摘要
目的观察艾灸治疗对类风湿关节炎(Rheumatoid arthritis,RA)患者血清中白介素-35(Interleukin-35,IL-35)、β-连环蛋白(β-catenin)、骨形成蛋白-2(bone morphogenetic protein-2,BMP-2)、白介素-1β(Interleukin-1β,IL-1β)的影响,探讨艾灸通过对类风湿关节炎患者骨代谢的影响,起到骨保护的作用机制。方法随机将72例RA患者分为治疗组(36例)和对照组(36例)。对照组采用常规西药治疗。治疗组采用常规西药和艾灸足三里、肾俞、阿是穴治疗,每周治疗3次,共治疗5周。比较两组RA患者治疗前后的临床症状相关评分、常规临床检验指标以及血清中IL-35、β-catenin、BMP-2、IL-1β的含量。结果治疗后,两组患者VAS评分、DAS28评分、晨僵评分和血清中BMP-2、β-catenin、IL-1β均显著降低(P<0.01),治疗组IL-35含量显著升高(P<0.01)。治疗组VAS评分、DAS28评分、晨僵评分和血清中BMP-2、β-catenin、IL-1β改善程度均优于对照组(P<0.05),但两组血清IL-35含量差异无统计学意义(P>0.05)。治疗组晨僵评分、关节肿胀数的改善值与血清中BMP-2改善值成正相关(P<0.01,P<0.05,r>0);治疗组RA患者治疗前后血清中β-catenin的改善值与晨僵评分改善值成正相关(P<0.05,r>0);治疗组血清中IL-35的改善值与DAS28评分改善值成负相关(P<0.05,r<0)。结论在常规西药治疗基础上,艾灸可能通过抑制RA患者血清中IL-35、IL-1β的水平,调节Wnt/β-catenin信号通路,调控β-catenin及BMP-2水平,降低RA炎症反应,调节骨代谢,达到骨保护的目的,从而预防和延缓RA患者的骨关节致畸或致残。
Objective To explore the effect of moxibustion on bone metabolism and the mechanism of bone protection,the effect of moxibustion,a traditional Chinese treatment in patients with rheumatoid arthritis(RA),especially the levels of two biomarkers,interleukin 35(IL-35)andβ-catenin in the serum of rheumatoid arthritis patients were investigated.Methods A total of 72 RA patients were randomly assigned equally to the treatment group(36 cases)and 36 patients each of the control group(36 cases).The control group was intervened with standardized Western medicine treatment.For the treatment group,moxibustion intervened on Zusanli,Shenshu,and Ashi acupoints three times a week for 5-week treatment,with the remaining treatments being the same as the control group.The clinical symptom-related scores,routine clinical test indicators,and serum IL-35,β-catenin,BMP-2,IL-1βcontents of RA patients before and after treatment were compared between the two groups.Results After treatment,VAS score,DAS28 score,morning stiffness score and BMP-2,β-catenin and IL-1βin serum in 2 groups significantly decreased(P<0.01),while IL-35 content in treatment group significantly increased(P<0.01).VAS score,DAS28 score,morning stiffness score and BMP-2,β-catenin and IL-1βin serum showed the obvious advantage of the treatment group over the control group(P<0.05),but the two groups(P>0.05)have no significant discrepancy in serum IL-35 content.For the treatment group,the improvement values of morning stiffness score and joint swelling number were positively correlated with the improvement values of BMP-2 andβ-catenin in serum(P<0.01,P<0.05,r>0).The improvement of serum IL-35 was negatively correlated with the improvement of DAS28 score in the treatment group(P<0.05,r<0).Conclusion On the basis of conventional western medicine treatment,moxibustion may inhibit the levels of IL-35 and IL-1βin serum of RA patients,regulate the Wnt/β-catenin signaling pathway,regulate the levels ofβ-catenin and BMP-2,reduce the inflammatory response of RA,regulate bone metabolism,and achieve the purpose of bone protection.Thus,bone and joint teratogenesis or disability in RA patients was prevented and delayed.
作者
王惠
武平
唐洁
陶偲钰
汪雪
杨宜
李媛
WANG Hui;WU Ping;TANG Jie;TAO Siyu;WANG Xue;YANG Yi;LI Yuan(Acupuncture and Massage,Chengdu University of TCM,Chengdu 610075,China;Traditional Chinese Medicine Doctor of Emei City,Emei 614200,China;The Affiliated Hospital of Chengdu University of TCM and Sichuan Provincial Hospital of TCM,Chengdu 610075,China)
出处
《世界科学技术-中医药现代化》
北大核心
2025年第5期1253-1259,共7页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家自然科学基金委员会面上项目(81373738):艾灸抑制RA滑膜血管翳形成的VEGF分子信号传导机制研究,负责人:武平
四川省科技厅科技计划重大前沿项目(2017JY0016):艾灸对类风湿关节炎患者VEGE的调节作用及相关因子影响的研究,负责人:武平。
