| Objective Through the method of clinical drug test to observe the clinicaleffect of Wenyang Huoxue Tongluo method combined with prednisone in treatmentof systemic sclerosis, and to explore its mechanism of action, providing reliabletheoretical basis, objective, scientific for clinical application.Methods1. Collected clinical specimens from patients with SSc, and dividedinto Wenyang Huoxue Tongluo method combined with prednisone treatment group(Chinese medicine and western medicine treatment group) and prednisone treatmentgroup (treatment group of Western Medicine), randomly, after8weeks of treatment,observe its efficiency, skin and joint tenderness integral and integral safety assessmentindex.2. Colleced SSc patients and matched healthy subjects, fasted venous blood2ml from upper limb, extracted and separated peripheral blood mononuclear cells,reverse transcription real-time fluorescence quantitative polymerase chain reaction(RT-PCR) to detect the expression of the mRNA of TGF-β1, CCL2/MCP-1,CCL5/RANTES in patients with systemic sclerosis in peripheral blood mononuclearcells, and compared with normal control group to understand the correlation betweenthe expression of mRNA in PBMC and clinical characteristics of the pathogenicfactor in patients with SSc, and lays the foundation for clearing the mechanism ofWenyang Huoxue Tongluo method combined with prednisone in treatment of thisdisease, deteced the virulence factor expression in patients with SSc who participatedthe clinical drug test, after8weeks of drug treatment.Results1. Clinical observation①36cases of patients with systemic sclerosis,shedding1cases, in Chinese medicine and western medicine treatment group of20cases,containing3cases of male and female17cases, average age is (47.2±11.2), thewestern medicine treatment group of15cases, all were female, mean age (40.8±4.76).Before treatment the basic situation no statistical significance of difference of twogroups(p＞0.05).②In two groups patients after treatment, traditional Chinese medicine combined with western medicine treatment group20cases,cured0(0)%,markedly effective3(15%), effective14(70%), invalid3(15%), the total efficiencyis85%;The control group15cases,cured0(0)%, markedly effective0(0%), effective8(53.3%), invalid7(46.7%), the total effective rate is53.3%, significantly lower thanthe traditional Chinese medicine combined with medicine treatment group (85%), thedifference is statistically significant (p＜0.05).③Before treatment the skin score andjoint tenderness score no significant difference of two groups of patients(p＞0.05),After8weeks drug treatment, two groups of patients skin score and jointtenderness score were decreased to some extent,but traditional Chinese medicinecombined with prednisone treatment is better than the group of prednisone, and thedifference is statistically significant (p＜0.05);④The two groups of patients afterdrug treatment, laboratory examination ESR were significantly decreased，aftertreatment of traditional Chinese and prednisone group, the decrease of ESR differentwas statistically significant (p＜0.05), and the difference has statistical significance oferythrocyte sedimentation rate of two groups after treatment (p＜0.05);⑤The twogroups of patients after treatment showed no obvious adverse reactions and sideeffects, safety indicators also had no abnormalThe experimental results①The relative expression of mRNA in52cases of SScpatients and healthy controls in PBMC TGF--β1,MCP-1, RANTES which RQ valuewere(1.95±1.58),(0.98±0.63),(1.33±0.81),significantly higher than that in healthycontrol group(1.10±0.54),(0.90±0.25),(1.04±0.34), and the difference is statisticallysignificant(p＜0.05);②ESR、CRP in high RQ value group was higher than that oflow RQ value group, and the difference was statistically significant(p＜0.05),complement C3,C4, anti-nuclear antibody positive rates, antibody positive rate of antiScl-70, antibody positive rate of anti Jo-1,interstitial pulmonary fibrosis,and so on,inthe RQ high expression group were higher than the value of RQ low expression group,but the difference was no statistically significant(p＞0.05);③Through thecomparison of difference which transforming growth factor, chemotactic factor of twogroups before and after treatment, found that patients in the two groups after8weeksof treatment can reduce the expression, but Traditional Chinese medicine combined with prednisone group is better than prednisone group,and the difference wasstatistically significant (p＜0.05), while TGF-β1both of the two groups,before andafter treatment, the difference has no statistical significance(p＞0.05).Conclusion1Using Wenyang Huoxue Tongluo method combined withprednisone treat SSc which has certain curative effect in the improvement and controlof skin sclerosis, joint pain, ESR, and has good security;2Upregulation of mRNAexpression of Transforming growth factor (TGF-β1), chemokine (MCP-1, RANTES)on mononuclear cells in peripheral blood (PBMC)of patients with SSc,which maypromote the occurrence and development of SSc;3Wenyang Huoxue Tongluomethod combined with prednisone on the clinical curative effect of prednisone in thetreatment of SSc may inhibit chemokine (MCP-1, RANTES) expression, one of themechanism for the inhibition of expression of the virulence factor may be the antifibrosis... |
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