Effect Of Han Bi Kang Decoction On Patients With Secondary Osteoporosis Of Rheumatoid Arthritis In Peripheral Blood RANKL/OPG

Objective: To investigate the expression of RANKL/OPG Han Bi Kang Decoction on patients with secondary osteoporosis of rheumatoid arthritis in the peripheral blood..Methods: Select the outpatient department of Rheumatology in our hospital and hospitalization in patients with secondary osteoporosis of rheumatoid arthritis in 80 cases.By using the random number table method were randomly divided into treatment group and control group with 40 cases in each group.Therapy by oral administration of Leflunomide Tablets 20 mg Methotrexate Tablets 10 mg 1 times a day,1 times a week,the control group was treated on the basis of taking carbonate calcium D3 1 tablets 1 times daily,Alfacalcidol Capsules 0.5ug 1 times a day.The treatment group was treated on the Han Bi Kang Tang(decoction free),each of the 1 pay,warm water,1,2,12 weeks.Each group were in the 0,4,8,12 week in case evaluation,the number of joint tenderness,joint swelling the number,time of morning stiffness,pain level vision control table value,DAS28 score,ELISA to detect80 cases of RA patients peripheral blood osteoprotegerin by ELISA(Osteoprotegerin,OPG)and receptor activator of nuclear factor-k B ligand(Recep Tor activator of nuclear factor-k B ligand,RANKL)level.The determination of ESR,C-reactive protein,rheumatoid factor and anti cyclic citrullinated peptide antibody,bone alkaline phosphatase,bone mineral density measurement.Results:The efficiency of the two groups,the control group was 80%,the effective rate of treatment group 91.9%,two groups had no statistically significant efficiency difference(Z=1.536,P>0.05,99%CI:0.144~0.163).The two groups were compared in patients with symptoms and signs index,after4,8,12 weeks treatment,two groups of patients were compared with before treatment,the time of morning stiffness,joint tenderness,joint swelling,28 joint disease activity score(Disease activity score in 28 joints,DAS28),pain visual analogue score(Visual level analog screen,VAS),TCM syndrome score were significantly reduced,the difference was statistically significant(P<0.05),between the two groups,the treatment group faster decreased(P<0.05).The two groups before and after treatment,bone alkaline phosphatase,rheumatoid factor,anti CCP antibody,C-reactive protein,erythrocyte sedimentation rate compared with before treatment were decreased,the difference was statistically significant(P < 0.05),the two groups A comparison of treatment group and control group decreased more significantly(P<0.05).In 12 weeks after the treatment,OPG detection of two groups of peripheral blood,the level of RANKL,after treatment of patients with OPG levels in the two groups were increased to some extent,the level of RANKL,RANKL/OPG ratio decreased,the difference was statistically significant(P < 0.05),between the two groups,the treatment group compared with control group,OPG level and RANKL level.The ratio of RANKL/OPG was more significant(P <0.05),the increased OPG level and decreased the level of RANKL,RANKL/OPG ratio of treatment group was more significant.Compared with the normal group,the patients with OPG,RANKL two groups was statistically significant difference of the ratio of RANKL/OPG(P<0.05),while the levels of OPG after treatment,and the ratio of RANKL/OPG there are still differences in normal group(P<0.05),the difference between the RANKL level and the normal group was not significant(P>0.05).Two groups of patients after treatment compared with before treatment,the bone density was not statistically significant(P>0.05),between the two groups,the treatment group compared with the control group at the lumbar spine,femur No statistically significant differences in carotid(P> 0.05),but there were significant differences in both Ward BMD(P <0.05).OPG,RANKL,ROC area under the RANKL/OPG curve indicated that the accuracy of the diagnostic test medium(P=0.001).Two groups of patients with no serious adverse reactions during treatment.The control group were followed up for 3 months in 10 cases of recurrence,the recurrence rate was28.57%,the treatment group had 3 cases of recurrence,the recurrence rate was 8.11%,the rate of recurrence was statistically significant difference between the two(=5.09,P=0.024,OR=0.221,95%CI:0.055 ~ 0.885)Conclusion(s):Han Bi Kang decoction can regulate osteoclast activity,stimulate bone cells,improve the level of OPG in human serum,reduce the ratio of the level of RANKL and RANKL/OPG,the inhibition of osteoclast formation and activation of osteoclasts,promote apoptosis,prevent bone resorption,prevent bone destruction,promote bone repair to have obvious protective effect on bone,the osteoclast and osteoblast balance,which may be one of the mechanisms of the drug for the treatment of rheumatoid arthritis.