加味附子汤在RA中的应用价值及其对NF-κB信号通路的影响

Application value of Jiawei Fuzi decoction in RA and its effect on NF-κB signaling pathway

目的探讨加味附子汤在类风湿关节炎(RA)中的应用价值及其对核因子-κB(NF-κB)信号通路的影响。方法选取2022年1月至2023年7月该院收治的120例RA患者作为研究对象,随机分为观察组(60例)和对照组(60例)。对照组采用来氟米特与氨甲蝶呤治疗,观察组在对照组基础上加服加味附子汤,两组疗程均为2周。记录两组临床疗效;记录两组治疗前及治疗2周后临床症状指标、炎症指标[类风湿因子(RF)、红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞介素(IL)-6、IL-1β]、NF-κB信号通路表达[磷酸化NF-κB P65(p-NF-κB-P65)、磷酸化NF-κB抑制蛋白α(p-IκBα)];记录两组不良反应。结果观察组总有效率高于对照组(P<0.05)。两组治疗2周后视觉模拟量表评分、晨僵时间、关节肿胀数、关节压痛数均低于治疗前,且观察组均低于对照组,双手平均握力高于治疗前,且观察组高于对照组(P<0.05)。两组治疗2周后RF、ESR、CRP、IL-6、IL-1β水平均低于治疗前,且观察组均低于对照组(P<0.05)。两组治疗2周后p-NF-κB-P65、p-IκBα水平均低于治疗前,且观察组均低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论加味附子汤在RA中具有较好的疗效,能够有效减轻临床症状,抑制炎症因子分泌及NF-κB信号通路表达,且具有较强的安全性。

Objective To investigate the application value of Jiawei Fuzi decoction in rheumatoid arthritis(RA)and its effect on nuclear factor-κB(NF-κB)signaling pathway.Methods A total of 120 RA patients admitted to the hospital from January 2022 to July 2023 were selected as the research objects and were randomly divided into observation group(60 cases)and control group(60 cases).The control group was treated with leflunomide and methotrexate,and the observation group was treated with Jiawei Fuzi decoction on the basis of the control group.Both groups were treated for 2 weeks.The clinical efficacy of the two groups was recorded.The clinical symptom indicators,inflammatory indicators[rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),interleukin(IL)-6,IL-1β]and expression of NF-κB signaling pathway[phosphorylated NF-κB P65(p-NF-κB-P65),phosphorylated NF-κB inhibitor proteinα(p-IκBα)]were recorded before treatment and 2 weeks after treatment in the two groups.The adverse reactions of the two groups were recorded.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).After 2 weeks treatment,the visual analogue scale score,morning stiffness time,joint swelling number and joint tenderness number of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group,and the average grip strength of both hands was higher than that before treatment,and that of the observation group was higher than that of the control group(P<0.05).After 2 weeks treatment,the levels of RF,ESR,CRP,IL-6 and IL-1βin the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).After 2 weeks treatment,the levels of p-NF-κB-p65 and p-IκBαin the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Jiawei Fuzi decoction has a good curative effect in RA,which can effectively reduce the clinical symptoms,inhibit the secretion of inflammatory factors and the expression of NF-κB signaling pathway,and has strong safety.