补肾解毒通络方对类风湿关节炎患者血清中血管新生相关因子的影响

Effect of Bushen Tongluo Jiedu decoction on the angiogenesis relative factors in the serum of patients with rheumatoid arthritis

关键词:  补肾解毒通络方  类风湿关节炎  临床疗效  血管新生相关因子

Key words:  Bushen Tongluo Jiedu decoction  rheumatoid arthritis  clinical efficacy  angiogenesis relative factors

摘要:

[目的]观察补肾解毒通络方对活动期类风湿关节炎（RA）患者临床疗效及血清中血管新生相关因子的影响。[方法]将78例活动期RA患者随机分为治疗组（n=38）和对照组（n=40）。治疗组予补肾解毒通络方联合甲氨蝶呤治疗，对照组予单药甲氨蝶呤治疗。记录治疗前后患者VAS评分、28处关节疾病活动度评分（DAS28）、中医证候疗效评估、C反应蛋白（CRP）、血沉（ESR）的变化，同时检测血清中VEGF、bFGF、TGF-β1的数值变化，并观察治疗过程中出现的不良反应。[结果]治疗6个月后，两组在中医症状评分、VAS、DAS28评分、CRP较治疗前均值均下降（P<0.05）；治疗组患者血清VEGF、bFGF水平较治疗前降低（P<0.05），TGF-β1水平较治疗前升高（P<0.05）；对照组患者仅血清VEGF、bFGF水平较治疗前降低（P<0.05）。两组相比，治疗组中医症状评分、VAS、DAS28评分、CRP均值低于对照组（P<0.05）；治疗组患者血清VEGF、bFGF水平较对照组明显降低（P<0.05），而TGF-β1水平较对照组明显升高（P<0.05）。[结论]补肾解毒通络方能有效缓解活动期RA临床症状，同时可通过下调RA患者血清中VEGF、bFGF，并上调TGF-β1的表达水平从而抑制新生血管增生，表明该方临床疗效可，且在对RA血管翳的形成可能具有一定的抑制作用。

Abstract:

[Objective] To investigate the effects of combined Bushen Tongluo Jiedu decoction on the correlation angiogenic growth factors in the serum of patients with rheumatoid arthritis(RA).[Methods] The 78 patients with RA were randomly divided into the treatment group (n=38) with Bushen Tongluo Jiedu decoction and methotrexate, and the control group (n=40) with only methotrexate. The change of VAS score, DAS28, TCM syndrome effect eveluation, CRP and ESR were recorded, and the changes of VEGF, bFGF and TGF-β1 in two groups before and after three months were observed. Untoward reaction during treatment was observed.[Results] After 6 months treatment, the scores of TCM symptoms, VAS, DAS28 and CRP in the two groups were decreased than before treatment(P<0.05). The treatment group to reduce the index levels of VEGF, bFGF in the serum was better than before treatment (P<0.05), and to raise the index levels of TGF-β1 was better than before treatment (P<0.05). The control group only vEGF and bEGF were better than before treatment (P<0.05). The scores of TCM symptoms, VAS, DAS28 and CRP in the treatment group were lower than those of the control group (P<0.05). VEGF and bFGF were remarkably decreased compared to that of control group (P<0.05), and TGF-β1 were significantly higher compared to that of control group (P<0.05).[Conclusion] The Bushen Tongluo Jiedu decoction can effectively relieve the clinical symptoms of RA in active stage, and the decoction through down-regulation of VEGF and bFGF, and up-regulation of TGF-β1 expression levels to inhibite angiogenic growth, it showed that it may have the inhibitory effect in the pannus formation of RA.