| Objective: To summarize professor Ma Hongbin’s clinical experience in treating goutyarthritis. To observe the effect of Qingrepaidu capsule in rat models of acute gouty arthritisinduced by MSU, and explores its preventive and therapeutic mechanism for acute goutyarthritis.Methods:1. To summarize Ma Hongbin’s clinical experience and cite the typical casesin the treatment of gouty arthritis by studying with the tutor. The tutor’s viewpoint onpathogenic factor and pathogenesis and dialectical treatment of gouty arthritis was elaboratedtheoretically. Summarize the tutor’s clinical experience in treating gouty arthritis.2.60healthy male SPF SD rats were randomly divided into6groups: Qingrepaidu capsule high,middle and low dose group, diclofenac sodium group, model group and normal group. Rats indifferent groups were given corresponding solution by gastric tube for7days. In the fifth day,after1hour of stomach irrigation, acute gouty arthritis rat model was established bymonosodium urate crystals injection in ankle joint cavity. Measured the swell of rat anklejoint in different groups before and after the model was established. All rats were sacrificedand take material after the model was established about48h. The morphological changes inthe synovial tissue were observed by light and transmission electron microscope. Theexpression levels of NF-κB, IL-1β and TNF-α in the articular leachate were monitored usingELISA.Results:1. Professor Ma Hongbin opined that the mechanism of gouty arthritis inChinese medicine mainly lied in two aspects of deficiency in origin and enrichment insymptom. It is based on deficiency of spleen and kidney, showing combination of heat-damp,phlegm-turbid, blood stasis. He suggested that the treatment should concentrate on thecombination differentiation disease and syndrome, clinical stages and differentiationtreatment. A temporary solution was used in the acute phase, and a permanent cure inremission. Under this academic experience, we have made in the clinical use of satisfiedclinical effect.2. The measurements show that the swelling degree of Qingrepaidu capsuleeach dose group was decreased more obviously after24h and48h of establishing models, andcompared with the model group, the difference of swelling degree was significant (P0.01, P0.05). Qingrepaidu capsule middle and high dose groups were superior to the low dosegroup on the inhibition of the joint swelling, there was no significant difference (P＞0.05).Histopathology examination revealed that Qingrepaidu capsule could abate tissue swelling ofankle joints, reduce inflammatory cell infiltration of synovial tissues and improve thepathologic changes of the hyperplasia of synovial and so on. And the middle and high dosegroups were comparatively remarkable. ELISA tests revealed that the expression levels ofNF-κB, IL-1β and TNF-α in the articular leachate of Qingrepaidu capsule each dose groupwere obviously lower than the model group (P0.01, P0.05). Qingrepaidu capsule middleand high dose groups were better than the low dose group on the inhibition of NF-κB, IL-1βand TNF-α expression, there was no significant difference (P＞0.05).Conclusion:1. Professor Ma Hongbin’s clinical experience in the treatment of goutyarthritis accorded with the clinical practice. Diseases differentiation and syndromedifferentiation in combination, prescription and syndrome in correspondence for treatinggouty arthritis can improve the clinical efficacy.2. Qingrepaidu capsule can relieve theswelling degree of ankle joints in rat models of acute gouty arthritis; improve hyperemia,edema and infiltration of inflammatory cell in joint synovial tissue. It can inhibit theexpression of NF-κB, IL-1β and TNF-α in articular tissue, which may be an importantpreventive and therapeutic mechanism for acute gouty arthritis. Qingrepaidu capsule high,middle dose group is better than the low dose group on the anti-inflammatory function. |
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