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目的:观察痹肿消汤对实验性关节炎大鼠滑膜组织血管内皮生长因子(vscularendothelialgrowthfactor,VEGF)表达水平的影响,探讨痹肿消汤治疗类风湿性关节炎的作用机制。方法:75只SD大鼠按随机数字表法分为4组(正常对照组,模型对照组,甲氨蝶呤治疗组,痹肿消汤治疗组),皮下注射Ⅱ胶原诱导实验性关节炎模型,用免疫组化法检测各组不同时间点大鼠滑膜组织VEGF的表达,同时采用关节指数积分法评价其关节炎症状。结果:免疫大鼠88.57%出现关节炎症状;模型组的关节炎指数逐渐增加,而痹肿消汤组和甲氨蝶呤组关节炎指数则在35d后逐渐下降。正常组滑膜组织未见明显VEGF表达,模型组VEGF表达犤(30.6±6.2)%于25d起就明显高于痹肿消汤组犤(16.2±4.4)%犦(P<0.001)和甲氨蝶呤组犤(24.4±3.6)%犦(P<0.001);随着时间的延长,模型组VEG表达逐渐升高,痹肿消汤组与甲氨蝶呤组的VEGF表达逐渐降低,于45d模型组更明显高于痹肿消汤组(P<0.001)和甲氨蝶呤组(P0.001),且痹肿消汤组又低于甲氨蝶呤组(P<0.001)。结论:VEGF参与了RA疾病滑膜炎的形成和发展过程;其VEGF表达的高低与关节炎症状的轻重有关。痹肿消汤可能通过阻断VEGF的表达来阻抑关节炎滑膜血管翳的形成或骨质侵袭。
OBJECTIVE: To observe the effect of Qizhongxiao decoction on the expression of vascular endothelial growth factor (VEGF) in the synovial tissue of experimental arthritis rats, and to explore the mechanism of the treatment of rheumatoid arthritis by Bianzhongxiao Decoction. Methods: Seventy-five SD rats were divided into four groups according to the random number table method (normal control group, model control group, methotrexate treatment group, Quxiexiao Decoction treatment group), subcutaneous injection of collagen II induced experimental arthritis model The expression of VEGF in synovial tissue of rats in each group at different time points was detected by immunohistochemical method. Arthritis symptoms were evaluated by joint index integral method. RESULTS: Arthritic symptoms were observed in 88.57% of the immunized rats. The arthritis index in the model group increased gradually, while the arthritis index in the Biaozhongxiao group and the methotrexate group decreased gradually after 35 days. No obvious VEGF expression was observed in the synovial tissue of the normal group. The expression of VEGF (30.6±6.2)% in the model group was significantly higher than that in the group treated with Qizhongxiao Decoction (16.2±4.4)% (P<0.001) and methylamine In the pterin group, it was (24.4±3.6)%(P<0.001); as time went by, the expression of VEG in the model group gradually increased, and the expression of VEGF in the group of Qizhongxiao decoction and methotrexate gradually decreased, on the 45th day. The model group was significantly higher than the Biaozhongxiao Decoction group (P<0.001) and the methotrexate group (P<0.001), and the Biaozhongxiao Decoction group was lower than the Methotrexate group (P<0.001). Conclusion: VEGF is involved in the formation and development of synovitis in RA. The level of VEGF expression is related to the severity of arthritis symptoms. Bianzhongxiao Decoction may block the formation of synovial vasospasm or bone invasion by blocking the expression of VEGF.