温经通络汤联合针灸治疗风寒湿痹型关节炎的疗效及对患者血清Wnt-3α,β-catenin及BMP-2表达的影响  

Effect of Wenjing Tongluo Decoction Combined with Acupuncture on Expression of Serum Wnt-3α,β-catenin and BMP-2 of Patients with Wind Cold Dampness Arthritis

作　　者：潘明柱[1] 荣兵[1] 贾峻[1] 李建[1] 

机构地区：[1]天津中医药大学第一附属医院,天津300193

出　　处：《中国实验方剂学杂志》2017年第24期175-179,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：天津市卫生局中医;中西医结合科研课题(07061)

摘　　要：目的:探讨温经通络汤结合针灸治疗风寒湿痹型关节炎的疗效及对患者血清分泌型糖蛋白(Wnt)-3α,β-链蛋白(β-catenin)及骨形成蛋白-2(bone morphogenetic proteins-2,BMP-2)表达的影响。方法:选自天津中医药大学第一附属医院2015年2月—2016年11月收治的112例风寒湿痹型类风湿性关节炎(RA)患者,按照随机数字表将其分成观察组与对照组,每组56例。观察组给予温经通络汤联合针灸治疗,对照组给予塞来昔布联合来氟米特治疗,比较两组临床疗效、治疗前后中医临床证候积分、红细胞沉降率(erythrocyte sedimentation rate,ESR),C反应蛋白(C-reaction protein,CRP)及类风湿因子(rheumatoid factor,RF)变化情况以及血清Wnt-3α,β-catenin及BMP-2水平变化情况。结果:治疗后,观察组总有效率为94.64%,对照组总有效率为74.00%,观察组优于对照组(P<0.01)。两组治疗后中医临床证候积分均较治疗前显著下降(P<0.01),与对照组治疗后比较,观察组降低更显著(P<0.01)。两组治疗后ESR,CRP,RF水平均较治疗前显著下降(P<0.01),与对照组治疗后比较,观察组下降更显著(P<0.05)。与治疗前比较,观察组治疗后血清Wnt-3α,β-catenin及BMP-2水平均显著下降(P<0.01),对照组治疗前后比较无统计学差异。结论:温经通络汤结合针灸治疗风寒湿痹型关节炎疗效显著,其可下调Wnt-3α,β-catenin,BMP-2表达,缓解关节疼痛及改善关节功能。Objective： To investigate the effect of Wenjing Tongluo decoction combined with acupuncture on the expression of serum Wnt-3α,β-catenin and bone morphogenetic proteins-2（ BMP-2） of patients with wind cold dampness arthritis. Method： The 112 patients with wind cold dampness type rheumatoid arthritis（ RA）treated in our hospital from February 2015 to November 2016,were randomly divided into observation group and control group,56 cases in each group. The observation group was treated with Wenjing Tongluo Tang combined with acupuncture,while the control group was treated with celecoxib combined with leflunomide. Then the clinical efficacy,clinical symptom scores of traditional Chinese medicine（ TCM）,erythrocyte sedimentation rate（ ESR）,C reactive protein（ CRP） and rheumatoid factor（ RF） changes and the changes of serum Wnt-3α,β-catenin and BMP-2 levels before and after the treatment were compared between two groups. Result： The total effective rate was94. 64% in observation group,significantly higher than 74. 00% in control group（ P〈0. 01）. After the treatment,the clinical symptom scores of TCM were significantly decreased as compared with those before the treatment in both groups（ P〈0. 01）,and the decrease was more obvious in observation group（ P〈0. 01）. ESR,CRP and RF levels were significantly decreased after the treatment in both groups（ P〈0. 01）,and the decrease was more obvious in observation group（ P〈0. 05）. The serum levels of Wnt-3α,β-catenin and BMP-2 were significantly decreased after treatment in observation group（ P〈0. 01）,but there was no significant difference in the control group before and after the treatment. Conclusion： Wenjing Tongluo decoction combined with acupuncture has remarkable curative effect in the treatment of wind cold dampness rheumatoid arthritis,and it may play a role in relieving joint pain and improving joint function by down-regulating Wnt-3α,β-catenin,and BMP-2 expression levels.

关 键 词：温经通络汤 针灸 风寒湿痹型关节炎 WNT信号通路 骨形成蛋白-2 

分 类 号：R287[医药卫生—中药学] R593.22[医药卫生—中医学]