热补针法对风寒湿阻型类风湿关节炎患者血浆中能量代谢相关基因Atp 5O、Atp 6V1B2表达的影响

Influence of Heat-reinforcing Needling on Expression of Plasma Atp 5O mRNA and Atp 6V1B2 mRNA in Patients with Rheumatoid Arthritis of Wind-cold-damp Retention Type

目的:观察热补针法对风寒湿阻型类风湿关节炎(RA)患者中医证候积分及血浆中能量代谢相关基因ATP合成酶亚单位O(Atp 5O)、溶酶体V1亚单位B 2(Atp 6V1B2)表达的影响,探讨热补针法"取热"的分子生物学机制。方法:将符合纳入标准的60例风寒湿阻型RA患者随机分为热补针法组、对照组,每组30例。两组均取关元、气海、足三里和关节局部腧穴,热补针法组施以热补针法,对照组施以平补平泻法,1次/d,连续5次为1个疗程,共治疗2个疗程。同时招募30名健康体检者作为正常对照组。观察患者治疗前后中医证候积分变化,RT-PCR法检测正常人及患者外周血中Atp 5O、Atp 6V1B2 mRNA的表达。结果:治疗后两组患者中医证候积分均较治疗前明显降低(P<0.05),热补针法组证候积分降低较对照组明显(P<0.05)。治疗前RA患者外周血中Atp 5O、Atp 6V1B2 mRNA表达均较正常人降低(P<0.05);治疗后两组患者Atp 5O、Atp 6V1B2 mRNA表达均较治疗前明显上调(P<0.05),且热补针法组的上调明显高于对照组(P<0.05),两组患者Atp 5O、Atp 6V1B2 mRNA表达与正常对照组的差异无统计学意义(P>0.05)。结论:热补针法上调血浆中能量代谢相关基因Atp 5O、Atp 6V1B2的表达是改善风寒湿阻型RA患者症状和"取热"的分子机制之一。

Objective To observe influences of heat-reinforcing needling（HRN）on scores of traditional Chinese medicine（TCM）symptoms and expression of plasma ATP synthase subunit O（Atp 5O）mRNA and lysosomal V1 subunit B2（Atp 6V1B2）mRNA in patients with wind-cold-damp retention type rheumatoid arthritis（RA）,so as to investigate its biological mechanisms in＂heat production＂.Methods Sixty wind-cold-damp retention type RA patients were randomly allocated to HRN group（n=30）and control group（n=30）.Guanyuan（CV 4）,Qihai（CV6）,bilateral Zusanli（ST 36）,and local acupoints near the knee-joint were selected for needling stimulation.Patients of the HRN group were treated by manipulating the acupuncture needle with HRN,and those of the control group treated by manipulating the needle with uniform reinforcing-reducing method.The treatments were performed once daily,5days a week,and two weeks altogether.The other 30 healthy volunteers were recruited as the normal control group.The TCM symptom scoring system（0-31 points,11items as the severities of pain,swelling and tenderness of the knee-joint）was used to evaluate the status of RA,and quantitative real-time PCR（RT-PCR）was used to detect the expression of plasma Atp 5O mRNA and Atp 6 V1B2 mRNA following removal of red blood cells.Results After the treatment,the TCM scores of both the HRN and control groups were significantly decreased（P〈0.05）,and that of the HRN group was significantly lower than that of the control group（P〈0.05）.Before the treatment,the expression levels of plasma Atp 5 O mRNA and Atp 6 V1B2 mRNA in RA patients were significantly lower than those of the normal group（P〈0.05）,and after the treatment,the expression levels of plasma Atp 5O mRNA and Atp 6 V1B2 mRNA were significantly increased in both HRN and control groups compared to pre-treatment in the same one group（P〈0.05）,and the up-regulated Atp 5O mRNA and Atp 6 V1B2 mRNA levels were remarkably higher in the control group than in the HRN group（P〈0.05）.Conclusion Both heat-producing needling and uniform reinforcing-reducing needling can improve RA patients＇ clinical symptoms,which may be associated with their actions in up-regulating expressions of plasma Atp 5 O mRNA and Atp 6 V1B2 mRNA.