桂枝附子汤对类风湿关节炎患者Th17/Treg、STAT3信号通路相关因子水平的影响  

Effects of Guizhi Fuzi Decoction on Th17/Treg and STAT3signaling pathway related factors in patients with rheumatoid arthritis

作　　者：石颖 彭薪颖 刘星[2] 彭雪莲 夏平 SHI Ying;PENG Xinying;LIU Xing(Department of Integrated Traditional Chinese and Western Medicine,Chongqing Ninth People's Hospital,Chongqing 402360,China;Department of Traditional Chinese Medicine,Dazu Hospital,Chongqing Medical University,Chongqing 402360,China)

机构地区：[1]重庆市第九人民医院中西医结合科,重庆402360 [2]重庆医科大学附属大足医院中医科,重庆402360 [3]重庆医科大学附属大足医院检验科,重庆402360

出　　处：《四川中医》2025年第3期194-198,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：2024年重庆市科卫联合中医药项目(编号:2024ZYYB009);2024年重庆市卫健委中医药项目(编号:2024WSJK140)。

摘　　要：目的:探讨桂枝附子汤治疗类风湿关节炎(RA)患者临床疗效及对Th17/Treg、STAT3信号通路相关因子水平的影响。方法:收集2023年1月~2024年1月我院收治的82例RA患者为研究对象,并分为观察组和对照组,每组41例。对照组给予常规治疗,观察组加服桂枝附子汤。比较两组临床疗效、治疗前后临床症状指标(晨僵时间、压痛关节、肿胀关节、滑膜厚度、关节积液、骨侵蚀、滑膜血流)、疗效指标[DAS28、VAS、中医症状积分、HAQ、类风湿因子(RF)、红细胞沉降率(ESR)、抗CCP抗体]、Th17/Treg及相关因子[白介素17(IL-17)、转化生长因子β(TGF-β)、白介素10(IL-10)、肿瘤坏死因子α(TNF-α)]、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、C3、C4)、STAT3信号通路相关因子(NLRP3、caspase-1、Foxp3、STAT3)mRNA水平变化情况。结果:观察组和对照组总有效率分别为92.68%、75.61%,两组比较具有统计学差异(P<0.05);治疗后,两组临床症状指标及疗效指标均有所改善,IL-10、TGF-β、CD8^(+)、Treg、Foxp3 mRNA水平有所上升,而IL-17、TNF-α、CD4^(+)、CD4^(+)/CD8^(+)、C3、C4、Th17、Th17/Treg、NLRP3、caspase-1、STAT3 mRNA水平有所下降(P<0.05),且观察组和对照组各指标比较均具有统计学差异(P<0.05)。结论:桂枝附子汤治疗RA临床效果显著,并可明显改善免疫功能及Th17/Treg平衡,调节STAT3信号通路。Objective: To investigate the clinical efficacy of Guizhi Fuzi Decoction in the treatment of patients with RA and its influence on Th17/Treg and STAT3signaling pathway related factors. Methods: A total of 82RA patients admitted to our hospital from January 2023to January 2024were collected as research objects and randomly divided into observation group and control group,with 41cases in each group. The control group was treated with conventional western medicine,and the observation group was supplemented with Guizhi Fuzi decoction. The clinical efficacy,clinical symptom indexes (morning stiffness time,tender joint,swollen joint,synovial membrane thickness,joint effusion,bone erosion and synovial blood flow),curative effect indexes [DAS28,VAS,TCM symptom score,HAQ,rheumatoid factor (RF),erythrocyte sedimentation rate (ESR),anti-CCP antibody],Th17/Treg and related factors [Transforming growth factor β (TGF-β),interleukin-10(IL-10),tumor necrosis factor α (TNF-α)],immune function indexes (CD4^(+) ,CD8^(+) ,CD4^(+) /CD8^(+) ,C3,C4),STAT3signaling pathway related factors (NLRP3,caspase-1,Foxp3,STAT3). Results: The total effective rate of observation group and control group was 92.68% and 75.61%,respectively ( P <0.05). After treatment,the clinical symptom indexes and efficacy indexes were improved in both groups,and the levels of IL-10,TGF-β,CD8^(+) ,Treg and Foxp3mRNA increased. The mRNA levels of IL-17,TNF-α,CD4^(+) ,CD4^(+) /CD8^(+) ,C3,C4,Th17,Th17/Treg,NLRP3,caspase-1and STAT3were decreased ( P <0.05). There were statistical differences between two groups ( P <0.05). Conclusion: Guizhi Fuzi Decoction can significantly improve the immune function and Th17/Treg balance in the treatment of RA,and regulate STAT3signaling pathway.

关 键 词：桂枝附子汤 类风湿关节炎 TH17/TREG STAT3 

分 类 号：R274.9[医药卫生—中西医结合]