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白虎追风丸抗RA作用机理研究——对AA大鼠滑膜细胞功能的影响
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摘要
类风湿关节炎是一种以周围关节的对称性多关节炎为主要特
    征的慢性全身性疾病,具有病程长,致残率高等特点。RA的病因
    未明,发病机制尚未完全清楚。已知由滑膜细胞、软骨细胞、巨
    噬细胞等分泌的单核因子如IL-1、TNF等在RA的急性滑膜炎症、
    纤维化,骨及软骨破坏中起主导作用。NO与PGE_2是重要的炎症介
    质,在RA的发病机制中起具有广泛的效应。因此,通过抑制RA
    滑膜分泌过多的细胞因子IL-1、TNF及释放过多的炎症介质NO、
    PGE_2应是治疗RA的可取途径之一。
     白虎追风丸是在白虎加桂枝汤基础上加减而成,具有清热祛
    湿、驱风通络止痛的功效,经多年临床运用证实本方对早期RA
    具有较好疗效。为了深入探讨其抗RA的作用机理,我们以大鼠
    AA作为病理模型,观察了白虎追风丸对AA大鼠的治疗作用,及
    其对原代培养滑膜细胞分泌IL-1β、TNF-α及释放NO、PGE_2的影
    响。
     本课题的研究结果表明:
     1、大鼠滑膜细胞原代培养方法学研究
     滑膜组织通过消化法与组织块培养法均能获得理想的培养
    体系,但消化法可获得三种典型的细胞形态:巨噬细胞样细胞
    (MCs)、成纤维样细胞(FCs)、树突样细胞(DCs),而组织块培
    养法只能获得FCs一种细胞形态。最佳消化分离条件为0.1%胶原
    酶(出含10%小牛血清DMEM完全培养液配制)消化2.5小时,
    再由0.25%胰蛋白酶(D-hanks液配制)消化0.5小时。
     2、白虎追风丸对AA大鼠的治疗作用
     白虎追风丸中、低剂量组使大鼠体重增加且增加量明显高于
    正常组,高剂量组与雷公藤多甙组体重增加量明显低于正常组,
    显示本方剂量相关性地对大鼠体重的增加量呈双向调节作用。白
    虎追风丸各剂量组对AA大鼠致炎侧的足趾肿胀尤其是继发性肿
    
    
    胀显示了良好的抑制作用,但与雷公藤多贰相比无显著性差异。
    改良玻璃容器测量法与足趾厚度法的足趾肿胀率测量结果呈正
    相关。踝关节病理切片显示,白虎追风丸高、中、低剂量组均可
    在不同程度上减轻滑膜水肿及炎性细胞浸h)],尤以高剂量组最为
    明显。雷公藤多贰组也可以减轻滑膜的炎性细胞浸润,但滑膜血
    管扩张较为明显。
     3、白虎追风丸对原代培养滑膜细胞功能的影响
     白虎追风丸各剂量组均可降低AA 大鼠原代滑膜细胞分泌的
    几-!0、TNF-日水平,也可降低培养上清液中 NO、PGEz水平,其
    作用与雷公膝多贰相比无显著性差异。
     本课题以白虎追风丸为处理因素,以AA大鼠为受试对象,通
    过消化法原代培养滑膜细胞,从细胞药理学的角度探讨了本方抗
    RA作用机理,实验结果初步揭示其治疗RA的机理与抑制滑膜细胞
    分泌炎症性细胞因子 IL-16、TNF-口及释放炎症介质 NO、PGEz
    有关,并对今后的进一步研究提出了引入中药血清药理学实验方
    法的设想。
ABSTACT
    Rheumatoid arthritis is a chronic disease mainly characterized
    as peripheral symmetric and polyarticular inflammation, it always
    lasting long time and having high cripple rate. Neither the cause
    nor the mechanism of RA is entirely clear. It has been known that
    monokines including IL- l 0 and TNF- Q secreted by
    synoviocytes, chondrocytes, macrophage have a main effect in the
    many processes of RA, such as acute synovial inflammation,
    fibrosis, distruction of bone and cartilage, etc. As two kinds of
    important inflammatory mediums, nitric oxide (NO) and
    prosglandin E 2 (PGE2) have a widely effect in the mechanism of
    RA. So, it must be a reasonable way to treat RA by restrain the
    synovial membrane secreting too many cytokines such as IL-l 6,
    TNF- Q or releasing too many inflammatory mediums such as NO,
    PGE2.
    Baihu Zhuifeng Wan (BFZFW) was created on the base of
    Baihu JiaGuizhi Tang. It has the effects of clearing heat and
    removing dampness, dispe1ling wind and activating channel,
    alleviating pain. lt has been proved having a good therapeutic
    effect for early RA through clinic operations for many years. To
    study the mechanism of this effect deeply, we observed the
    therapeutic effect on adjuvant arthritis(AA) rats by BHZFW, and
    the effect on the secretion level of IL-l 6,TNF- Q and releasing
    level of NO, PGE2 by primary cultured synoviocytes derived from
    those AA rats.
    The results of this discussion indicate that:
    1. Although we can get primary cultured synviocytes by both
    digesting method and tissue method, just digesting method makes it
    Sure that we can observe three typical kinds of cell shapes:
    3
    
    
    Macrophagelike cells (MCs), fibroblastlike cells (FCs), dendritic
    cells (DCs). At the same time, we get only one kind of cell shape
    by tissue method: FCs. The best condition for digesting
    synoviocyte is digested by 0. l% coIIagenase for 2.5 hours, and the
    digested by 0.25% tripsin for 0.5 hour.
    2.The therapeutic effects of BHZFW on AA rats.
    The middle and low dose of BHZFW obviously make the added
    weight of AA rats larger than the control. High dose and
    triterpenoids make the added weight smaller than the control. Such
    results showe a two way regulation effect to the weight adding of
    AA rats. Each dose of BHZFW showe a good restraining effect on
    the sweIling rate of AA rats' paws, especially the continued
    sweIIing, but there is not obviousIy difference from the effect of
    triterpenoids. There is a positive corre1ation between the paw
    volume method and paw thickness method on measuring the
    swelling rate. Pathological study indicate that all the doses of
    BHZFW can Iighten the synovium sweIling and inflammatory ceIls
    infiltration, high dose is more obviousIy. Triterpenoids also can
    lighten the infiltration of inflammatory cells but always aIong with
    enl arged .vessel s.
    3.The effect of BHZFW to primary synviocyte function.
    Each dose of BHZFW can decrease the IL-l or TNF- Q level
    secreted by primary cultured synviocytes derived'from AA rats, so
    does NO and PGE2. There is not any obvious difference between
    BHZFW and triterpenoids.
    Making BHZFW as treating factor and AA rats as tested object,
    we researched the anti-RA mechanism of BHZFW from the metl1od
    of cytopharmcological by primary cu1tured digested synoviocytes
    in this discussion. The resu1ts of this experiment showe that the
    4
    
    mechanism is concerned with decreased lL- 1 P, TNF- Q secretion
    level and NO, PGE2 releasing level by synoviocytes. In this article
    we also consider the seropharmcological experimental method as
    a usefuI approach tbr fLlture study.
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