OBJECTIVE: This study investigated the effect of salvia miltiorrhiza-asarum ointment(SMAO) plus Chinese medical massage on knee osteoarthritis in a rat model.METHODS: Hulth's method was used to establish a Sprague-Dawley rat model of knee osteoarthritis(OA). The levels of matrix metalloproteinase-13(MMP-13), collagen-tumor necrosiⅡ, aggrecan, interleukin(IL)-1β,s factor-α(TNF-α), and IL-6 were measured by enzyme-linked immunosorbent assays. The joint space was assessed by a Perlove X-ray system. Histopathology was examined by hematoxylin-eosin and Safranin O staining. The m RNA and protein expression levels of Notch1,MMP-13, collagen-II, and aggrecan were measured by quantitative reverse transcription-polymerase chain reaction and Western blotting, respectively.RESULTS: SMAO plus Chinese medical massage significantly decreased the levels of MMP-13, IL-1β,TNF-α, and IL-6, and increased serum collagen-and aggrecan levels. Pathological injury of the kneⅡe joint was improved by SMAO treatment. m RNA and protein expression of Notch1 and MMP-13 was remarkably downregulated, but collagen-s were significantly upregulaⅡte and aggrecan leveld in cartilage tissues.CONCLUSION: SMAO combined with Chinese medical massage effectively relieves OA symptoms,which may involve inhibiting inflammation through the Notch1/MMP-13 signaling pathway.