OBjECTIVE:To observe the efficacy and safety of oral Sanhuangwuji powder,anti-rheumatic drugs(ARDs),and ginger-partitioned acupoint stimulation at Zusanli(ST 36) on the treatment of rheumatoid arthritis(RA) complicate...OBjECTIVE:To observe the efficacy and safety of oral Sanhuangwuji powder,anti-rheumatic drugs(ARDs),and ginger-partitioned acupoint stimulation at Zusanli(ST 36) on the treatment of rheumatoid arthritis(RA) complicated by peptic ulcer.METHODS:This prospective randomized controlled study included 180 eligible inpatients and outpatients randomly assigned to an ARD treatment(n = 60),ginger-partitioned stimulation(n =60),or combination treatment(n = 60).Patients assigned to the ARD group were given oral celecoxib,methotrexate,and esomeprazole.Patients assigned to theginger-partitioned stimulation group were given ginger-partitioned acupoint stimulation at Zusanli(ST 36) in addition to the ARDs.Patients in the combination treatment group were given oral Sanhuangwuji powder,ginger-partitioned acupoint stimulation at Zusanli(ST 36),and ARDs.All patients were followed up for 2 months to evaluate clinical effects and safety.The study was registered in the World Health Organization database at the General Hospital of Chengdu Military Area Command Chinese People's Liberation Army(ChiCTR-TCC12002824).RESULTS:The combination treatment group had significantly greater improvements in RA symptoms,laboratory outcomes,and gastrointestinal symptom scores,compared with the other groups(P < 0.05).The peptic ulcer healing rate in the combination treatment group was significantly greater than that in the ARD treatment group(x^2 = 16.875,P < 0.05) and the ginger-partitioned stimulation group(x^2 = 6.171,P<0.05).CONCLUSION:Combination treatment with ginger-partitioned acupoint stimulation at Zusanli(ST36),oral Sanhuangwuji powder,and ARDs had a better clinical effect for RA with complicated peptic ulcer,compared with ARD treatmentalone or in combination with ginger-partitioned acupoint stimulation.展开更多
OBJECTIVE: To investigate the effect of Sanhuangyilong decoction plus methotrexate(MTX) on Interferon gamma(IFN-γ) and tumor necrosis factor alpha(TNF-α) in the serum and synovial fluid of rheumatoid arthritis(RA) p...OBJECTIVE: To investigate the effect of Sanhuangyilong decoction plus methotrexate(MTX) on Interferon gamma(IFN-γ) and tumor necrosis factor alpha(TNF-α) in the serum and synovial fluid of rheumatoid arthritis(RA) patients with damp-heat-obstruction symptom pattern, Sanhuangyilong decoction and the role of TNF-α and IFN-γ in the development of RA.METHODS: RA inpatients with damp-heat-obstruction symptom pattern(partly with knee joint effusion) were selected as the research subjects. Before the treatment, healthy subjects and osteoarthritis(OA) patients with knee joint effusion were assigned to the serum control group and the synovial fluid control group, respectively; during the treatment, RA patients with damp-heat-obstruction symptom pattern were divided into two groups:one is combined group that was administered Sanhuangyilong decoction plus MTX; the other group was MTX group that received MTX only. The expression levels of TNF-α and IFN-γ in the serum and synovial fluid were measured with enzyme-linked immunosorbent assay(ELISA) before and after the treatment, and the peripheral blood levels of erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and disease activity score in 28 joints(DAS28)were determined.RESULTS: Before treatment, the serum levels of TNF-α and IFN-γ in the RA patients with dampheat-obstruction symptom pattern were higher than those in healthy control group(P < 0.05).The expression levels of TNF-α and IFN-γ in the synovial fluid of the RA patients were higher than those in the serum of the RA patients(P < 0.05). The expression levels of TNF-α and IFN-γ in the synovial fluid of the RA patients were higher than those of the sy-novial fluid of the osteoarthritis patients(P < 0.05).The expression of TNF-α and IFN-γ in the serum and synovial fluid of the RA patients had no correlation with the inflammatory activity index ESR, CRP,or DAS28(P > 0.05). After 2 weeks of treatment, the expression level of TNF-α and IFN-γ in the combined group had increased, although the difference was not statistically significant(P > 0.05); in contrast, ESR, CRP, and DAS28 decreased, and the difference was statistically significant(P < 0.01). After 4 weeks of therapy, TNF-alpha and IFN-γ, ESR,CRP, and DAS28 in the combined group decreased compared with the before-treatment levels(P <0.01). After 2 w of treatment, the differences in the TNF-α and IFN-γ expression levels in the combined group were not statistically significant(P > 0.05)compared with that in the MTX group, although there were statistically significant differences in the ESR, CRP, and DAS28(P < 0.05). After 4 weeks of treatment, differences in TNF-α, IFN-γ, ESR, CRP, and DAS28 in the combined group compared with MTX group were statistically significant(P < 0.01).CONCLUSION: TNF-α and IFN-γ might be involved in the development of RA. The RA patients with damp-heat-obstruction symptom pattern show better benefits from the treatment of Sanhuangyilong decoction plus MTX, and the treatment is superior to that of using MTX only.展开更多
OBJECTIVE:To study the effect of methotrexate(MTX) combined with Sanhuang Yilong decoction(SYD) on aquaporin(AQP) expression,and to explore the role of AQPs in the pathogenesis of rheumatoid arthritis(RA).METHODS:A to...OBJECTIVE:To study the effect of methotrexate(MTX) combined with Sanhuang Yilong decoction(SYD) on aquaporin(AQP) expression,and to explore the role of AQPs in the pathogenesis of rheumatoid arthritis(RA).METHODS:A total of 118 dampness-heat blockage type RA patients who were hospitalized in the General Chengdu Military Hospital between January2014 and December 2016 were selected as subjects in this study(30 patient of these patients with knee joint effusion were assigned to the RA synovial fluid group).For the pre-treatment controlgroups,30 healthy volunteers were recruited as the healthy control group and 30 osteoarthritis(OA) patients with knee joint effusion were included as OA synovial fluid control group.The RA dampnessheat blockage syndrome treatment groups were divided into 45 cases in the combined group and 45 cases in the MTX group.The combined group received MTX combined with SYD treatment while the MTX group received MTX alone.AQP1,AQP2 and AQP3 expressions were detected in the serum and synovial fluid.RESULTS:AQP1 had the highest expression,followed by AQP3,and AQP2.The serum levels of AQP1,AQP2 and AQP3 were all significantly lower than those in the healthy volunteers(P < 0.05),while the synovial fluid AQP1,AQP2 and AQP3 expression in the RA group were comparable to these in the OA groups(P > 0.05).After treatment for2 weeks,serum AQP1,AQP2,AQP3 were significantly increased and erythrocyte sedimentation rate,C-reactive protein,disease activity score of 28 joints were decreased in the combined group(P < 0.05).CONCLUSION:Abnormal expression of AQPs inhibits water metabolism in RA dampness-heat blockage syndrome,so liquid is accumulated at the joint,which may play an important role in the pathogenesis of RA.MTX combined with SYD for the treatment of RA can effectively increase AQP expression.展开更多
Objective： To observe the expression of CD13/APN in peripheral blood lymphocytes and skin lesions of patients with advanced psoriasis vulgaris, and discuss its effect on the pathogenesis of psoriasis. Methods： CD 13...Objective： To observe the expression of CD13/APN in peripheral blood lymphocytes and skin lesions of patients with advanced psoriasis vulgaris, and discuss its effect on the pathogenesis of psoriasis. Methods： CD 13 expression in peripheral blood lymphocytes and skin lesions was detected by flow cytometry and imrnunohistochemical technique, respectively. Results were compared with those of healthy controls. Results： CD 13 expression was significantly higher in peripheral blood lymphocytes of patients with advanced psoriasis vulgaris than in that of healthy controls, and in skin lesions than in healthy skin tissues. The expression was mainly in the suprabasal layers of skin lesions, and positively correlated to PASI （R 0.78029）. Conclusion： The significantly higher expression of CD13 in peripheral blood lymphocytes and skin lesions of the patients with advanced psoriasis vulgaris probably is related to immunological abnormality, blood vessel abnormality and proliferation of keratinocyte in the pathogenic course of psoriasis. It may be a novel and effective way to treat psoriasis with specific CD13 inhibitors.展开更多
基金the Scientific Research Foundation of Sichuan Health Department(Study of the Regulatory Mechanism of Th Cells in Rheumatoid Arthritis Treated with Sanhuangylong Decoction and Its Component United With Methotrexate,No.120573)
文摘OBjECTIVE:To observe the efficacy and safety of oral Sanhuangwuji powder,anti-rheumatic drugs(ARDs),and ginger-partitioned acupoint stimulation at Zusanli(ST 36) on the treatment of rheumatoid arthritis(RA) complicated by peptic ulcer.METHODS:This prospective randomized controlled study included 180 eligible inpatients and outpatients randomly assigned to an ARD treatment(n = 60),ginger-partitioned stimulation(n =60),or combination treatment(n = 60).Patients assigned to the ARD group were given oral celecoxib,methotrexate,and esomeprazole.Patients assigned to theginger-partitioned stimulation group were given ginger-partitioned acupoint stimulation at Zusanli(ST 36) in addition to the ARDs.Patients in the combination treatment group were given oral Sanhuangwuji powder,ginger-partitioned acupoint stimulation at Zusanli(ST 36),and ARDs.All patients were followed up for 2 months to evaluate clinical effects and safety.The study was registered in the World Health Organization database at the General Hospital of Chengdu Military Area Command Chinese People's Liberation Army(ChiCTR-TCC12002824).RESULTS:The combination treatment group had significantly greater improvements in RA symptoms,laboratory outcomes,and gastrointestinal symptom scores,compared with the other groups(P < 0.05).The peptic ulcer healing rate in the combination treatment group was significantly greater than that in the ARD treatment group(x^2 = 16.875,P < 0.05) and the ginger-partitioned stimulation group(x^2 = 6.171,P<0.05).CONCLUSION:Combination treatment with ginger-partitioned acupoint stimulation at Zusanli(ST36),oral Sanhuangwuji powder,and ARDs had a better clinical effect for RA with complicated peptic ulcer,compared with ARD treatmentalone or in combination with ginger-partitioned acupoint stimulation.
基金Supported by National Natural Science Foundation Project of China(Investigation of the Influence of Functional Polymorphisms in ANAPC4 on Susceptibility to Rheumatoid Arthritis,No.81072455)the Army Medical Research "Twelfth Five Year Plan" Key Project(High Humidity Environment Factors Damage the Establishment of Appropriate Technology Platform and Study Comprehensive Medical Service Safeguard Measures,No.BWS11J06)the Sichuan Provincial Health Department(Study the Regulatory Mechanism of the Cells in Rheumatoid Arthritis Treated with Sanhuangyilong Decoction and its Component united with Methotrexate,No.120573)
文摘OBJECTIVE: To investigate the effect of Sanhuangyilong decoction plus methotrexate(MTX) on Interferon gamma(IFN-γ) and tumor necrosis factor alpha(TNF-α) in the serum and synovial fluid of rheumatoid arthritis(RA) patients with damp-heat-obstruction symptom pattern, Sanhuangyilong decoction and the role of TNF-α and IFN-γ in the development of RA.METHODS: RA inpatients with damp-heat-obstruction symptom pattern(partly with knee joint effusion) were selected as the research subjects. Before the treatment, healthy subjects and osteoarthritis(OA) patients with knee joint effusion were assigned to the serum control group and the synovial fluid control group, respectively; during the treatment, RA patients with damp-heat-obstruction symptom pattern were divided into two groups:one is combined group that was administered Sanhuangyilong decoction plus MTX; the other group was MTX group that received MTX only. The expression levels of TNF-α and IFN-γ in the serum and synovial fluid were measured with enzyme-linked immunosorbent assay(ELISA) before and after the treatment, and the peripheral blood levels of erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and disease activity score in 28 joints(DAS28)were determined.RESULTS: Before treatment, the serum levels of TNF-α and IFN-γ in the RA patients with dampheat-obstruction symptom pattern were higher than those in healthy control group(P < 0.05).The expression levels of TNF-α and IFN-γ in the synovial fluid of the RA patients were higher than those in the serum of the RA patients(P < 0.05). The expression levels of TNF-α and IFN-γ in the synovial fluid of the RA patients were higher than those of the sy-novial fluid of the osteoarthritis patients(P < 0.05).The expression of TNF-α and IFN-γ in the serum and synovial fluid of the RA patients had no correlation with the inflammatory activity index ESR, CRP,or DAS28(P > 0.05). After 2 weeks of treatment, the expression level of TNF-α and IFN-γ in the combined group had increased, although the difference was not statistically significant(P > 0.05); in contrast, ESR, CRP, and DAS28 decreased, and the difference was statistically significant(P < 0.01). After 4 weeks of therapy, TNF-alpha and IFN-γ, ESR,CRP, and DAS28 in the combined group decreased compared with the before-treatment levels(P <0.01). After 2 w of treatment, the differences in the TNF-α and IFN-γ expression levels in the combined group were not statistically significant(P > 0.05)compared with that in the MTX group, although there were statistically significant differences in the ESR, CRP, and DAS28(P < 0.05). After 4 weeks of treatment, differences in TNF-α, IFN-γ, ESR, CRP, and DAS28 in the combined group compared with MTX group were statistically significant(P < 0.01).CONCLUSION: TNF-α and IFN-γ might be involved in the development of RA. The RA patients with damp-heat-obstruction symptom pattern show better benefits from the treatment of Sanhuangyilong decoction plus MTX, and the treatment is superior to that of using MTX only.
基金the Army Medical Research Twelfth Five Year Plan Key Project(No.BWS11J06)the Sichuan Provincial Health Department(No.120573)
文摘OBJECTIVE:To study the effect of methotrexate(MTX) combined with Sanhuang Yilong decoction(SYD) on aquaporin(AQP) expression,and to explore the role of AQPs in the pathogenesis of rheumatoid arthritis(RA).METHODS:A total of 118 dampness-heat blockage type RA patients who were hospitalized in the General Chengdu Military Hospital between January2014 and December 2016 were selected as subjects in this study(30 patient of these patients with knee joint effusion were assigned to the RA synovial fluid group).For the pre-treatment controlgroups,30 healthy volunteers were recruited as the healthy control group and 30 osteoarthritis(OA) patients with knee joint effusion were included as OA synovial fluid control group.The RA dampnessheat blockage syndrome treatment groups were divided into 45 cases in the combined group and 45 cases in the MTX group.The combined group received MTX combined with SYD treatment while the MTX group received MTX alone.AQP1,AQP2 and AQP3 expressions were detected in the serum and synovial fluid.RESULTS:AQP1 had the highest expression,followed by AQP3,and AQP2.The serum levels of AQP1,AQP2 and AQP3 were all significantly lower than those in the healthy volunteers(P < 0.05),while the synovial fluid AQP1,AQP2 and AQP3 expression in the RA group were comparable to these in the OA groups(P > 0.05).After treatment for2 weeks,serum AQP1,AQP2,AQP3 were significantly increased and erythrocyte sedimentation rate,C-reactive protein,disease activity score of 28 joints were decreased in the combined group(P < 0.05).CONCLUSION:Abnormal expression of AQPs inhibits water metabolism in RA dampness-heat blockage syndrome,so liquid is accumulated at the joint,which may play an important role in the pathogenesis of RA.MTX combined with SYD for the treatment of RA can effectively increase AQP expression.
文摘Objective： To observe the expression of CD13/APN in peripheral blood lymphocytes and skin lesions of patients with advanced psoriasis vulgaris, and discuss its effect on the pathogenesis of psoriasis. Methods： CD 13 expression in peripheral blood lymphocytes and skin lesions was detected by flow cytometry and imrnunohistochemical technique, respectively. Results were compared with those of healthy controls. Results： CD 13 expression was significantly higher in peripheral blood lymphocytes of patients with advanced psoriasis vulgaris than in that of healthy controls, and in skin lesions than in healthy skin tissues. The expression was mainly in the suprabasal layers of skin lesions, and positively correlated to PASI （R 0.78029）. Conclusion： The significantly higher expression of CD13 in peripheral blood lymphocytes and skin lesions of the patients with advanced psoriasis vulgaris probably is related to immunological abnormality, blood vessel abnormality and proliferation of keratinocyte in the pathogenic course of psoriasis. It may be a novel and effective way to treat psoriasis with specific CD13 inhibitors.
