摘要
目的 探讨重骨颗粒对类风湿关节炎(rheumatoid arthritis,RA)骨质疏松患者骨代谢及Notch通路相关因子的影响.方法 将70例RA骨质疏松患者随机分成对照组和观察组各35例,对照组予以甲氨蝶呤和碳酸钙D3 口服,观察组在此基础上加以重骨颗粒冲服,疗程均为12周.观察疼痛视觉模拟评分(VAS)、28个关节活动度评分(DAS28)、简化疾病活动指数(SDAI)、血沉(ESR),检测肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、IL-6、骨代谢[骨钙素(OC)、Ⅰ型前胶原氨基末端肽(PINP)、β胶原降解产物(β-CTX)],双能X线骨密度仪检测腰椎、股骨骨密度值,RT-qPCR法检测Notch1、Jagged1、Hes1 mRNA表达量.结果 观察组ACR70为71.43％,明显高于对照组的42.86％(x2=4.769,P＜0.05).与治疗前比较,两组治疗后 DAS28、VAS、SDAI、ESR、TNF-α、IL-1β、IL-6、β-CTX、Notch1、Jagged1、Hes1 mRNA 均显著降低(P＜0.01),OC、PINP、腰椎和股骨骨密度均明显升高(P＜0.05,P＜0.01).观察组治疗后 DAS28、VAS、SDAI、ESR、TNF-α、IL-1 β、IL-6、β-CTX、Notch1、Jagged1、Hes1 mRNA均明显低于对照组治疗后(P＜0.05,P＜0.01),OC、PINP、腰椎和股骨骨密度均明显高于对照组治疗后(P＜0.05,P＜0.01).结论 重骨颗粒能改善RA骨质疏松患者疾病活动,改善骨代谢,降低炎症因子,其机制可能与调节Notch通路有关.
Abstract
Objective To investigate the effects of Chonggu granules on bone metabolism and Notch pathway related factors in patients with rheumatoid arthritis(RA)osteoporosis.Methods Seventy patients with RA and osteoporosis were randomly divided to the control group and the observation group,with 35 cases each group.Methotrexate and calcium carbonate D3 were administered orally in the control group.On the basis of the treatment,the observation group was given Chonggu granules.The course lasted for 12 weeks.The pain visual analog score(VAS),28 joint mobility score(DAS28),simplified disease activity index(SDAI),blood sedimentation(ESR),tumor necrosis factor-alpha(TNF-α),interleukin-1 β(IL-1β),IL-6,osteocalcin(OC),pre-collagen amino-terminal peptide type Ⅰ(PINP),and β-collagen degradation product(β-CTX)were examined.Lumbar spine and femoral BMD values were detected using dual-energy X-ray absorptiometry.mRNA expressions of Notch1,Jagged1,and Hes1 were determined with RT-qPCR.Results ACR70 in the observation group was 71.43％.The mRNA levels of DAS28,VAS,SDAI,ESR,TNF-α,IL-1β,IL-6,β-CTX,Notch1,Jagged1,and Hes1 decreased significantly in both groups after treatment(P＜0.01).OC,PINP,BMD of the lumbar spine and the femur increased significantly(P＜0.05,P＜0.01).In the observation group,the mRNA levels of DAS28,VAS,SDAI,ESR,TNF-α,IL-1β,IL-6,β-CTX,Notch1,Jagged1,and Hes1 decreased(P＜0.05,P＜0.01).The bone mineral density of the lumbar spine and the femur,OC,and PINP were higher(P＜0.05,P＜0.01).Conclusion Chonggu granules relieve disease activity,improve bone metabolism,and reduce inflammatory factors in patients with RA and osteoporosis.The mechanism may be related to the regulation of Notch pathway.
基金项目
新安医学与中医药现代化研究所"揭榜挂帅"项目(2023CXMMTCM005)
省级中医优势专科建设项目(皖中医药服务秘[2022]34号)
安徽省临床医学研究转化专项项目(20230429510702014)
安徽省临床医学研究转化专项项目(20230429510702015)
安徽省高校协同创新项目(GXXT-2021-085)
维普
万方数据