艾灸对类风湿关节炎患者血清中白三烯B4、基质金属蛋白酶-9的影响Regulatory effect of moxibustion on LTB4/MMP-9 in serum of patients with rheumatoid arthritis

唐洁; 武平; 余泽芸; 汪雪; 陶偲钰; 蒋楠楠; 陈观华; 帅柔纤

doi:10.13702/j.1000-0607.20220088

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艾灸对类风湿关节炎患者血清中白三烯B4、基质金属蛋白酶-9的影响Regulatory effect of moxibustion on LTB4/MMP-9 in serum of patients with rheumatoid arthritis

临床研究 | 更新时间：2023-12-01

- 艾灸对类风湿关节炎患者血清中白三烯B4、基质金属蛋白酶-9的影响Regulatory effect of moxibustion on LTB4/MMP-9 in serum of patients with rheumatoid arthritis
- Regulatory effect of moxibustion on LTB4/MMP-9 in serum of patients with rheumatoid arthritis
- 针刺研究 2023年48卷第5期页码：488-493
- 作者机构：
  
  1. 成都中医药大学针灸推拿学院
  2. 宜宾市第一人民医院
- 作者简介：
- 基金信息：
  
  国家自然科学基金项目(No.81373738);四川省科技计划项目(No.2017JY0016);成都中医药大学杏林学者计划教授专项(No.030055014)
- DOI：10.13702/j.1000-0607.20220088
  中图分类号：
- 纸质出版日期：2023
- 稿件说明：
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唐洁, 武平, 余泽芸, 等. 艾灸对类风湿关节炎患者血清中白三烯B4、基质金属蛋白酶-9的影响Regulatory effect of moxibustion on LTB4/MMP-9 in serum of patients with rheumatoid arthritis[J]. 针刺研究, 2023,48(5):488-493.

TANG Jie, WU Ping, YU Ze-yun, et al. Regulatory effect of moxibustion on LTB4/MMP-9 in serum of patients with rheumatoid arthritis[J]. Acupuncture research, 2023, 48(5): 488-493.
唐洁, 武平, 余泽芸, 等. 艾灸对类风湿关节炎患者血清中白三烯B4、基质金属蛋白酶-9的影响Regulatory effect of moxibustion on LTB4/MMP-9 in serum of patients with rheumatoid arthritis[J]. 针刺研究, 2023,48(5):488-493. DOI： 10.13702/j.1000-0607.20220088.

TANG Jie, WU Ping, YU Ze-yun, et al. Regulatory effect of moxibustion on LTB4/MMP-9 in serum of patients with rheumatoid arthritis[J]. Acupuncture research, 2023, 48(5): 488-493. DOI： 10.13702/j.1000-0607.20220088.

摘要

目的:观察艾灸对类风湿关节炎(RA)患者血清中白三烯B4(LTB4)、白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)和基质金属蛋白酶-9(MMP-9)含量的影响，探讨艾灸对RA的骨保护机制。方法:将RA患者随机分为对照组33例和治疗组31例。对照组予常规药物治疗，连续治疗5周；治疗组在对照组基础上予双侧肾俞、足三里及阿是穴艾灸治疗，每周3次，连续治疗5周。观察两组患者治疗前后视觉模拟量尺(VAS)评分、晨僵评分、关节压痛数、关节肿胀数、28关节疾病活动度(DAS28)评分，生化法检测血清中类风湿因子(RF)、血沉(ESR)、C反应蛋白(CRP)含量，ELISA法检测血清中LTB4、IL-17、TNF-α、MMP-9的含量。结果:治疗后，治疗组和对照组VAS评分、晨僵评分、关节压痛数、关节肿胀数、DAS28评分和血清中RF含量均较治疗前明显降低(P<0.01

P<0.05)

治疗组CRP、ESR、LTB4、IL-17、TNF-α、MMP-9含量均较治疗前明显降低(P<0.01);治疗后，治疗组VAS评分、晨僵评分、关节压痛数、关节肿胀数、DAS28评分和血清中LTB4、IL-17和MMP-9含量明显低于对照组(P<0.01

P<0.05);治疗组治疗前后血清中LTB4、IL-17、TNF-α含量变化与MMP-9含量变化存在正相关性(P<0.05

r>0)。结论:艾灸肾俞、足三里、阿是穴并联合常规西药能明显改善RA患者关节疼痛和疾病活动度，对RA有潜在的骨保护作用，其机制可能与艾灸调控LTB4水平、抑制炎性因子IL-17产生，减少MMP-9生成有关。

Abstract

Objective To observe the effects of moxibustion on the contents of leukotriene B4(LTB4)

interleukin-17(IL-17)

tumor necrosis factor-α(TNF-α) and matrix metalloproteinase-9(MMP-9) in serum

and explore the protection mechanisms of moxibustion in the patients with rheumatoid arthritis(RA). Methods A total of 64 patients with RA were randomly divided into treatment group(n=31) and control group(n=33). The patients in the control group were treated with conventional medication for consecutive 5 weeks. Based on the treatment in the control group

the patients in the treatment group were treated with moxibustion at bilateral Shenshu(BL23)

Zusanli(ST36) and Ashi points

3 times a week

for consecutive 5 weeks. Separately

the visual analogue scale(VAS) score

morning stiffness score

the number of tender joints

the number of swollen joints

the score of the disease activity score of 28 joints(DAS28) were observed; the contents of rheumatoid factor(RF)

erythrocyte sedimentation rate(ESR) and C-reative protein(CRP) in serum were determined by biochemical method; and the contents of LTB4

IL-17

TNF-α and MMP-9 in serum were detected by using ELISA before and after treatment in the patients of both groups. Results After treatment

VAS score

morning stiffness score

the number of tender joints

the number of swollen joints

DAS28 score

the contents of serum RF in both groups

and contents of serum CRP

ESR

LTB4

IL-17

TNF-α and MMP-9 in the treatment group were significantly reduced when compared with those before treatment(P<0.01

P<0.05). After treatment

VAS score

morning stiffness score

the number of tender joints

the number of swollen joints

DAS28 score

and the levels of LTB4

IL-17 and MMP-9 in serum were obviously lower in the treatment group when compared with the control group(P<0.01

P<0.05). In the treatment group

the changes before and after treatment in the levels of LTB4

IL-17 and TNF-α were positively correlated with that of MMP-9(P<0.05

r>0). Conclusion Moxibustion at BL23 and ST36 combined with conventional medication significantly relieves joint pain and reduce disease activity in RA patients

which may be related to the modulation of LTB4

IL-17 and MMP-9 by moxibustion.

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