Wnt/β-catenin信号通路探讨重骨颗粒治疗肝肾亏虚型膝骨关节炎的作用机制  

Exploring the mechanism of Zhonggu Granules in treating knee osteoarthritis of liver and kidney deficiency type through Wnt/β-catenin signal pathway

作　　者：程丽丽 尚双双 戈扬 汤忠富 徐昌萍 李明[2] 黄传兵[2] CHENG Lili;SHANG Shuangshuang;GE Yang;TANG Zhongfu;XU Changping;LI Ming;HUANG Chuanbing(Anhui University of Traditional Chinese Medicine,Hefei 230012,China;Department of Rheumatology and Immunology,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学,安徽合肥230012 [2]安徽中医药大学第一附属医院风湿免疫科,安徽合肥230031

出　　处：《中国骨质疏松杂志》2023年第10期1466-1471,共6页Chinese Journal of Osteoporosis

基　　金：安徽省高校自然科学研究基金重点项目(KJ2020A0395);安徽省高校协同创新项目(GXXT-2021-085);2022年度安徽省卫生健康科研项目重点项目(AHWJ2022a005)。

摘　　要：目的观察重骨颗粒(CGG)对肝肾亏虚型膝骨关节炎(KOA)患者的临床疗效及基于Wnt/β-catenin信号通路探讨CGG治疗KOA可能的作用机制。方法将60名纳入患者随机分为氨基葡萄糖组和重骨颗粒组两组,每组30例。氨基葡萄糖组服用盐酸氨基葡萄糖片(0.75 g bid口服),而重骨颗粒组则服用重骨颗粒(每日1付,两次分服),持续治疗8周。观察两组治疗前后中医证候积分、临床疗效、视觉模拟量表(VAS)评分、WOMAC量表评分、Lysholm评分以及血沉(ESR)、超敏C反应蛋白(hs-CRP)的变化,并且RT-PCR法检测外周血Wnt1、β-catenin、GSK3βmRNA表达量,ELISA法检测IL-6、IL-1β水平。结果重骨颗粒组临床疗效优于氨基葡萄糖组(P<0.05),治疗后重骨颗粒组的中医证候积分、VAS评分、WOMAC评分,以及Lysholm评分中除使用支撑物方面外均较氨基葡萄糖组改善显著(P<0.05);重骨颗粒组ESR、hs-CRP、IL-6和IL-1β水平的降低程度也显著大于氨基葡萄糖组(P<0.05);重骨颗粒组Wnt1、β-catenin水平的降低程度以及GSK3β水平的升高程度也均大于氨基葡萄糖组(P<0.05)。结论重骨颗粒可以有效降低肝肾亏虚型KOA患者的中医证候评分,改善膝关节临床症状,其可能的作用机制与抑制Wnt/β-catenin信号通路以及抑制促炎因子的表达有关。Objective To investigate the clinical efficacy of Chonggu granule(CGG)in the treatment of knee osteoarthritis(KOA)in patients with liver and renal disease,as well as the probable mechanism of CGG in the treatment of KOA based on the Wnt/-catenin signaling pathway.Methods With 30 instances in each group,60 patients were randomly assigned to one of two groups:glucosamine or heavy bone granules.During 8 weeks,the glucosamine group took glucosamine hydrochloride tablets(0.75 g bid orally),while the Chonggu granule group took Chonggu granule(1 fu per day,twice split).TCM syndrome score,clinical efficacy,visual analogue scale(VAS)score,WOMAC scale score,Lysholm score,erythrocyte sedimentation rate(ESR),and high-sensitivity C-reactive protein(hs-CRP)levels were measured in both groups before and after therapy.RT-PCR was used to detect the mRNA expression of wnt1,β-catenin and GSK3βin peripheral blood,and ELISA was used to detect the levels of IL-6 and IL-1β.RT-PCR was used to quantify wnt1,-catenin,and GSK3βmRNA expression in peripheral blood,and ELISA was utilized to measure IL-6 and IL-1βlevels.Results The therapeutic effectiveness of CGG was higher than that of glucosamine(P<0.05).After treatment,the TCM syndrome score,VAS score,WOMAC score,and Lysholm score in the Chonggu granule group were significantly higher than in the glucosamine group(P<0.05);ESR,hs-CRP,IL-6,and IL-1βlevels in the CGG group were also significantly lower than in the glucosamine group(P<0.05);The decrease in Wnt1 andβ-catenin levels,as well as the rise in GSK3β,were larger in the CGG group than in the glucosamine group(P<0.05).Conclusion CGG can effectively reduce the TCM syndrome score of KOA patients with liver-kidney deficiency,improve knee pain symptoms,and joint function,and its possible mechanism is related to the inhibition of the Wnt/β-catenin signaling pathway and the inhibition of pro-inflammatory factor expression.

关 键 词：重骨颗粒 肝肾亏虚 膝骨关节炎 WNT/Β-CATENIN信号通路 

分 类 号：R259[医药卫生—中西医结合]