The Observation Of Clinical Effect Of Hebi Recipe On Rheumatoid Arthritis And Its Anti-inflammatory Mechanism

Objective:To explain the theoretical basis of the treatment of rheumatoid arthritis(RA)with the method of regulating liver and spleen,To observe the clinical efficacy of Hebi Recipe(HBR)combined with methotrexate(MTX)and iguratimod(T-614)in the treatment of active RA and to improve the anxiety and depression of patients,and to use the cholinergic anti-inflammatory pathway(CAP)to explore the mechanism of action of RA in the treatment of RA.Method:Clinical study:69 patients with RA,33 patients with MTX+T-614 as the control group,36 patients with Hebi Recipe+MTX+T-614 for the treatment group,12 weeks of treatment.Observe the clinical efficacy and improve the anxiety and depression status of RA patients.Experimental study:Fibroblast-like synoviocytes(FLS)were cultured in the knee joint sterile synovial tissue of 6 RA patients obtained by surgery.FLS was stimulated with drug serum containing agonist,MTX,T-614,and sputum,physiological saline,respectively.The levels of interleukin(IL)-17 and high mobility protein superfamily 1(HMGB1)in synovial cell supernatant were observed by ELISA.The a 7 nicotinic acetylcholine receptor(α7nAChR)was detected by Western Blotting in synovial cells.The levels of nuclear factor-kappaB(NF-κB)p65,phosphorylation signal transducer and transcriptional activator 3(p-STAT3)were detected,and the level of a 7nAchR mRNA in synoviocytes was detected by RT-PCRResults:Clinical study:TCM syndrome efficacy,ACR20 compliance rate,DAS28 score,Health Assessment Questionnaire(HAQ)score,laboratory parameters,and anxiety and depression of treatment group were significantly improved compared with the control group.Especially in the improvement of systemic liver disorders,the treatment group has obvious advantages.Experimental study:Hebi Recipe can increase the expression of α 7nAChR and p-STAT3 in synoviocytes,decrease the expression of NF-kBp65,and decrease the levels of inflammatory factors IL-17 and HMGB1.Conclusion:Liver and spleen disorders are one of the main factors in the pathogenesis of RA.They play an important role in the pathogenesis of early RA and affect the development and outcome of RA.The combination of Hebi Recipe MTX and T-614 can effectively alleviate the clinical symptoms,signs and anxiety and depression of patients with RA,reduce laboratory indicators,reduce disease activity and improve clinical efficacy.The mechanism of action may be to up-regulate the expression of α 7nAChR in FLS,activate CAP,decrease the levels of inflammatory factors such as IL-17 and HMGB1,and reduce the inflammatory response of RA.