补肾强督方对强直性脊柱炎患者Dickkopf1蛋白水平的影响

Effects of Bushen Qiangdu Formula on the Level of Dickkopf1 in 45 Cases of Ankylosing Spondylitis

目的探讨补肾强督方治疗强直性脊柱炎(AS)的可能作用机制。方法本研究为前瞻性病例对照研究。应用酶联免疫吸附测定法(ELISA)检测45例AS患者(AS组,给予补肾强督方,每日1剂,疗程为6个月)治疗前后及40名健康人(健康组)血清Dickkopf1蛋白(DKK1)水平,并检测AS组治疗前后血沉(ESR)、C反应蛋白(CRP)、中医证候积分、巴氏强直性脊柱炎功能指数(BASFI)、巴氏强直性脊柱炎病情活动指数(BASDAI)、枕墙距、指地距、Schober试验、胸廓活动度水平。治疗过程中观察不良反应。结果 AS组治疗前血清DKK1水平较健康组明显降低(P<0.05),治疗后血清DKK1水平较治疗前明显升高(P<0.05),且与健康组比较差异无统计学意义(P>0.05)。治疗后ESR、CRP、中医证候积分、BASFI、BASDAI、枕墙距、指地距较治疗前均明显降低(P<0.05或P<0.01);Schober试验、胸廓活动度均较治疗前均明显升高(P<0.01)。患者治疗过程中未见明显不良反应。结论补肾强督方能明显改善AS患者临床症状、体征,且安全可靠,其可能作用机制与升高血清DKK1水平有关。

Objective To observe the effects of Bushen Qiangdu Formula（ kidney-supplementing and Governor Vessel-strengthening formula） on the level of Dickkopf1（ DKK1） in patients with ankylosing spondylitis（ AS）.Methods A prospective case-control study was conducted. Totally 45 cases of AS were selected as the AS group and given Bushen Qiangdu Formula one dose daily. The treatment lasted for 6 months. Forty healthy persons were selected as the healthy group. The level of DKK1 was detected with enzyme-linked immunosorbent assay（ ELISA） in both groups. The levels of erythrocyte sedimentation rate（ ESR）,C-reactive protein（ CRP）,traditional Chinese medicine（ TCM） syndrome scores,Bath Ankylosing Spondylitis Functional Index（ BASFI）,Bath Ankylosing Spondylitis Disease Activity Index（ BASDAI）,finger-floor distance,pulvinar-wall distance,Schober test and thorax activity were detected in the AS group. The adverse reactions were observed in the treatment. Results Before treatment,the level of DKK1 in the AS group was significantly lower than that in the healthy group（ P〈0. 05）. After treatment,the level of DKK1 was significantly increased in the AS group（ P〈0. 05） and there was no significant difference between groups（ P〈0. 05）. The levels of ESR,CRP,TCM syndrome scores,BASFI,BASDAI,finger-floor distance and pulvinar-wall distance were significantly decreased after treatment（ P〈0. 05 or P〈0. 01）. The levels of Schober test and thorax activity were significantly increased after treatment（ P〈0. 01）. There was no adverse reaction occurring during the treatment. Conclusion The lower level of DKK1 in AS patients causes excessive activation of osteoblast pathway. Bushen Qiangdu Formula is effective and safe for AS. It can increase the level of DKK1 and interfere with new bone formation.