重骨颗粒对类风湿关节炎骨质疏松患者骨代谢及Notch通路的影响  

Effects of Chonggu granules on bone metabolism and Notch pathway in patients with rheumatoid arthritis and osteoporosis

作　　者：汤忠富 梁竹君 黄传兵[1,2] 程丽丽 陈君洁 尚双双 李明 刘思娣[1,2] TANG Zhongfu;LIANG Zhujun;HUANG Chuanbing;CHENG Lili;CHEN Junjie;SHANG Shuangshuang;LI Ming;LIU Sidi(Department of Rheumatology,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM,Hefei 230031,China;Chuzhou Combined Traditional Chinese and Western Medicine Hospital,Chuzhou 239000,Anhui,China)

机构地区：[1]安徽中医药大学第一附属医院风湿科,安徽合肥230031 [2]新安医学与中医药现代化研究所,安徽合肥230031 [3]滁州市中西医结合医院,安徽滁州239000

出　　处：《中国骨质疏松杂志》2024年第9期1323-1328,共6页Chinese Journal of Osteoporosis

基　　金：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(20230429510702014,20230429510702015);安徽省高校协同创新项目(GXXT-2021-085)。

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%(χ^(2)=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-1β、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。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-1β(IL-1β),IL-6,osteocalcin(OC),pre-collagen amino-terminal peptide type I(PINP),andβ-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.

关 键 词：类风湿关节炎 骨质疏松 重骨颗粒 骨代谢 NOTCH通路 

分 类 号：R959[医药卫生—药学]