摘要
目的:探讨类风湿关节炎(RA)患者的血瘀状态与核因子-κB通路的活化及致炎/抑炎细胞因子之间的关系及新风胶囊(XFC)对其影响。方法:将76例RA患者随机分为XFC组(3粒/次,3次/d)和来氟米特(LEF)组(1片/次,1次/d);连续治疗3个月。20名健康体检者为正常组。采用ELISA法检测两组血清中IL-10、IL-6、IL-17、Act1、p50、p65、IκBα、血小板活化因子(PAF)、血小板活化因子-乙酰水解酶(PAF-AH)、CCP水平,另外检测血小板(PLT),检测血沉(ESR),检测C反应蛋白(CRP),类风湿因子(RF),检测D-二聚体(D-D)、纤维蛋白原(FBG)、凝血酶时间(TT)、凝血酶原时间(PT)、部分凝血酶原时间(APTT)水平。结果:与正常组比较,RA患者外周血中D-D、FBG、PLT明显升高,TT缩短,IL-10、PAF-AH的表达明显降低,IL-6、IL-17、Act1、p50、p65、IκBα、PAF明显升高(P<0.05,P<0.01)。与对照组比较,XFC组D-D、FBG、PLT、IL-6、IL-17、Act1、p65水平明显降低(P<0.05,P<0.01),且在改善患者关节疼痛、关节肿胀、关节压痛、晨僵明显优于对照组(P<0.05,P<0.01)。Spearman相关性分析显示,RA患者的凝血指标、血瘀总积分以及PAF/PAF-AH与细胞因子、NF-κB通路以及血瘀症状总积分、临床症状体征、疾病活动性指标等呈明显相关性。结论:XFC能降低RA患者外周血细胞因子水平并抑制NF-κB的活化,从而改善其血瘀状态。
Objective： To investigate the relationship between blood stasis and activation of NF-κB pathway in patients with rheumatoid arthritis（RA）, and the influence of Xinfeng Capsule（XFC） on it. Methods： Totally 76 RA patients were randomly and averagely divided into XFC group（3 tablets/time, tid） and LEF group（1 tablet/time, qd）, with 20 physical examination as a control. After treating for 3 months, the levers of IL-10, IL-6, IL-17, Act1, p50, p65, IκBα. PAF, PAF-AH, and CCP in serum of patients were detected by using ELISA. The blood platelet（PLT） and erythrocyte sedimentation rate（ESR） of patients were detected by using automatic blood cell analyzer and Westergren method. The CRP and RF of patients were detected by using automatic biochemical analyzer, and the levels of D-D, FBG, TT, PT and APTT were tested by using automated coagulation instrument. Results： Compared with control group, the levels of D-D, FBG, and PLT in peripheral blood of RA patients increased significantly, APTT and TT were shortened, expression of IL-10 and PAF-AH was decreased significantly, and levers of IL-6, IL-17, Act1, p50, p65, IκBα, and PAF were decreased significantly（P〈0.05, P〈0.01）. Compared with control group, the levels of D-D, FBG, PLT, IL-6, IL-17, Act1, and p65 of patients in XFC group decreased significantly（P〈0.05, P〈0.01）, and the improvement in arthralgia, arthrocele, morning stiffness and so on of patients in XFC group was superior to that of control group significantly（P〈0.05, P〈0.01）. The results of correlation analysis showed that there were obvious correlations among RA patients＇ coagulation indicators, total integration of coagulation, PAF/PAF-AH, cytokines, NF-κB pathway, total integration of blood stasis symptoms, clinical signs and symptoms, disease activity index and so on. Conclusion： XFC could reduce the peripheral blood cytokines levels of RA patients and inhibit the activation of NF-κB pathway to improve the state of blood stasis.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2016年第11期4684-4689,共6页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家临床重点专科中医风湿病科建设项目(No.财社[2013]239号)
国家中医药重点学科中医痹病学建设项目(No.国中医药发[2009]30号)
"十二五"国家科技支撑计划项目(No.2012BAI26B02)
安徽省重点实验室建设项目(No.1306c083035)
安徽省科技计划项目(No.11010402170)~~
