【摘要】 目的:观察和痹方对类风湿关节炎(RA)骨质侵蚀的干预作用,探讨RANKL-RANK信号传导系统对肝脾失调证早期RA骨代谢平衡的调控机制。方法:将符合纳入标准的78例肝脾失调型早期RA患者,随机分为对照组和治疗组,每组39例。对照组服用甲氨蝶呤,治疗组在对照组基础上加用和痹方。治疗3个月,观察ACR20达标率、DAS28评分及中医症候量化积分和相关炎性指标及对RANK/RANKL/OPG通路的影响。结果:治疗组与对照组治疗后ACR20达标率分别为87.68%,56.32%,治疗组优于对照组(P<0.01)。两组治疗后证候积分、DAS28评分、抗环瓜氨酸肽抗体、白介素-17、血清抗酒石酸酸性磷酸酶、核因子-κB受体活化因子受体(RANKL)、RANKL/OPG比值均较治疗前显著降低(P<0.05,P<0.01),且治疗组较对照组降低明显(P<0.05,P<0.01);治疗后两组OPG水平较治疗前明显升高(P<0.05,P<0.01),且治疗组升高优于对照组(P<0.05)。结论:和痹方可有效改善肝脾失调型早期RA患者的关节及全身症状,提示该治法对RANK/RANKL/OPG系统诱导的骨质破坏有明显调控作用。更多还原

【Abstract】 Objective: To observe the effects of Hebi Formula on early rheumatoid arthritis bone erosion and explore the regulatory mechanism of RANKL-RANK signaling pathway on liver and spleen disorder type of early RA bone metabolism balance.Methods: Totally 78 inpatients and outpatients of early RA were randomly assigned to the treatment group(prescribed Hebi Formula and MTX for 39 cases) and the control group(prescribed with MTX alone for 39 cases).The efficacy of American College of Rheumatology 20(ACR20),disease activity score in 28 joints(DAS28),TCM syndrome scores,laboratory related indices rheumatoid factor and RANK/RANKL/OPG systems were observed before and after 3-month treatment.Results: After treatment,the standard arriving rate of ACR20 in the treatment group was 87.68%,which was better than that of control group accounting for 56.32%(P<0.05); the levels of DAS28,TCM syndrome scores,Ant-CCP,IL-17,TRAP,RANKL,RANKL/OPG were significantly lower than before treatment(P<0.05,P<0.01),and the treatment group was lower than control group(P<0.05,P<0.01); the levels of OPG was significantly increased than before treatment in both groups(P<0.05,P<0.01),and the treatment group was better than control group(P<0.05).Conclusion: Hebi Formual could effectively improve joints and systemic symptoms in early RA patients with the liver and spleen disorder,and regulate bone erosion induced by RANK/RANKL/OPG system.更多还原