杜仲腰痛丸通过NF-κB信号通路对腰椎间盘突出症炎性因子的调控影响

Effect of Duzhongyaotong Pills on Inflammatory Factors of Lumbar Disc Herniation through NF-κB Sig⁃nal Pathway

目的观察腰椎间盘突出症患者核因子-κB(NF-κB)通路调控致炎/抑炎细胞因子之间的关系及杜仲腰痛丸对其的影响并探讨其作用机制。方法80例患者随机分为观察组与对照组,每组40例。观察组服用杜仲腰痛丸,对照组服用双氯芬酸钠缓释片,两组均治疗2周。用ELISA检测治疗前后血清NF-κB信号通路指标(P50、P65、IkBa)、白细胞介素-1(IL-1)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)表达含量及C反应蛋白(CRP)、红细胞沉降率(ESR),观察各组之间的变化;采用日本骨科协会(JOA)评分、症状积分量表及VAS评分评定疗效,并进行相关性分析观察记录各个指标数值并进行SPSS统计学分析。结果两组治疗后NF-κB信号通路指标、IL-1、TNF-α、CRP、ESR与治疗前比较均降低(P<0.01),IL-10明显升高(P<0.01)。两组治疗后JOA评分、症状量化积分、VAS积分与本组治疗前比较均显著改善(P<0.01);但对照组效果优于观察组(P<0.01)。结论杜仲腰痛丸可通过抑制NF-κB信号通路的活化,上调IL-10水平,下调IL-1、TNF-α等水平的表达,抑制腰椎间盘突出症患者异常的炎症免疫反应,减轻腰部疼痛,改善生活质量。

Objective:To investigate the relationship between nuclear factor-κB(NF-κB)pathway and inflam⁃matory/anti-inflammatory cytokines in patients with lumbar disc herniation and the effect of Duzhong Yaotong Pills on them.Methods:A total of 80 patients with lumbar disc herniation were divided into the observation group and control group,40 cases in each group.The observation group took Duzhong Yaotong Pills,while the con⁃trol group took diclofenac sodium sustained-release tablets;both groups were treated for two weeks.NF-κB in se⁃rum before and after treatment was tested by ELISA;the expression of signal pathway indexes(P50,p65,Ikba),in⁃terleukin-1(IL-1),interleukin-10(IL-10),tumor necrosis factor(TNF-α),CRP and ESR were observed;the ef⁃fect was evaluated by JOA score,symptom integral scale and VAS score;the correlation analysis was carried out to record the values of each index;SPSS statistical credits were made for these values analysis.Results:1)After treatment,NF-κB signal pathway index,IL-1,TNF-α,CRP,ESR were significantly decreased(P<0.01)and IL-10 significantly increased(P<0.01).The observation group was better than the control group.2)Compared with the group before treatment,the JOA score,symptom quantification score and VAS score in the observation group and the control group were significantly reduced after treatment(P<0.01).Conclusion:Duzhong Yaotong Pills can inhibit the abnormal inflammatory immune response of patients with lumbar disc herniation,reduce the lumbar pain and improve the quality of life by inhibiting the activation of NF-κB signal pathway,up regulating the level of IL-10 and down regulating the expressions of IL-1 and TNF-α.