羌防归芎汤对急性期类风湿关节炎患者外周血单核细胞TLR4、TRAF6、IL-1β表达的影响

Influence of Qiangfang Guixiong Decoction on TLR4,TRAF6 and IL-1β in Peripheral Blood Mononuclear Cells of Patients with Acute Rheumatoid Arthritis

目的观察羌防归芎汤治疗对急性期类风湿关节炎(RA)患者外周血单核细胞Toll样受体4(TLR4)、肿瘤坏死因子受体相关因子6(TRAF6)、白介素1β(IL-1β)表达的影响。方法将患者120例按照随机数字表法分为观察组和对照组各60例,两组均给予维生素、非甾体抗炎药等基础治疗,在此基础上对照组给予雷公藤多苷片治疗,观察组在对照组基础上给予羌防归芎汤治疗。观察两组中医证候积分、晨僵时间、关节压痛指数、关节肿胀指数,检测者血沉(ESR)、类风湿因子(RF)水平和外周血单核细胞TLR4、TRAF6、IL-1β表达情况。结果治疗后两组中医证候积分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗后两组晨僵时间、关节压痛指数、关节肿胀指数显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组总有效率为90.00%,显著高于对照组75.00%(P<0.05);治疗后两组ESR、RF水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗后两组TLR4、IL-1β表达显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05),两组TRAF6表达显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。结论羌防归芎汤能够明显改善急性期RA患者外周血单核细胞TLR4、TRAF6、IL-1β表达和临床症状,提高治疗效果。

Objective： To observe the influence of Qiangfang Guixiong Decoction on toll like receptor 4 （TLR4）, tumor necrosis factor receptor related factor 6 （TRAF6） and interleukiu 1β （IL- 1β） in peripheral blood mononuclear cells of patients with acute rheumatoid arthritis（RA）. Methods： 120 cases of patients with acute RA were selected as the study objects, and were divided into the observation group and the control group according to random number table method,60 cases in each group. All the two groups were given basic treatment such as vitamins and non-steroidal anti-inflammatory drugs. On the basis of that,the control group were given tripterygium wilfordii tablet treatment,and the observation group were given Qiangfang Guixiong Decoction on the basis of the control group. TCM syndrome scores,time of morning stiffness,joint tenderness index,and joint swelling index were observed in the two groups,as well as ESR（ESR）,rheumatoid factor（RF） levels and TLR4,TRAF6 and IL-1β expression in peripheral blood mononuclear ceils. Results： TCM symptom scores after treatment were significantly lower than those before treatment in the two groups（P〈 0.05）, and those in the observation group were significantly lower than those in the control group （P〈 0.05）. The time of morning stiffness,joint tenderness index and joint swelling index were significantly lower than those before treatment （P〈 0.05）, and those in the observation group was significantly lower than those in the control group （P〈 0.05）. The total effective rate of the observation group was 90.00% which was significantly higher than that of the control group （75.00%）（P〈 0.05）. TLR4 and IL-1β expression after treatment was significantly lower than that before treatment （P〈 0.05）, and that in the observation group was significantly lower than that in the control group （P〈 0.05）. TRAF6 expression was significantly higher than that before treatment （P〈 0.05）, and that in the observation group was significantly higher than that in the control group （P〈 0.05）. Conclusion： Qiangfang Guixiong Decoction can obviously improve TLR4, TRAF6 and IL-1β expression in peripheral blood mononuclear cells of RA patients at acute stage,as well as clinical symptoms. It can improve treatment effect.