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Phonopheresis Associated with Nanoparticle Gel from Phyllanthus amarus Relieves Pain by Reducing Oxidative Stress and Proinflammatory Markers in Adults with Knee Osteoarthritis

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Abstract

Objective

To determine the changes in serum levels of inflammatory biomarkers and antioxidant levels among the knee osteoarthritis (OA) patients after treatment with Phyllanthus amarus (PP) by nanoparticle gel phonophoresis.

Methods

This study was a randomized, double-blind, placebo-control, parallel-group, clinical trial involving 30 subjects with mild-to-moderate degree of knee OA. The patients were allocated to two groups using a computer-generated random numbers, and received conventional ultrasound therapy (control group, 15 cases) and PP (treatment group, 15 cases) once daily for 10 sessions. The pain was evaluated by visual analogue scale (VAS). Serum levels of tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbnent assay (ELISA). Nitric oxide (NO) was determined by modified Griess reagent. The antioxidant effects, including superoxide dismutase (SOD) and total antioxidant capacity (TAC), were also measured by ELISA assay.

Results

The VAS score was significantly decreased in the treatment group compared with the control group after treatment (P<0.01). The serum concentrations of TNF-α and NO were significantly reduced in the treatment group compared with the control group (P<0.01) after treatment. However, the serum concentrations of SOD and TAC in the treatment group were significantly higher after treatment compared with the control group (P<0.01).

Conclusion

PP could alleviate knee pain and significantly reduce systemic anti-inflammatory effects in knee OA patients.

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Author information

Authors and Affiliations

  1. Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand

    Pinkaew Decha

  2. Department of Pharmaceutical Sciences. Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand

    Kiattisin Kanokwan

  3. Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Tocharus Jiraporn

  4. Department of Anatomy, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

    Jumnongprakhon Pichaya

  5. Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Awoot Pisittawoot

Authors
  1. Pinkaew Decha
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  2. Kiattisin Kanokwan
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  3. Tocharus Jiraporn
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  4. Jumnongprakhon Pichaya
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  5. Awoot Pisittawoot
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Contributions

Conceptualization: P Decha, K Kanokwan. Investigation: P Decha. Metodology: P Decha, K Kanokwan. Supervisor: T Jiraporn, A Pisittawoot. Writing: P Decha, T Jiraporn, and J Pichaya.

Corresponding author

Correspondence to Pinkaew Decha.

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The authors declare no conflicts of interest.

Additional information

Supported by CMU Junior Research Fellowship Program and the Faculty of Associated Medical Sciences, Chiang Mai University, Thailand (No. 8/2560)

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Decha, P., Kanokwan, K., Jiraporn, T. et al. Phonopheresis Associated with Nanoparticle Gel from Phyllanthus amarus Relieves Pain by Reducing Oxidative Stress and Proinflammatory Markers in Adults with Knee Osteoarthritis. Chin. J. Integr. Med. 25, 691–695 (2019). https://doi.org/10.1007/s11655-019-3202-8

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  • DOI: https://doi.org/10.1007/s11655-019-3202-8

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