摘要
目的探索断藤益母汤抑制巨噬细胞趋化力防治急性期类风湿关节炎(RA)的生物学机制。方法将80例急性期RA患者随机均分为对照组与治疗组各40例。对照组口服美洛昔康片和氨甲蝶呤片。治疗组在对照组的基础上口服断藤益母汤。治疗后,评估两组疗效。监测关节治疗前后的肿胀和压痛指数、晨僵时长、C反应蛋白(CRP)、血沉(ESR)、DAS28评分、HAQ评分、肿瘤坏死因子-α(TNF-α)、核转录因子-κB(NF-κB)、CXC趋化因子受体7(CXCR7)和CXC趋化因子配体12(CXCL12)的表达。结果治疗后,治疗组总有效率高于对照组;治疗组关节肿胀和压痛指数、晨僵时长的开始改善均早于对照组,且治疗6周后,3指标均低于对照组;治疗组ESR和DAS28评分的开始改善均早于对照组,且治疗3周后,CRP、ESR、DAS28和HAQ评分均低于对照组;治疗组巨噬细胞中TNF-α、NF-κB、CXCR7和CXCL12表达开始降低均早于对照组,且治疗1周后TNF-α和CXCL12表达均低于对照组,而NF-κB、CXCR7分别是在3周后、6周后(均P<0.05)。结论断藤益母汤治疗急性期RA疗效满意,其机制可能是通过抑制TNF-α/NF-κB信号轴,下调CXCR7表达,继而抑制CXCL12所介导的巨噬细胞趋化力。
Objective:To investigate the biological mechanism of Duanteng Yimu Decoction on enhancing the chemotaxis of macrophages in the prevention and treatment of acute rheumatoid arthritis(RA).Methods:A total of 80 patients with acute RA treated in Shenzhen Bao′an Traditional Chinese Hospital were randomly divided into the control group and treatment group,with 40 patients in each group.The control group received meloxicam tab⁃lets and methotrexate tablets.The treatment group was added with oral Duanteng Yimu Decoction on the basis of the control group.After treatment,the efficacy of the two groups was evaluated.Swelling and tenderness index,morning stiffness duration,C-reactive protein(CRP),ESR,DAS28 score,HAQ score,tumor necrosis factor-α(TNF-α),NF-κB,CXC chemokine receptor 7(CXCR7)and CXC chemokine ligand 12(CXCL12)were monitored before and after treatment.Results:After treatment,the total efficacy rate of the treatment group was higher than that of the control group.The joint swelling and tenderness index and morning stiffness length in the treatment group were improved earlier than those in the control group,and the three indexes were lower than those in the control group after 6 weeks of treatment.ESR and DAS28 scores in the treatment group were improved earlier than those in the control group,and CRP,ESR,DAS28 and HAQ scores were lower than those in the control group after 3 weeks of treatment.The expression of TNF-α,NF-κB,CXCR7 and CXCL12 in macrophages in the treat⁃ment group began to decrease earlier than that in the control group,and the expression of TNF-αand CXCL12 in the treatment group was lower than that in the control group after 1 week of treatment,while NF-κB and CXCR7 were decreased after 3 weeks and 6 weeks,respectively(P<0.05).Conclusion:Duanteng Yimu Decoction has sat⁃isfactory efficacy in the treatment of acute RA,and the mechanism may be through inhibiting TNF-α/NF-κB signal axis,down-regulating CXCR7 expression,and subsequently inhibiting CXCL12-mediated macrophage chemotaxis.
作者
郑献敏
王辉
徐剑峰
徐泽军
叶仁群
Zheng Xianmin;Wang Hui;Xu Jianfeng;Xu Zejun;Ye Renqun(Shenzhen Bao′an Traditional Chinese Hospital,Guangdong,Shenzhen 518133,China)
出处
《中国中医急症》
2022年第8期1179-1183,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
深圳市宝安区科技创新局基础研究项目(2020JD493)。
关键词
类风湿关节炎
急性期
断藤益母汤
巨噬细胞
趋化
Rheumatoid arthritis
Acute phase
Duanteng Yimu Decoction
Macrophage
Chemotaxis
