文献类型：期刊文献

中文题名：基于RANKL-RANK-OPG环路探讨骨痨愈康丸改善肝肾亏虚型类风湿关节炎患者骨破坏机制研究

英文题名：Effects of Gulao Yukang Pills on the bone destruction mechanism in rheumatoid arthritis patients with liver-kidney deficiency based on RANKL-RANK-OPG loop

作者：李平顺[1];王钢[2];周孟茹[3]

第一作者：李平顺

机构：[1]甘肃中医药大学,兰州730000;[2]甘肃中医药大学附属医院风湿骨病科,兰州730000;[3]兰州大学基础医学院,兰州730000

第一机构：甘肃中医药大学

年份：2020

卷号：35

期号：3

起止页码：1603

中文期刊名：中华中医药杂志

外文期刊名：China Journal of Traditional Chinese Medicine and Pharmacy

收录：CSTPCD;;北大核心:【北大核心2017】；CSCD:【CSCD_E2019_2020】；

基金：国家自然科学基金项目(临床预实验)(No.81860858)。

语种：中文

中文关键词：类风湿关节炎;骨痨愈康丸;RANKL-RANK-OPG环路;破骨细胞;细胞因子;肝肾亏虚

外文关键词：Rheumatoid arthritis;Gulao Yukang Pills;RANKL-RANK-OPG loop;Osteoclasts;Cytokines;Liverkidney deficiency

摘要：目的:基于核因子κB受体激活配体(RANKL)-NF-κB受体激活剂(RANK)-骨保护素(OPG)环路探讨骨痨愈康丸改善肝肾亏虚型类风湿关节炎(RA)患者骨破坏机制研究。方法:将60例患者按随机数字表法随机分为对照组与治疗组,每组30例。对照组服用甲氨喋呤(10mg/次,口服,2次/周);治疗组在对照组基础上加服骨痨愈康丸(15丸/次,口服,2次/d),两组均备用依托考西片(60mg/次,口服,1次/d),不加服免疫抑制剂及其他治疗本病的中成药。连续治疗3个月后观察两组的疗效差异、DAS28评分和症状改善情况,以及用ELISA法检测血清白细胞介素(IL)-1、IL-6、IL-17、肿瘤坏死因子-α(TNF-α)、骨保护素(OPG)、RANKL、(M-CSY)、Ⅰ型胶原氨基端前肽(PINP)、骨钙素(BGP)、骨特异性碱性磷酸酶(BAP)含量,Western Blot法检测膝关节液RANKL、RANK、OPG蛋白的表达,DTX-200型骨密度仪检测左髋关节骨质BMD值,检测血液和尿液中Ca、P代谢等指标的变化情况。结果:治疗后治疗组总有效率为93.33%(28/33),优于对照组83.33%(25/30)(P<0.05);治疗后两组RA患者临床症状明显减轻,DAS28评分,血清IL-1、IL-6、IL-17、TNF-α、RANKL、M-CSY、PINP含量,膝关节液RANKL、RANK蛋白和尿液中Ca、P等指标均降低;血清OPG、Ca、BAP、BGP含量及膝关节OPG蛋白与治疗前比较均升高(P<0.05,P<0.01)。治疗组RA患者OPG、RANKL、RANK、IL-1、IL-6、IL-17、TNF-α、M-CSY、PINP、BGP、BAP、Ca、P、BMD的改善较对照组更明显(P<0.01)。结论:骨痨愈康丸可以减轻RA患者临床症状,改善骨质破坏,其机制可能是与影响RANKL-RANKOPG环路的表达有关。
Objective:To study effects of Gulao Yukang Pills on the bone destruction mechanism in RA patients with liver-kidney deficiency based on RANKL-RANK-OPG loop.Methods:Sixty patients were randomly divided into control group and treatment group by random number table,30 cases in each group.The control group received methotrexate(10mg,orally,2 times/week);On the basis of the control group,the patients in the treatment group were given Gulao Yukang Pills(15 pills/time,oral,2 times/day),and the patients in both groups were treated with etonecoxib tablets(60mg,oral,1 time/day),without immunosuppressant and other Chinese patent medicines.Continuous 3 months after treatment to observe the curative effect of two groups of difference,DAS28 score and symptoms improve the situation,and using ELISA method to detect serum IL-1,IL-6,IL-17,TNF-α,OPG and RANKL,M-CSY,PINP,BGP,BAP content,The protein expressions of RANKL,RANK and OPG in knee fluid were detected by Western blot,DTX-200 type osteoporosis bone mineral density instrument to detect the left hip BMD values,Ca and P in the blood and urine metabolic changes of the indicators.Results:After treatment,the total effective rate of the treatment group was 93.33%,which was better than 83.33%of the control group(P<0.05).After treatment,the clinical symptoms of RA patients in the two groups were significantly reduced,with DAS28 score,serum IL-1,IL-6,IL-17,TNF-α,RANKL,M-CSF,PINP content,knee fluid RANKL,RANK protein and urine Ca,P and other indicators decreased.The content of OPG,Ca,BAP,BGP and OPG protein in knee joint were all increased,which was statistically significant compared with that before treatment(P<0.05).Changes in OPG,RANKL,RANK,IL-1,IL-6,IL-17,TNF-α,M-CSF,PINP,BGP,BAP,Ca,P,BMD in RA patients in the treatment group were more significant than those in the control group,with statistically significant differences(P<0.01).Conclusion:Gulao Yukang Pills can alleviate the clinical symptoms of RA patients and improve bone destruction,and its mechanism may be related to the influence of RANKL-RANK-OPG loop expression.