中药熏洗治疗类风湿关节炎优选方案的实验研究

Experimental Study of Preferred Traditional Chinese Medicine Fumigation in Treatment of Rheumatoid Arthritis

目的：比较不同的熏洗时间、不同温度、不同浓度药液熏洗对疗效的影响,探讨熏洗法治疗类风湿关节炎（RA）的最佳方案。方法：将66只雄性SD大鼠随机抽取6只为空白对照组,其余建立胶原诱导型关节炎（CIA）大鼠模型。造模成功后再次随机分为模型组（n=6）、熏洗组1～9组（n=6×9）。观察各组大鼠的一般情况、体质量、足容积、关节炎指数（AI指数）、血清IL-1β、TNF-α水平,以及HE染色镜下大鼠踝关节滑膜病理变化。结果：模型组大鼠体质量、足容积、关节炎症评分较正常组显著升高（P〈0.05）,治疗后上述各指标熏洗组1～9组较模型组均明显降低（P〈0.05）;熏洗4周后,熏洗组1～9组与模型组比较,IL-1β、TNF-α水平明显下降,P〈0.05,差异有统计学意义。空白对照组大鼠病理HE染色正常,模型组可见关节腔变窄、关节腔内可见炎细胞、血管翳形成,熏洗组可见中度炎细胞浸润,滑膜变薄、滑膜细胞稍有增生,中度肿胀;与模型组相比,血管翳较少。经过加权计算大鼠足趾容积、AI评分、IL-1β水平、TNF-α水平综合得分,结合熏洗组1～9组正交实验设计方案,得出最佳熏洗方案为熏洗时间30 min、温度41℃、高浓度药液。结论：中药熏洗法在改善关节功能、调节免疫方面具有一定作用,熏洗法治疗CIA大鼠,在熏洗30 min、温度41℃、高浓度药液条件下治疗效果最佳。

Objective： To compare the different fumigation time,different temperature,different concentrations of liquid fumigation on the efficacy of fumigation treatment of RA. Methods： Sixty-six male SD rats were randomly divided into blank control group（ n = 6） and collagen-induced arthritis（ CIA） model group（ n = 60）. After successful modeling,the model group was randomly divided into the model group（ n = 6） and the fumigation 1-9 groups（ n = 6 × 9）. The general condition,weights,foot volume,arthritis index,serum IL-1β and TNF-α levels,and pathological changes of synovial membrane of rats ankle under HE staining were observed. Results： The weights,foot volume and arthritis indexes in the model group were significantly higher than those of the the normal group（ P 〈 0. 05）. After treatment,the above-mentioned indexes in the fumigation groups were obviously decreased compared with those of the model group（ P 〈 0. 05）.After 4 weeks fumigation,IL-1β and TNF-α levels in 1 to 9 fumigation groups were significantly lower than those of the model group（ P 〈 0. 05）,and the difference was statistically significant. In the control group,the HE staining was normal. Model group had obviously significant proliferation of synovial tissue,a large number of inflammatory cell infiltration,and formation. Fumigation group＇s synovial thinning,moderate swelling and inflammation were slightly lighter.Conclusion： Fumigating and washing method of traditional Chinese medicine have a certain role in improving joint function and regulation of immunity. The best conditions of fumigation method for the treatment of CIA rats is fumigation 30 min,temperature 41 ℃ and high concentration of liquid.