| 1 PurposeTo observe the clinical effect of Professor Ding E’s Qiangjishu on patients with ankylosing spondylitis(AS),and its influence on the levels of IL-23/IL-17 axis-related cytokines IL-23,IL-17,IL-22,TNF-α,laboratory related indexes and clinical curative effect indexes.To explore the relationship between IL-23/IL-17 axis-related cytokines and AS,and to study the effect and mechanism of Professor Ding E Qiang Jishu on the expression level of IL-23/IL-17 axis-related cytokines in AS patients2 Methods2.1 Theoretical ResearchBased on clinical practice and studying relevant domestic and foreign literature,explore the relationship between AS and TCM disease names,diseases,disease meridians and etiology,analyze Professor Ding E’s unique insights on the occurrence and development of AS and the origin of the creation of Qiangji Shu Provide a strong argument for the treatment of AS.2.2 Clinical Research2.2.1 Changes and correlation of IL-23/IL-17 axis-related cytokine levels and related indexes in AS patientsFrom the Health Management Center of Anhui Provincial Hospital of Traditional Chinese Medicine,20 healthy subjects were selected as the healthy control group,and60 hospitalized and outpatient AS patients in rheumatology department were selected as the AS group.Two sets of general information are comparable(P > 0.05).IL-23,IL-17,IL-22,TNF-α,ESR,hs-CRP,ASO,IgA and other laboratory indexes were detected in both healthy control group and AS group.The changes of TCM syndrome score,VAS,BASFI,BASDAI,BAS-G,SAS,SDS and SF-36 were observed in 60 patients with AS.SPSS23.0 statistical software was used to analyze the above related data.2.2.2 Effect of Professor Ding E’s Qiangjishu on experimental indexes,clinical efficacy and quality of life of patients with ASSixty AS patients who met the inclusion criteria were randomly divided into control group(tripterygium glycosides tablets group)and study group(Tripterygium glycosides + Qiangjishu group),each with 30 cases.The changes of serum IL-23 / IL-17 axis related factors IL-23,IL-17,IL-22,TNF-α and ESR,hs-CRP,ASO,IgA,TCM syndrome score,VAS,BASFI,BASDAI,BAS-G,SAS,SDS,SF-36 were observed in the two groups.SPSS23.0 statistical software was used to analyze the above related data.3 Results3.1 Theoretical Analysis Results3.1.1 The occurrence and development of AS are closely related to immune infla mmation and bone destruction;3.1.2 Cytokines IL-23,IL-17,IL-22,and TNF-α interact with each other,and levels are closely related to the progression of AS;3.1.3 The disease of AS always belongs to the deficiency of the original and the real,the body is affected by the deficiency,and the disease is caused by decay;3.1.4 Based on the key pathogenesis of AS,strong evidence is provided for Qiangjishu in treating AS.3.2 Clinical Research Results3.2.1 Comparison of IL-23/IL-17 axis-related cytokine levels between AS group and healthy control groupComparing the two groups,the serum levels of IL-23,IL-17,IL-22 and TNF-α in the AS group were significantly higher than those in the healthy control group(P<0.01).3.2.2 Comparison of related laboratory indicators between AS group and healthy control groupIn comparison between the two groups,the levels of serum ESR,hs-CRP,ASO and IgA in patients with AS were significantly higher than those in healthy controls(P<0.01 or P<0.05).3.2.3 Study on the correlation between IL-23/IL-17 axis-related cytokine levels a nd other indicators in AS group(1)Correlation between IL-23/IL-17 axis-related cytokine levels and laboratory indicators in AS groupRelated results showed that the serum IL-23 level of patients in the AS group was positively correlated with ESR,hs-CPR,and ASO(P<0.01);the serum IL-17 level was positively correlated with ESR,hs-CPR,and ASO(P<0.01);Serum IL-22 levels were positively correlated with ESR,hs-CPR,and ASO(P<0.01);TNF-α was positively correlated with ESR,hs-CPR(P<0.01).(2)Correlation between IL-23 / IL-17 axis related cytokines and TCM syndrome score in AS groupRelated results showed that that the level of serum IL-23 in AS patients was positively correlated with lumbosacral back pain,back pain,joint swelling,lumbar spinal activity limitation,morning stiffness,joint fever,joint cold,fatigue,lumbar and knee weakness,stabbing pain,dry mouth,yellow urine,heavy limbs,cold and warm(P < 0.01 or P <0.05);Serum IL-17 level was positively correlated with lumbosacral back pain,spinal back pain,joint swelling,lumbar and spinal activity limitation,morning stiffness,joint fever,fatigue,lumbar and knee pain(P < 0.01).Serum IL-22 level was positively correlated with lumbosacral back pain,spinal back pain,joint swelling,lumbar and spinal activity limitation,morning stiffness,joint fever,joint coldness,fatigue,lumbar and knee weakness,stabbing pain,dry mouth not to drink,yellow urine,limb distress,fear of cold and warm(P < 0.01 or P < 0.05).The level of serum TNF-α was positively correlated with lumbosacral back pain,spinal back pain,joint swelling,lumbar and spinal activity limitation,morning stiffness,joint fever,joint cold,fatigue,lumbar and knee weakness,stabbing pain,dry mouth not to drink,yellow urine,limb distress,fear of cold and warm(P < 0.01 or P < 0.05).(3)Correlation between IL-23 / IL-17 axis-related cytokines levels and clinical efficacy evaluation indexes in AS groupRelated results showed that serum IL-23 levels in AS patients were positively correlated with VAS,BASFI,BASDAI,and BAS-G(P<0.01);serum IL-17 levels were positively correlated with VAS,BASFI,BASDAI,and BAS-G(P <0.01);serum IL-22 levels were positively correlated with VAS,BASFI,BASDAI,and BAS-G(P <0.01);serum TNF-αlevels were positively correlated with VAS,BASFI,BASDAI,and BAS-G(P <0.01 or P<0.05).(4)Correlation between IL-23 / IL-17 axis-related cytokines levels and quality of life assessment indexes in AS groupRelated results showed that serum IL-23 levels in AS group were positively correlated with SAS and SDS(P < 0.01),and negatively correlated with SF-36(GH,PF,RP,RE,BP,VT,MH)Correlation(P < 0.01);IL-17 level is positively correlated with SAS and SDS(P<0.01),and SF-36(GH,PF,RP,RE,BP,VT,MH)was negatively correlated(P< 0.01);IL-22 levels were positively correlated with SAS and SDS(P < 0.01),and SF-36(GH,PF,RP,RE,SF,BP,VT,MH)were negatively correlated(P<0.01 or P<0.05);TNF-α levels were positively correlated with SAS and SDS(P < 0.01),and SF-36(GH,PF,RP,RE,VT,MH)were negatively correlated(P < 0.01).3.2.4 Clinical effect of Qiangjishu on AS patientsCompared between the two groups,the clinical efficacy of the study group was significantly better than that of the control group,which was statistically significant(P<0.05).3.2.5 Effect of Qiangjishu on TCM Syndromes of AS PatientsBoth groups compared,there was no significant difference in clinical efficiency before treatment(P> 0.05),but the clinical significance of the study group was significantly higher than that of the control group(P <0.05).3.2.6 Effect of Qiangjishu on the level of IL-23/IL-17 axis related cytokinesCompared with before treatment,the levels of serum IL-23,IL-17,IL-22 and TNF-α in the two groups were significantly decreased(P < 0.01).Compared with the control group,the serum levels of IL-23,IL-17 and IL-22 in the study group decreased more significantly(P < 0.01 or P < 0.05).3.2.7 Effect of Qiangjishu on Laboratory Related IndexesCompared with before treatment,serum ESR,hs-CPR,ASO and IgA in the two groups were significantly decreased(P < 0.01).Compared with the control group,ESR,hs-CPR and IgA in the study group decreased more significantly(P < 0.05).3.2.8 Effect of Qiangjishu on TCM syndrome integralComparison of the two groups,compared with before treatment,the two groups in improving patients with lumbosacral back pain,back pain,joint swelling,lumbar spinal activity is limited,morning stiffness,joint fever,joint cold,fatigue,waist and knees,stabbing pain,dry mouth do not want to drink,yellow urine,heavy limbs,cold and warm symptoms have played a curative effect(P < 0.01 or P < 0.05).The curative effect of the study group was more prominent than that of the control group in improving the symptoms of lumbosacral back pain,back pain,joint swelling,lumbar spinal activity limitation,morning stiffness,joint cold,lumbar and knee soreness and stabbing pain(P < 0.01 or P < 0.05),especially in improving morning stiffness and stabbing pain(P < 0.01).3.2.9 Effect of Qiangjishu on clinical efficacy-related indicatorsCompared with before treatment,the scores of VAS,BASFI,BASDAI and BAS-G of AS patients in the two groups were significantly decreased(P < 0.01).Compared with the control group,the scores of VAS,BASFI,BASDAI and BAS-G in the study group decreased more significantly(P < 0.01 or P < 0.05).3.2.10 Effect of Qiangjishu on quality of life related indicatorsCompared with before treatment,SAS and SDS scores decreased significantly in both groups(P < 0.01),while SF-36(GH,PF,RP,RE,BP,VT,MH)scores increased significantly(P < 0.01 or P < 0.05).SAS and SDS scores in the study group were significantly lower than those in the control group(P < 0.05),and SF-36(GH,PF,RP,RE,SF,BP,VT,MH)scores were significantly higher than those in the control group(P < 0.01).4 Conclusion4.1 The changes IL-23,IL-17,IL-22 and TNF-α levels related to IL-23 / IL-17 axis play an important role in the evolution of AS diseases;4.2 Based on the pathogenesis of AS,which is the key to the pathogenesis of AS,Qiangjishu is of great significance in treating AS;4.3 Serum IL-23,IL-17,IL-22,and TNF-α levels in AS patients are elevated;4.4 There is a correlation between the level of IL-23/IL-17 axis-related cytokines in AS patients and related laboratory indicators;4.5 The level of IL-23/IL-17 axis-related cytokines in AS patients is correlated with TCM syndrome integral,VAS,BASFI,BASDAI,BAS-G,SAS,SDS,SF-36;4.6 Qiangjishu can improve the total clinical effectiveness and clinical effectiveness,and improve the clinical efficacy;4.7 Qiangjishu can significantly down-regulate the serum levels of IL-23,IL-17,IL-22,and TNF-α in AS patients,and reduce the body’s immune inflammation and bone destruction process;4.8 Qiangjishu can reduce the levels of ESR,hs-CRP,ASO and IgA in patients with AS,reduce disease activity,regulate the body’s immune function,and stabilize the condition;4.9 Qiangjishu can reduce the scores of TCM syndromes,VAS,BASFI,BASDAI,and BAS-G scores of AS patients,and alleviate the corresponding symptoms of AS patients;4.10 Qiangjishu can reduce SAS and SDS points,increase SF-36 points in all dimensions,and improve the quality of life of patients with AS;... |
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