黑骨藤追风活络胶囊治疗风寒湿痹型类风湿关节炎的临床疗效及机制

古金华; 吴娅琳; 陈文礼; 赵平

doi:10.13422/j.cnki.syfjx.2018030180

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黑骨藤追风活络胶囊治疗风寒湿痹型类风湿关节炎的临床疗效及机制

临床 | 更新时间：2024-01-04

- 黑骨藤追风活络胶囊治疗风寒湿痹型类风湿关节炎的临床疗效及机制
- Clinical Efficacy and Mechanism of Heiguteng Zhuifeng Huoluo Capsule in Treating Rheumatoid Arthritis
- 中国实验方剂学杂志 2018年24卷第3期页码：180-184
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金项目（81660758）
- DOI：10.13422/j.cnki.syfjx.2018030180
  中图分类号： R259
- 纸质出版日期：2018
- 稿件说明：
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古金华, 吴娅琳, 陈文礼, 等. 黑骨藤追风活络胶囊治疗风寒湿痹型类风湿关节炎的临床疗效及机制[J]. 中国实验方剂学杂志, 2018,24(3):180-184.

GU Jin-hua, WU Ya-lin, CHEN Wen-lin, et al. Clinical Efficacy and Mechanism of Heiguteng Zhuifeng Huoluo Capsule in Treating Rheumatoid Arthritis[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(3): 180-184.
古金华, 吴娅琳, 陈文礼, 等. 黑骨藤追风活络胶囊治疗风寒湿痹型类风湿关节炎的临床疗效及机制[J]. 中国实验方剂学杂志, 2018,24(3):180-184. DOI： 10.13422/j.cnki.syfjx.2018030180.

GU Jin-hua, WU Ya-lin, CHEN Wen-lin, et al. Clinical Efficacy and Mechanism of Heiguteng Zhuifeng Huoluo Capsule in Treating Rheumatoid Arthritis[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(3): 180-184. DOI： 10.13422/j.cnki.syfjx.2018030180.

摘要

目的：探讨黑骨藤追风活络胶囊治疗风寒湿痹型类风湿关节炎的临床疗效及深层作用机制。方法：将80例宜宾市第二人民医院确诊的风寒湿痹型类风湿关节炎患者随机分为观察组与对照组，各40例，对照组给予口服洛索洛芬钠，60 mg/次，3次/d，氨甲蝶呤（MTX）7.5~2 mg/次，1次/周；观察组在口服洛索洛芬钠基础上加用黑骨藤追风活络胶囊治疗，0.9 g/次，3次/d，连续服药3个月；采用视觉模拟评分法（VAS）观察治疗前后关节压痛数、关节肿胀数、关节肿胀指数、双手平均握力、静息痛、晨僵时间变化；酶联免疫吸附试验（ELISA）检测两组患者治疗前后血清中血沉（ERS），C-反应蛋白（CRP），类风湿因子（RF）含量变化；ELISA法检测两组患者治疗前后关节液中白细胞介素（IL）-17A，IL-18，IL-27含量变化；实时荧光定量聚合酶链式反应（Real-time PCR）检测两组患者治疗前后关节液微小mRNA （microRNA，miR）-146a，miR-16表达变化。结果：经Ridit分析，观察组临床疗效优于对照组（P<0.05）；观察组治疗后关节压痛数、关节肿胀数、关节肿胀指数、双手平均握力、静息痛、晨僵时间改善程度均显著优于对照组（P<0.01）；观察组治疗后血清ERS，CRP，RF含量明显低于对照组；观察组治疗后关节液IL-17A，IL-18，IL-27含量及miR-146a，miR-16表达明显低于对照组。结论：黑骨藤追风活络胶囊可能通过降低miR-146a，miR-16表达，调控炎症因子释放，进而减轻自身免疫因子的表达，从而达到改善风寒湿痹型RA患者体征及症状的作用。

Abstract

Objective:To explore the clinical efficacy and deep mechanism of Heiguteng Zhuifeng Huoluo capsule in treatment of rheumatoid arthritis. Method:The 80 patients with rheumatoid arthritis diagnosed in The Second People's Hospital of Yibin were randomly divided into observation group (40 cases) and control group (40 cases). The control group was given with oral loxoprofen sodium 60 mg/time

3 times/d; methotrexate (MTX) 7.5-2 mg/times

1 time/week; the observation group was given with additional Heiguteng Zhuifeng Huoluo capsule based on oral loxoprofen sodium

0.9 g/time

3 times/d

for continuous 3 months. The changes of joint tenderness

joint swelling

joint swelling index

average grip strength

rest pain and morning stiffness time were observed by using visual analogue scale (VAS) before and after treatment. The levels of erythrocyte sedimentation rate (ERS)

C-reactive protein (CRP) and rheumatoid factor (RF) were measured by enzyme linked immunosorbent assay (ELISA) before and after treatment. The changes of interleukin (IL)-17A

IL-18 and IL-27 in synovial fluid were measured by ELISA. Real-time PCR was used to detect the expression levels of microRNA (miR)-146a and miR-16 in the synovial fluid before and after treatment. Result:The clinical efficacy of the observation group was better than that of the control group (P <0.05) by Ridit analysis. The number of joint tenderness

joint swelling

joint swelling index

average grip strength

rest rest pain and morning stiffness were significantly better in observation group than those in control group (P <0.01). The expression levels of ERS

CRP and RF in serum of the observation group were significantly lower than those in control group

and the expression levels of IL-17A

IL-18

IL-27

miR-146a and miR-16 in synovial fluid of observation group were also significantly lower than those in control group. Conclusion:Heiguteng Zhuifeng Huoluo capsule can reduce the expression of miR-146a and miR-16

regulate the release of inflammatory factors

and reduce the expression of autoimmune factors

so as to improve the signs and symptoms of rheumatoid arthritis.

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