Chronic Disease Control

Effect of Jiawei Yanghe decoction on serum Wnt-3α, OSCAR, RNKL levels and knee joint function in patients with type 2 diabetes mellitus complicated with knee osteoarthritis

  • Guyue ZHANG ,
  • Ge ZHANG ,
  • Hui WANG
Expand
  • 1.Department of Endocrinology,Tangshan Workers' Hospital,Tangshan 063000,Hebei,China
    2.Department of Geriatrics,Tangshan Workers' Hospital,Tangshan 063000,Hebei,China
    3.Department of Traditional Chinese Medicine,Tangshan Workers' Hospital,Tangshan 063000,Hebei,China

Received date: 2026-03-31

  Online published: 2026-07-14

Abstract

Objective To investigate the effects of Jiawei Yanghe Decoction on the levels of serum secretory glycoprotein-3α (Wnt-3α), osteoclast-related receptor (OSCAR), receptor activator of NF-κB ligand (RANKL), and the knee joint function in patients with type 2 diabetes mellitus complicated by knee osteoarthritis. Methods A total of 98 patients with type 2 diabetes mellitus complicated by knee osteoarthritis were randomly divided into a control group (celecoxib + conventional hypoglycemic therapy) and an observation group (celecoxib + conventional hypoglycemic therapy + Jiawei Yanghe Decoction) using the random number table method, with 49 cases in each group. Both groups received treatment for 4 weeks. The clinical efficacy, score of traditional Chinese medicine syndrome, levels of serum Wnt-3α, OSCAR, RNKL, glucose and lipid metabolism indexes, insulin-like growth factor (IGF), transforming growth factor-β (TGF-β), 25-hydroxyvitamin D3 [25(OH)D3], inflammatory factors, pain, and knee joint function were compared between the two groups. Results After 4 weeks of treatment, the total effective rate of the observation group was significantly higher than that of the control group (P 0.05). Moreover, after 4 weeks of treatment, the scores of joint pain, pain fixation, swelling, limited joint activity, aversion to wind and cold, preference for joint warmth and stimulation, as well as the levels of serum Wnt-3α, RNKL, fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), IGF, interleukin-1 (IL-1), interleukin-6 (IL-6), scores of visual analogue scale (VAS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) in both groups were lower compared to those before treatment. Notably, the values in the observation group were significantly lower than those in the control group (P 0.05). In addition, the levels of serum OSCAR, TGF-β, and 25(OH)D3 were higher than those before treatment, and the levels in the observation group were significantly higher than those in the control group (P 0.05). Conclusions Jiawei Yanghe decoction, in combination with celecoxib and routine hypoglycemic therapy, can effectively enhance the traditional Chinese medicine syndrome score of patients with type 2 diabetes mellitus complicated by knee osteoarthritis. It can also regulate the serum levels of Wnt-3α, OSCAR, RNKL, IGF, TGF-β, and 25(OH)D3, reduce the inflammatory response, alleviate pain, and improve the body's glucose and lipid metabolism as well as knee joint function, demonstrating good clinical efficacy.

Cite this article

Guyue ZHANG , Ge ZHANG , Hui WANG . Effect of Jiawei Yanghe decoction on serum Wnt-3α, OSCAR, RNKL levels and knee joint function in patients with type 2 diabetes mellitus complicated with knee osteoarthritis[J]. The Journal of Practical Medicine, 2026 , 42(13) : 2381 -2387 . DOI: 10.3969/j.issn.1006-5725.2026.13.014

References

[1] KING L K, WAUGH E J, MACKAY C, et al. Formulating knee osteoarthritis management plans taking type 2 diabetes into account: Qualitative study of arthritis therapists using theoretical domains framework[J]. J Rheumatol, 2022, 49(12): 1365-1371. doi: 10.3899/jrheum.220535 .
[2] SU Y C, HSIEH P C, LAI E C, et al. Comparison of sodium-glucose cotransporter 2 inhibitors versus glucagon-like peptide-1 receptor agonists and risks of osteoarthritis and arthroplasty in patients with type 2 diabetes mellitus: A propensity score-matched cohorts retrospective study[J]. Diabetes, 2025, 41(5): e70051. doi: 10.1002/dmrr.70051 .
[3] 陈星燃, 晏飞, 王领弟, 等. 十枣汤加味散联合塞来昔布胶囊治疗湿热瘀闭型膝骨关节炎性滑膜炎临床研究[J]. 辽宁中医杂志, 2025, 52(1): 83-86. doi: 10.13192/j.issn.1000-1719. 2025.01.023 .
[4] 贾祥, 徐田杰, 樊佳欣, 等. 二甲双胍通过激活SIRT1/p53信号通路对骨关节炎大鼠关节软骨发挥保护作用[J]. 实用医学杂志, 2024, 40(23): 3306-3316. doi: 10.3969/j.issn.1006-5725.2024.23.005 .
[5] 余皓, 张洫, 李雪萍, 等. 独活寄生汤对膝关节骨性关节炎患者膝关节功能、疼痛及血清炎症因子的影响[J]. 中华中医药学刊, 2025, 43(6): 117-121. doi: 10.13193/j.issn.1673-7717.2025. 06.022 .
[6] 汪子俊, 余小勇, 俞振翰, 等. 除痹强骨汤联合浮针对寒湿阻络型膝骨性关节炎患者的临床疗效[J]. 中成药, 2025, 47(7): 2461-2465. doi: 10.3969/j.issn.1001-1528.2025.07.055 .
[7] 薛英, 田永祥, 刘峰瑞, 等. 独活寄生汤对老年膝骨关节炎血清TLR4/NF-κB信号通路的影响[J]. 中华中医药学刊, 2025, 43(4): 201-205. doi: 10.13193/j.issn.1673-7717.2025.04.033 .
[8] 陈丹, 王成, 邢海辉. 火针密刺法联合身痛逐瘀汤对风痰瘀络型膝骨性关节炎患者的临床疗效[J]. 中成药, 2024, 46(3): 826-830. doi: 10.3969/j.issn.1001-1528.2024.03.018 .
[9] 杨智军, 杨文龙, 夏汉庭, 等. 加味阳和汤含药血清对MC3T3-E1与RAW264.7细胞共育体系的影响[J]. 中国骨质疏松杂志, 2022, 28(9): 1342-1346. doi: 10.3969/j.issn.1006-7108. 2022.09.017 .
[10] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志, 2021, 13(4): 315-409. doi: 10.3760/ cma.j.cn115791-20210221-00095 .
[11] 中华医学会骨科学分会关节外科学组, 中国医师协会骨科医师分会骨关节炎学组, 国家老年疾病临床医学研究中心(湘雅医院), 等. 中国骨关节炎诊疗指南(2021年版)[J]. 中华骨科杂志, 2021, 41(18): 1291-1314. doi: 10.3760/cma.j.cn121113-20210624-00424 .
[12] 国家中医药管理局. 中医病证诊断疗效标准[M]. 南京: 南京大学出版社, 1994: 75-79.
[13] 中华中医药学会骨伤科分会膝痹病(膝骨关节炎)临床诊疗指南制定工作组. 中医骨伤科临床诊疗指南·膝痹病(膝骨关节炎)[J]. 康复学报, 2019, 29(3): 1-7. doi: 10.3724/SP.J.1329. 2019.03001 .
[14] 胡珊珊, 刘晓, 罗汉才, 等. 低强度脉冲超声调控治疗疼痛性膝骨关节炎的临床研究[J]. 实用医学杂志, 2023, 39(21): 2783-2788. doi: 10.3969/j.issn.1006-5725.2023.21.015 .
[15] 宋雨珂, 徐金凡, 何晓铭, 等. 髌下脂肪垫高信号强度对膝骨关节炎症状及结构的相关性[J]. 实用医学杂志, 2024, 40(23): 3373-3378. doi: 10.3969/j.issn.1006-5725.2024.23.015 .
[16] EBRAHIM H A, ALZAMIL N M, AL-ANI B, et al. Suppression of knee joint osteoarthritis induced secondary to type 2 diabetes mellitus in rats by resveratrol: Role of glycated haemoglobin and hyperlipidaemia and biomarkers of inflammation and oxidative stress[J]. Arch Physiol Biochem, 2022, 128(5): 1375-1382. doi: 10.1080/13813455.2020.1771378 .
[17] LIN C P, CHUNG C H, LU C H, et al. Glucagon-like peptide-1 receptor agonists therapy to attenuate the risk of knee osteoarthritis and total knee replacement in type 2 diabetes mellitus: A nation-wide population-based cohort study[J]. Medicine, 2025, 104(6): e41243. doi: 10.1097/MD.0000000000041243 .
[18] KING L K, STANAITIS I, HUNG V, et al. National institute of health and care excellence clinical criteria for the diagnosis of knee osteoarthritis: A prospective diagnostic accuracy study in individuals with type 2 diabetes[J]. Arthritis Care Res, 2025, 77(5): 623-630. doi: 10.1002/acr.25464 .
[19] KING L K, WAUGH E, MACKAY C, et al. 'It’s a dance between managing both': A qualitative study exploring perspectives of persons with knee osteoarthritis and type 2 diabetes mellitus on the impact of osteoarthritis on diabetes management and daily life[J]. BMJ Open, 2022, 12(11): e061472. doi: 10.1136/bmjopen-2022-061472 .
[20] 王权, 邵强, 王勇刚. 塞来昔布联合双氯芬酸钠治疗膝关节骨关节炎患者的临床研究[J]. 中国临床药理学杂志, 2023, 39(15): 2169-2173. doi: 10.13699/j.cnki.1001-6821.2023.15.009 .
[21] 廖太阳, 张力, 杨楠, 等. 基于AMPK/mTOR信号通路研究膝痹宁方对膝骨关节炎模型大鼠的改善作用机制[J]. 中国药房, 2023, 34(1): 23-28. doi: 10.6039/j.issn.1001-0408.2023.01.05 .
[22] 王强, 谭章勇, 诸葛恒艳, 等. 基于TLR-4/NF-κB P65信号通路研究独活寄生汤对膝骨关节炎的治疗作用及机制[J]. 中药材, 2024, 47(6): 1524-1530. doi: 10.13863/j.issn1001-4454.2024.06. 032 .
[23] 张伟, 汪昌雄, 李强, 等. 针刀松解结合益气活血通络汤治疗早中期膝骨关节炎顽固性疼痛效果观察[J]. 辽宁中医杂志, 2024, 51(7): 141-144. doi: 10.13192/j.issn.1000-1719.2024.07.038 .
[24] 梁鹏, 韦瑞文, 宁莉, 等. 双合汤联合关节腔药物注射治疗膝关节骨性关节炎临床观察[J]. 中华中医药学刊, 2024, 42(6): 228-231. doi: 10.13193/j.issn.1673-7717.2024.06.046 .
[25] 李鹏飞, 李永吉, 李琳琳, 等. 独活寄生汤加减联合针刀整体松解疗法、Mulligan动态关节松动术治疗膝骨关节炎的临床观察[J]. 中药材, 2024, 47(9): 2363-2366. doi: 10.13863/j.issn1001-4454.2024.09.038 .
[26] 朱锐, 蒋涛. 龙火汤对肝肾亏虚证膝骨性关节炎患者的临床疗效[J]. 中成药, 2024, 46(12): 4225-4228. doi: 10.3969/j.issn.1001-1528.2024.12.053 .
[27] ARRUDA A L, HARTLEY A, KATSOULA G, et al. Genetic underpinning of the comorbidity between type 2 diabetes and osteoarthritis[J]. Am J Hum Genet, 2023, 110(8): 1304-1318. doi: 10.1016/j.ajhg.2023.06.010 .
[28] 范元赫, 杨永菊, 张宇, 等. 黄芪及其活性成分治疗骨关节炎的研究现状[J]. 中华中医药学刊, 2025, 43(2): 168-172. doi: 10.13193/j.issn.1673-7717.2025.02.036 .
[29] 刘艳伟, 沈健, 于瑞杰, 等. 针药结合治疗膝骨关节炎的疗效及对血清炎症疼痛介质的影响[J]. 中华中医药学刊, 2025, 43(2): 216-219. doi: 10.13193/j.issn.1673-7717.2025.02.044 .
Outlines

/