| Clinical researchObjectiveTo investigate the clinical efficacy and safety of Yiqi Huoxue recipe in treating rheumatoid arthritis(RA).MethodsA total of 100 patients with rheumatoid arthritis from January2016 to September 2017 in Wuhan General Hospital of the Chinese people's Liberation Army(PLA)were selected and divided into two groups according to the randomized double-blind method: the test group(n = 50)and the control group(n = 50).The control group was treated with methotrexate,and the test group was treated with methotrexate combined with Yiqi Huoxue prescription.After 3 months of treatment,the difference of the two treatment methods in ACR20?ACR50?ACR70?DAS28?ESR?CRP?anti-CCP and incidence of adverse reactions were compared between the two groups.ResultsAfter3 months of treatment,the two groups of patients in the DAS28?RF?ESR?CRP?anti-CCP were significantly improved than before treatment(P<0.05),the test group in ACR20?ACR50?ACR70?DAS28?RF?ESR?CRP?anti-CCP and so on were significantly improved than the control group(P<0.05),the incidence of adverse reactions in the test group was significantly lower than that in the control group(P<0.05),the incidence of adverse reactions in the test group was significantly lower than that in the control group(P<0.05),and the incidence of adverse reactions in the test group was significantly lower than that in the control group(P<0.05).ConclusionYiqi Huoxue prescription combined with methotrexate can significantly improve the symptoms and biochemical indexes of patients with RA,improve the clinical efficacy and decrease the incidence of adverse reactions.It is worth popularizing in clinic.Experimental researchObjectiveTo investigate the effect of Yiqi Huoxue recipe(YQHXF)on TLRs of synovial tissue of adjuvant arthritis rats(animal model of rheumatoid arthritis),and to explore the mechanism of Yiqi Huoxue prescription(YQHXF)in treating rheumatoid arthritis(RA).To provide a theoretical basis for the application of Yiqi Huoxue recipe in clinic and to provide a new therapeutic target for the clinical treatment of RA.MethodsSixty Wistar rats were randomly divided into blank group,model group,high dose group of Yiqi Huoxue prescription,middle dose group of Yiqi Huoxue prescription,low dose group of Yiqi Huoxue prescription and Tripterygium wilfordii group,except blank group,The other rats were induced by Freund's complete adjuvant to establish adjuvant arthritis model.2 weeks later,each drug groups were given medicines accordingly by gastric perfusion once a day for 3 weeks.The control group and model group were given isopyknic normal saline in the same way.After 3 weeks of drug intervention,the rats were killed by cervical dislocations and the synovial tissues of the knee joints were removed from the rats.The main indicators included arthritis index of rats,toe swelling degree of rats.The histopathological changes of rat synovium and the expression of TLR2?4?9 protein and m RNA in rat synovial tissue.ResultsAfter 3 weeks of gastric perfusion,the toe swelling degree,arthritis index,synovial histopathological changes and the expression of TLR2?4?9 in each model group were significantly higher than those in the blank group(P<0.01),and the toe swelling degree and arthritis index in each administration group were significantly higher than those in the control group(P<0.01).The histopathological changes of synovium and the expression of TLR2?4?9 in the model group were significantly improved than those in the model group(P<0.01),and the swelling degree of toe and arthritis index in the middle and high dose groups of Yiqi Huoxue recipe were significantly improved than those of the model group.The histopathological changes of synovium and the expression of TLR2 ? 4 ? 9 were better than those of low dose group and tripterygium wilfordii group(P<0.05).Conclusion1.TLR2?4?9 may be involved in the occurrence and development of rheumatoid arthritis;2.Yiqi Huoxue prescription can improve the arthritis symptoms of adjuvant arthritis rats,and its therapeutic effect is bette Rthan that of Tripterygium wilfordii polyglycoside tablets.3.The therapeutic mechanism of Yiqi Huoxue recipe on rheumatoid arthritis may be related to the inhibition of the overexpression of TLR2?4?9 in synovial tissue.4.TLR2?4?9 may be a new target for the diagnosis and treatment of rheumatoid arthritis. |
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