摘要
目的:基于护骨素(OPG)/核因子κB受体活化因子配体(RANKL)/核因子κB受体活化因子(RANK)信号通络探讨清热利湿活血法对活动期类风湿关节炎(RA)患者骨代谢的影响及临床疗效。方法:选取自2018年12月至2021年12月于我院风湿科就诊的120例活动期RA患者作为研究对象,随机分为对照组(60例,艾拉莫德片+碳酸钙D_(3)片)及治疗组(60例,清热利湿活血方药+艾拉莫德片+碳酸钙D_(3)片),疗程均为12周,观察治疗前后血清RANKL及OPG的含量、血沉(ESR)、C反应蛋白(CRP)、28个关节的疾病活动度评分(DAS28)-ESR、类风湿因子(RF)、抗环瓜氨酸(CCP)抗体、骨钙素(BGP)、Ⅰ型前胶原氨基端前肽(PINP)、β胶原特殊序列(β-CTx)及肝肾功能安全性指标。结果:治疗12周时,治疗组中医证候有效率明显高于对照组(P<0.05)。在降低ESR,CRP,DAS28-ESR,β-CTX,RANKL及升高OPG/RANKL比值方面,治疗组均明显优于对照组(P<0.05),在降低CCP,RF及升高PINP,BGP方面,两组无明显差异(P>0.05)。结论:清热利湿活血法可显著降低RA患者炎症指标和疾病活动度,疗效确切,且能够显著降低RA患者血清β-CTX,RANKL水平,升高OPG/RANKL比值,主要通过抑制RA患者的骨吸收来调节骨代谢。
Objective:To explore the effect of Qingre Lishi Huoxue treatment on bone metabolism in patients with active rheumatoid arthritis(RA),based on osteoprotegerin(OPG)/nuclear factor κB receptor activating factor ligand(RANKL)/nuclear factorκB receptor activating factor(RANK)signal pathway.Methods:A total of 120 patients with active RA treated in the Rheumatology Department of our hospital from December 2018 to December 2021 were randomly divided into control group(60 cases,islamod tablets+calcium carbonate D_(3) tablets)and treatment group(60 cases,Qingre Lishi Huoxue Prescription+islamod tablets+calcium carbonate D_(3) tablets).In a 12-week course of treatment,the contents of serum RANKL,OPG,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),disease activity score of 28 joints(DAS28)-ESR,rheumatoid factor(RF),anti cyclic citrulline(CCP)antibody,osteocalcin(BGP),type Ⅰ procollagen N-terminal propeptide(PINP),β collagen special series(β-CTX),and liver and kidney function safety indexes were observed before and after the treatment.Results:After treatment of 12 weeks,the effective rate of TCM syndromes in the treatment group was significantly higher than that in the control group(P<0.05).In the aspects of reducing ESR,CRP,DAS28-ESR,β-CTX,RANKL,and increasing OPG/RANKL ratio,the effects in treatment group were significantly better than that in control group(P<0.05),and there was no significant difference between two groups in the aspects of reducing CCP and RF,and increasing PINP and BGP(P>0.05).Conclusion:Qingre Lishi Huoxue treatment significantly reduced the inflammatory index and the disease activity.The treatment efficacy is obvious.It significantly reduced the serum levels of β-CTX and RANKL,increases OPG/RANKL ratio,by reducing bone resorption,so as to improve bone metabolism in RA patients.
作者
张迪
樊冰
刘英
姜萍
李大可
ZHANG Di;FAN Bing;LIU Ying;JIANG Ping;LI Da-ke(The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China)
出处
《中国新药杂志》
CAS
CSCD
北大核心
2022年第23期2333-2337,共5页
Chinese Journal of New Drugs
基金
国家自然科学基金资助项目(81874449)
山东省中医药科技发展计划项目(2019-0146)
山东省中医药科技发展计划项目(2019-0129)。
