白芍总苷胶囊联合来氟米特对类风湿关节炎Th1/Th2细胞平衡和外周血单核细胞TLR4/NF-κB信号通路的影响  

Effect of Total Glucosides of Peony Capsules Combined with Leflunomide on Th1/Th2 Cell Balance and Peripheral Blood Monocyte Cells TLR4/NF-κB Signal Pathway in the Treatment of Rheumatoid Arthritis Patients

作　　者：燕宇翔 Yan Yuxiang(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121000

出　　处：《锦州医科大学学报》2024年第4期42-46,共5页Journal of Jinzhou Medical University

基　　金：辽宁省教育科学“十四五”规划项目,项目编号:JG22DB269。

摘　　要：目的探讨白芍总苷胶囊联合来氟米特对类风湿关节炎(rheumatoid arthritis,RA)患者辅助性T细胞(helper T cell,Th)1/Th2细胞平衡和外周血单核细胞Toll样受体4(toll-like receptor 4,TLR4)/核因子κB(nuclear factorκB,NF-κB)信号通路的影响。方法按照信封抽签法将锦州医科大学附属第一医院2021年4月至2023年12月期间接收的129例RA患者分为对照组(n=64,来氟米特片治疗)和观察组(n=65,白芍总苷胶囊联合来氟米特片治疗)。对比两组疗效、临床症状、病情评分、疾病相关指标、Th1/Th2细胞平衡和TLR4/NF-κB信号通路相关指标,同时观察两组不良反应发生情况。结果观察组的临床总有效率高于对照组(P<0.05)。与对照组相比,观察组治疗2个月后晨僵时间缩短,关节肿胀数和关节压痛数减少,疼痛视觉模拟量表(visual analog scale of pain,VAS)评分和RA患者病情评价(disease activity score 28,DAS28)评分下降,C反应蛋白、红细胞沉降率、类风湿因子下降,Th2细胞升高,Th1细胞、Th1/Th2下降,TLR4信使核糖核酸(messenger ribonucleic acid,mRNA)、NF-κB mRNA下降(P<0.05)。两组不良反应发生率对比无差异(P>0.05)。结论白芍总苷胶囊联合来氟米特治疗RA患者,可促进患者症状改善,提高临床治疗效果,可能与调节Th1/Th2细胞平衡和抑制外周血单核细胞TLR4/NF-κB信号通路激活有关。Objective To investigate the effect of total glucosides of paeony capsules combined with leflunomide on helper T cells(Th)1/Th2 cells balance and peripheral blood monocyte cells Toll-like receptor 4(TLR4)/nuclear factorκB(NF-κB)signaling pathways in the treatment of rheumatoid arthritis(RA)patients.Methods 129 RA patients who were admitted to our hospital from April 2021 to December 2023 were divided into control group(n=64,treated with leflunomide tablets)and observation group(n=65,treated with total glucosides of paeony capsules combined with leflunomide tablets)according to the envelope drawing method.The efficacy,clinical symptoms,disease scores,disease related indicators,Th1/Th2 cells balance and peripheral blood TLR4/NF-κB signaling pathway related indicators between two groups were compared,and the occurrence of adverse reactions in two groups were observed.Results The total clinical effective rate in observation group was higher than that in control group(P<0.05).Compared with the control group,the morning stiffness time was shortened,the number of joint swelling and joint tenderness was reduced,the pain visual analogue scales(VAS)and the RA patients condition assessment(DAS28)scores were decreased,and C-reactive protein,erythrocyte sedimentation rate,rheumatoid factor were decreased,Th2 cells were increased,Th1 cells,Th1/Th2 cells were decreased,TLR4 messenger RNA(mRNA),and NF-κB mRNA were decreased in observation group at 2 months after treatment(P<0.05).There was no difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Treatment of RA patients with total glucosides of paeony capsules combined with leflunomide,which can promote the improvement of patient symptoms,and improve clinical treatment effectiveness,may be related to regulating Th1/Th2 cells balance and inhibition of TLR4/NF-κB signaling pathway activation in peripheral blood monocyte cells.

关 键 词：白芍总苷胶囊 来氟米特 类风湿关节炎 TH1/TH2 TLR4/NF-κB信号通路 

分 类 号：R445.2[医药卫生—影像医学与核医学]