therapeutic failure rate was similar in the rebamipide and misoprostol groups (13.6% vs 13.1%, p=0.8580). The total severity score of the gastrointestinal symptoms was significantly lower in the rebamipide group than in the misoprostol group (p=0.0002). The amount of antacid used was significantly lower in the rebamipide group than in the misoprostol group (p=0.0258). CONCLUSIONS: Rebamipide can prevent gastric ulcers when used with NSAIDs and can decrease the gastrointestinal symptoms associated with NSAID administration. When the possibility of poor compliance and the potential adverse effects of misoprostol are considered, rebamipide appears to be a clinically effective and safe alternative.
Adult ; Aged ; Alanine/administration & dosage/adverse effects/*analogs & derivatives ; Anti-Inflammatory Agents, Non-Steroidal/*adverse effects ; Anti-Ulcer Agents/*administration & dosage/adverse effects ; Arthritis/drug therapy ; Butanones/adverse effects ; Diclofenac/adverse effects/analogs & derivatives ; Double-Blind Method ; Drug Administration Schedule ; Gastric Mucosa ; Humans ; Middle Aged ; Misoprostol/*administration & dosage/adverse effects ; Quinolones/*administration & dosage/adverse effects ; Stomach Ulcer/chemically induced/*prevention & control ; Thiazines/adverse effects ; Thiazoles/adverse effects ; Treatment Outcome