摘要
目的观察中药青蒿对类风湿关节炎(RA)患者外周血和滑膜细胞培养液TNF-α、IL-6水平的影响,探讨青蒿治疗RA的免疫机制。方法 (1)入选50例活动性RA患者,随机分为两组,对照组口服甲氨蝶呤(MTX)10 mg,1次/w。治疗组服中药青蒿20 g,1剂/d;MTX 10 mg,1次/w。两组疗程均为12 w。用ELISA法检测两组治疗前后血清TNF-α、IL-6水平。(2)收集25例活动性RA患者关节液标本,体外分离培养滑膜细胞,以生长良好的3～5代滑膜细胞进行实验,分为对照组、青蒿琥酯(ART)12.5μg/ml组、MTX 20μg/ml组、ART+MTX组。结果 (1)两组RA患者血清IL-6水平均较治疗前显著降低(P<0.05);治疗后治疗组TNF-α水平较治疗前降低(P<0.05),对照组TNF-α水平虽较治疗前降低,但差异无显著性(P>0.05),治疗后治疗组的TNF-α水平较对照组显著降低(P<0.05);治疗后两组IL-6水平无显著差异(P>0.05);(2)RA患者滑膜细胞IL-6、TNF-α水平变化:ART 12.5μg/ml、MTX 20μg/ml及两种药物的混合液分别处理滑膜细胞48 h后,培养上清液中TNF-α、IL-6水平均较对照组降低(P<0.05);组间比较,ART与MTX联合应用较单用一种药物能更显著降低细胞因子水平(P<0.05)。结论青蒿能明显降低RA患者的TNF-α、IL-6水平,这可能是青蒿治疗RA的作用机制之一。
Objective To investigate the effects of abrotani herba on TNF - α and IL - 6 levels in the culture solution of peripheral blood and fibroblast - like synoviocytes （FKS） of patients with rheumatoid arthritis （ RA）, and to discuss the immunologic mechanism of treatment of RA with abrotani herba. Methods （ 1 ） Fifty patients with active RA were randomly divided into two groups. The patients in control group took 10 mg methotrexate （MTX）once per week. Those in treatment group took a dose of 20 g abrotani herba per day and 10 mg MTX once per week. The course of treatment for both groups was equally 12 w. The serum TNF - α and IL - 6 levels of the two groups were detected by enzyme - linked immunosorbent assay （ELISA） before and after the treatment. （ 2 ） The synovia samples of 25 patients with active RA were collected. The FLS were isolated and cultured in vitro. The well - growing 3rd - 5th generations of FLS were divided into the control group, the group treated with 12.5 μg/ml artesunate （ART）, the group treated with 20 μg/ml MTX and the group treated with both ART and MTX. Results （ 1 ） Compared with the conditions before the treatment, the serum IL - 6 level in RA patients of the two groups decreased significantly （ P 〈 0.05）, and the TNF - α level of the treatment group decreased after the treatment（P 〈 0.05 ）. Although the TNF - α level of the control group decreased after the treatment, there was no significant difference（P 〉0.05 ）. The TNF - α level of the treatment group remarkably decreased after the treatment（ P 〈 0.05 ）, compared with that of the control group. There was no significant difference in IL - 6 levels between the two groups （ P 〉 0.05 ）. （2） The IL - 6 and TNF - α levels of synoviocyte in RA patients changed as follow：compared with the control group, the TNF -α and IL - 6 levels in the cultured supernatant all decreased after the synoviocyte was respectively treated with ART, MTX and the mixed liquor of both medicines
出处
《西南国防医药》
CAS
2012年第1期4-7,共4页
Medical Journal of National Defending Forces in Southwest China
基金
四川省卫生厅课题资助项目(080094)
关键词
青蒿
甲氨蝶呤
类风湿关节炎
细胞因子
abrotani herba
methotrexate
rheumatoid arthritis
cytokine
