Evaluation of the efficacy of intra-articular injection of PRP combined with Fangfeng Xibi decoction in the treatment of KOA

HUANG Yu; KUANG Song; ZHOU Hao; WANG Xiang; XU Jintao

doi:10.3969/j.issn.1002-3429.2025.16.018

Abstract：Objective To investigate the efficacy of intra-articular injection of platelet-rich plasma(PRP)combined with Fangfeng Xibi decoction in the treatment of knee osteoarthritis(KOA),and to analyze its effects on oxidative stress and Toll-like receptor-4(TLR-4)/myeloid differentiation factor 88(MyD88)signaling pathways.Methods A total of 150 patients with KOA from September 2021 to September 2024 were selected,and divided into three groups according to random number table method,with 50 patients in each group.The PRP group received intra-articular injections of PRP,the decoction group received Fangfeng Xibi decoction,and the combination group received intra-articular injections of PRP combined with Fangfeng Xibi decoction.The efficacy and adverse reactions of the three groups were compared,as well as the visual analog scale(VAS)score,Western Ontario and McMaster Universities Osteoarthritis Index Visualization Scale(WOMAC)scores,oxidative stress,and TLR-4/MyD88 signaling pathway-related gene expression levels before and after treatment.Results The total effective rate of the combination group was 100.00%,which was higher than 88.00%of the PRP group and 68.00%of the decoction group,and higher in the PRP group than in the decoction group(P<0.05).After treatment,the VAS,WOMAC scores and the expression levels of TLR-4 and MyD88 mRNA in the combination group were lower than those in the PRP group and the decoction group,and lower in the PRP group than in the decoction group(P<0.05).After treatment,the level of malondialdehyde in the combination group was lower than that in the PRP group and the decoction group,and lower in the PRP group than in the decoction group,while glutathione peroxidase,superoxide dismutase,total antioxidant capacity were higher than those in PRP group and decoction group,and higher in the PRP group than in the decoction group(P<0.05).There was no difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion Intra-articular injection of PRP combined with Fangfeng Xibi decoction for the treatment of KOA patients can improve clinical efficacy,reduce pain levels,inhibit oxidative stress reactions,and has certain safety.The mechanism of its efficacy is related to the inhibition of TLR-4/MyD88 signaling pathway activation.