补肾通督方对强直性脊柱炎患者血清TNF-α、TGF-β_1及骨代谢的影响

Effects of "Bushen Tongdu Decoction" on Serum TNF-α,TGF-β_1 and Bone Metabolism in Patients with Ankylosing Spondylitis

目的:探讨补肾通督方治疗强直性脊柱炎(AS)骨代谢的作用机制。方法:65例AS患者随机分为治疗Ⅰ组(30例,用柳氮磺胺吡啶治疗)和治疗Ⅱ组(35例,用补肾通督方治疗),并设正常组30例。采用酶联免疫吸附法(ELISA)测定各组治疗前及治疗24周后血清肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、骨钙素(BGP)、Ⅰ-型胶原C末端肽(CTX)水平;同时采用双能X线(DEXA)骨密度仪测量治疗前后腰椎和股骨颈的骨密度(BMD)。结果:治疗前两组患者BMD降低,血清TNF-α、CTX水平升高,TGF-β1、BGP下降,与正常组比较有显著差异(P<0.05,P<0.01);治疗后,治疗Ⅱ组各项指标均有不同程度改善(P<0.05,P<0.01),且TNF-α、CTX和骨密度的改善明显优于治疗Ⅰ组(P<0.05)。结论:补肾通督方可通过调节AS相关细胞因子网络平衡,抑制骨吸收、促进骨形成,有效治疗AS患者骨量丢失。

Objective： To investigate the treatment mechanisms of ＂Bushen Tongdu Decoction＂ in bone metabolism in patients with ankylosing spondylitist （AS）. Methods： Sixty subjects were randomly divided into treatment group Ⅰ in which 30 cases were treated with Azulfidine and treatment group Ⅱ in which 35 cases were treated with ＂Bushen Tongdu Decoction＂; and control group with 30 healthy people was established. Before and 24 weeks after treatment, the levels of serum tumor necrosis factor-α （TNF-α）, transforming growth factor β1 （TGF-β1）, osteocalcin （BGP）, and C-terminal telopeptides of type I collagen （CTX） were assayed by ELISA in all groups; and the bone mineral density （BMD） of lumbar vertebrate and femoral neck was detected by DEXA. Results： Before treatment, in comparison with control group, the BMD decreased, TNF-α and CTX increased, TGF-β1 and BGP dropped （P〈0.05, P〈0.01） in two treatment groups; after treatment, above indexes in treatment group Ⅱ all improved （P〈0.05, P〈 0.01）; and TNF-α, CTX and BMD were improved more significantly in treatment group Ⅱ than in treatment group Ⅰ （P〈 0.05）. Conclusion： ＂Bushen Tongdu Decoction＂ can regulate AS-related cytokine network, inhibit bone suppression and promote bone formation to fight against bone loss.