【摘要】：目的:觀察熱補(bǔ)針?lè)▽?duì)風(fēng)寒濕阻型類風(fēng)濕關(guān)節(jié)炎(RA)患者中醫(yī)證候積分及血漿中能量代謝相關(guān)基因ATP合成酶亞單位O(Atp 5O)、溶酶體V1亞單位B 2(Atp 6V1B2)表達(dá)的影響,探討熱補(bǔ)針?lè)?取熱"的分子生物學(xué)機(jī)制。方法:將符合納入標(biāo)準(zhǔn)的60例風(fēng)寒濕阻型RA患者隨機(jī)分為熱補(bǔ)針?lè)ńM、對(duì)照組,每組30例。兩組均取關(guān)元、氣海、足三里和關(guān)節(jié)局部腧穴,熱補(bǔ)針?lè)ńM施以熱補(bǔ)針?lè)?對(duì)照組施以平補(bǔ)平瀉法,1次/d,連續(xù)5次為1個(gè)療程,共治療2個(gè)療程。同時(shí)招募30名健康體檢者作為正常對(duì)照組。觀察患者治療前后中醫(yī)證候積分變化,RT-PCR法檢測(cè)正常人及患者外周血中Atp 5O、Atp 6V1B2 mRNA的表達(dá)。結(jié)果:治療后兩組患者中醫(yī)證候積分均較治療前明顯降低(P0.05),熱補(bǔ)針?lè)ńM證候積分降低較對(duì)照組明顯(P0.05)。治療前RA患者外周血中Atp 5O、Atp 6V1B2 mRNA表達(dá)均較正常人降低(P0.05);治療后兩組患者Atp 5O、Atp 6V1B2 mRNA表達(dá)均較治療前明顯上調(diào)(P0.05),且熱補(bǔ)針?lè)ńM的上調(diào)明顯高于對(duì)照組(P0.05),兩組患者Atp 5O、Atp 6V1B2 mRNA表達(dá)與正常對(duì)照組的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:熱補(bǔ)針?lè)ㄉ险{(diào)血漿中能量代謝相關(guān)基因Atp 5O、Atp 6V1B2的表達(dá)是改善風(fēng)寒濕阻型RA患者癥狀和"取熱"的分子機(jī)制之一。
[Abstract]:Methods: 60 RA patients with wind-cold and dampness resistance were randomly divided into heat supplement acupuncture group and control group with 30 cases in each group. Guanyuan, Qihai, Zusanli and joint local acupoints were taken in both groups. Heat supplement acupuncture was used in the heat supplement acupuncture group, and the control group was treated with the flat tonifying and flattening and reducing method once a day, for 5 consecutive times as a course of treatment for 2 courses of treatment. At the same time, 30 healthy people were recruited as the normal control group. The changes of TCM syndromes before and after treatment were observed. RT-PCR was used to detect the expression of Atp 5 OG Atp 6V1B2 mRNA in the peripheral blood of normal subjects and patients. Results: after treatment, the scores of TCM syndromes in the two groups were significantly lower than those before the treatment (P0.05), and the scores of syndrome in the heat supplement acupuncture group were significantly lower than those in the control group (P0.05). Before treatment, the expression of Atp 5OO P 6V1B2 mRNA in peripheral blood of RA patients was significantly lower than that of normal controls (P0.05), and the expression of Atp 5OO Atp 6V1B2 mRNA in both groups was significantly higher than that before treatment (P0.05), and the up-regulation of Atp 5OO Atp 6V1B2 mRNA in heat supplementation group was significantly higher than that in control group (P0.05), and the Atp 5OU Atp expression in both groups was significantly higher than that in control group (P0.05). There was no significant difference between 6V1B2 mRNA expression and normal control group (P0.05). Conclusion: the up-regulation of the expression of Atp _ 5OO _ (Atp) 6V1B2 is one of the molecular mechanisms for improving symptoms and "heat removal" in patients with RA with wind-cold and dampness resistance.
【作者單位】： 甘肅中醫(yī)藥大學(xué)醫(yī)學(xué)技術(shù)學(xué)院;蘭州大學(xué)第二醫(yī)院中醫(yī)科;甘肅中醫(yī)藥大學(xué)針灸推拿學(xué)院;甘肅中醫(yī)藥大學(xué)附屬醫(yī)院風(fēng)濕骨病科;
【基金】：甘肅省自然科學(xué)基金項(xiàng)目(No.1208RJZA 185) 國(guó)家中醫(yī)藥管理局甘肅鄭氏針?lè)▽W(xué)術(shù)流派傳承工作室項(xiàng)目(No.2305135901)
【分類號(hào)】：R246.1

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