The Clinical And Experiment Research Of Tongbi 2 Mixture Treatment Of Rheumatoid Arthritis

Objective:The subject of this research is using DAS28 to observe the clinical efficacy and safety of Tongbi 2mixtureon the treatment of PJk;and research on the Tongbi 2mixture type of collagen-induced arthritis(Collagen Induced Arthritis,CIA) animal model of chemokine effects of IL-8 from histopathology,imaging and the point of view of cytokine on the Tongbi 2mixture reveal the role of targets and the role of mechanisms for systematic and standardized use of the side, the development of new drugs for the treatment of RA,providing a reliable basis.Methods:1.Clinical part:in 1987 in the United States Institute of Rheumatology(ACR) classification criteria for the diagnosis based on the use of randomized controlled method,60 cases of the 2:1 ratio of RA patients were randomly divided into treatment group and control group,40 cases of treatment group, to Tongbi 2 mixture,20 cases of the control group,to methotrexate(MTX), the treatment of 3 months was observed in patients with DAS28 change,to evaluate its clinical efficacy.MAIN OUTCOME MEASURES:The number of swollen joints(SJC),the number of tender joints(TJC),the overall health(GH), erythrocyte sedimentationrate(ESR),C-reactive protein(CRP),rheumatoid factor(RF),routine blood test,renal(BUN,CREA),liver function(ALT,AST).2.Experimental parts:the use of CIA rat model of experimental animals to observe degree of joint swelling,joint X-ray changes,pathological changes in synovial joints.And histological methods used to observe the mixture Tongbi 2 synovial tissues of CIA rats the impact of histological grade.And the use of primary culture methods,the use of detection ELESA fibroblast-like synovial cell supernatant levels of IL-8. Results:The total effective rate was 80%,control group,the total effective rate was 70%.The two groups after treatment than before treatment DAS28 score decreased significantly,there are significant difference(P＜0.001).Note on the side Tongbi 2 mixture can be significantly improved with MTX in patients with RA disease activity,but no significant inter-group differences in comparison (P＞0.05).The two groups before and after the treatment of joint swelling and tenderness in the number,GH has improved the test by the statistical difference(P＜0.001 or P＜0.05).And the treatment group compared with the control group,with the exception of a number of joint tenderness,the treatment group to improve the indicators compared with the control group no significant difference(P＞0.05).The two groups after treatment than before treatment ESR,CRP,RF has decreased significantly,there are significant differences(P＜0.001 or P＜0.05).The treatment group but ESR,CRP,RF improvement compared with the control group,no difference(P＞0.05).For synovium,the rationale for the effects of rickets,the 2nd group Tongbi mixture,MTX group than in the difference between the normal control group (P＜0.001),and there are differences between the model group(P＜0.001,or P＜0.005);Tongbi 2Mixture and MTX group comparison group there was no significant difference(P＞0.05).For imaging articular joints of rats the effects of the Group Tongbi 2mixture, MTX group than in the difference between the normal control group(P＜0.001), and there are differences between the model group(P＜0.008);Tongbi 2mixture and MTX group difference between groups was not significant(P＞0.05).The chemokine IL-8 the effects of stimulation by IL-1β,the synovial cells secrete IL-8 significantly higher than the normal group(P＜0.01),plus drug group,on the Tongbi 2 mixture group than in IL-1βgroup and MTX group can significantly reduce the IL-8 secretion,the difference was statistically significant(P＜0.05),and MTX group of IL-8 secretion and IL-1βshowed no significant difference between groups(P＞0.05).Conclusion: 1.Tongbi 2 mixture able to reduce the significant improvement in RApatients with DAS28,number of tender joints,swollen joints number of overall health status,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP), rheumatoid factor(RF),prompted Tongbi mixture of Chinese medicine 2 of RA treatment has a good effect.2.Tongbi 2 mixture of RAsynovial tissues of patients with inflammatory joint disease has a good therapeutic effect.Its mechanism may be on the Tongbi 2 mixture could inhibit the chemokine IL-8 expression,inhibition of neutrophil infiltration in synovial tissues of RA inhibit angiogenesis,to inhibit the role of inflammation in RA.This may be the mixture Tongbi RA treatment on the 2nd one of the main mechanism.3.Tongbi 2mixture could significantly reduce the degree of cartilage and bone destruction of CIA rats,suggesting that Tongbi 2 mixture could effectly protect the cartilage and bone of CIA rats.