| Background:Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease which is characterized by basic pathological joint synovial inflammation. Protraction illness, often involving multiple body joints, eventually leading to loss of joint function and disability, seriously threatening the quality of leaving of patients. Herbal fumigation method with the drug, treat disease outside the body, ease the condition has unique advantages in a wide range of clinical applications. However, herbal fumigation method specific embodiment with the experience, not consistent. the lack of standards, leading herbal fumigation forms, mode of operation also vary widely.Objective:Fumigation by comparing different times, different temperature, different concentrations of liquid on the efficacy of fumigation programs to explore the best method of treatment of RA, in order to find the best efficacy based herbal fumigation method of operation for clinical medicine fumigation. Promote the standardization of traditional Chinese medicine nursing development, and promote continuous improvement of traditional Chinese medicine nursing operation.Methods:(1) We select SD rats were established collagen-induced arthritis (Collagen-Induced Arthritis, CIA) rat model. Rats were randomly divided into model group (n=6), fumigation group 1-9 group (n= 6* 9), model group after modeling without treatment. Fumigation Group 1-9 Group assign different experimental program in accordance with the orthogonal experimental design. Orthogonal table according to the time (20min,30min,40min), temperature (38℃,41℃, 44℃), concentration (low, medium, high) of three factors, three levels of distribution.(2) Baseline comparison:Compare the weight of rats in each group, toe volume.(3) Comparative modeling before the rats, before fumigation two weeks, four weeks fumigation in general.(4) Comparison of rats in each group before the fumigation, Fumigation two weeks, four weeks fumigation weight change.(5) Comparison of rats in each group before the fumigation, Fumigation two weeks, four weeks fumigation toe volume change.(6) We observed each group of rats Fumigation, Fumigation two weeks, four weeks fumigation toe swelling, deformation degree carried AI score, blank control group without the score.(7) Fumigation After 4 weeks, the heart blood, centrifugation, enzyme-linked immunosorbent assay (ELISA), to compare the serum TNF-α, IL-1β levels in rats.(8) Fumigation After 4 weeks, the collection side of the ankle joint pathology tissue samples of each group were evaluated for pathologic morphology.(9) Orthogonal experimental design data variance analysis, calculate the best fumigation program.Results:(1) Rats before modeling weight, volume toe was no significant difference,P> 0.05.(2) The rats before modeling generally in good condition; after modeling, model group, fumigation group 1～9 rats were there joint swelling, injection site skin ulcer appeared some rats; Fumigation 2 weeks,4 weeks, the symptoms continued to increase group rats, rat tail base aggravate ulcers, joint swelling significantly, unable to bear weight, limited mobility, affecting feeding, and even individual rat broken toe, swollen joints of rats fumigation group had improved, joint swelling still evident activity still; the control group was normal.(3) Model group, fumigation group and control group comparison of its time, reduce the body weight, P<0.05, the difference was statistically significant. Fumigation group compared with the body weight of rats in the model group, the rats after fumigation treatment to improve weight loss, body weight of rats in model group continued to decline significantly, P<0.05, the difference was statistically significant. Fumigation group 1～9 rats were assigned different fumigation program in accordance with the orthogonal experimental design, each group showed no significant difference, P> 0.05.(4) Prior to fumigation, fumigation and model group rats compared with the control group significantly increased the volume of toe, comparison of the two P> 0.05, the difference was not statistically significant, comparable. Fumigation two weeks, four weeks, the model group, fumigation group and control group comparison of its time, toe volume were increased, P<0.05, the difference was statistically significant. Fumigation two weeks, four weeks, fumigation group compared with model group, Fumigation group volume decreased, while the model group volume continued to increase, both comparison P<0.05, the difference was statistically significant. Fumigation group 1～9 rats in accordance with the orthogonal experimental design analysis of variance, the best care program for the A2B3C3, namely fumigation 30min, temperature 44℃, a high concentration of liquid.(5) Prior to fumigation and fumigation group model group scores were greater than 4 points, successful model, comparison of the two, P> 0.05, the difference was not statistically significant, both comparable. Fumigation two weeks, four weeks, fumigation group compared with model group, fumigation group scored lower than the model group, P<0.05, the difference was statistically significant. Fumigation group 1-9 rats in accordance with the orthogonal experimental design analysis of variance, the best care program for the A2B3C3, namely fumigation 30min, temperature 44℃, a high concentration of liquid.(6) Four weeks after fumigation, fumigation group 1-9 group compared with the model group, IL-1β levels were significantly decreased, P<0.05, the difference was statistically significant. Fumigation group 1-9 rats in accordance with the orthogonal experimental design analysis of variance, the best care program for the A2C1B1, namely fumigation 30min, low concentration,38℃ liquid.(7) Four weeks after fumigation, fumigation group 1-9 group compared with the model group, TNF-α levels were significantly decreased, P<0.05, the difference was statistically significant. Fumigation group 1-9 rats in accordance with the orthogonal experimental design analysis of variance, that is the best care program for the A2B2C2 Fumigation 30min,41℃, the concentration of the liquid.(8) Pathological HE staining of normal control group of rats. Model group obviously significant proliferation of synovial tissue, a large number of inflammatory cell infiltration, and formation. Fumigation Group synovial thinning, moderate swelling, inflammation slightly lighter.(9) Through the volume weighted toe rats, AI score, IL-1β levels, TNF-a level composite score, combined with fumigation group 1-9 sets of orthogonal experimental design, optimum care program for the A2B2C3. That fumigation time 30min,41℃, a high concentration of liquid.Conclusions(1) After 4 weeks, fumigation group 1～9 group compared with model group, general conditions improved, toe swelling turns relatively light. Pathological staining showed synovial variable thin, inflammatory cell infiltrate mildly. Serum IL-1 level and TNF-level were lower than the model group. Prove that traditional Chinese medicine fuming washing in improving joint function, regulating immunity plays a very important role, but rat paw edema in the short term is still difficult to improve.(2) The best treatment effect in the fumigation of 30min, temperature of 41℃, under the condition of high concentration liquid. In addition, fumigation time 30min, temperature 44℃, high concentration of liquid medicine to improve the effect of joint swelling is better.(3) Fumigation treatment of RA has the best washing time, washing temperature and washing concentration. The results of this study provide an important reference value and reference value for the clinical treatment of RA. |
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