世界中医药

目的：观察当归拈痛汤对类风湿关节炎大鼠足趾关节的改变情况及探讨其对滑膜细胞凋亡通路的影响。方法：选取50只Wistar雄性大鼠，并随机分为模型组、低剂量组、中剂量组和高剂量组；除对照组外其余均建立胶原诱导的关节炎(Collagen Induced Arthritis，CIA)模型，在类风湿关节炎模型制备成功后开始给药：对照组和模型组予以6.5 g/kg生理盐水，低剂量组、中剂量组和高剂量组均为当归拈痛汤灌胃给药，分别给予生药6.5 g/kg，13.0 g/kg，19.5 g/kg。干预时间28 d。采用容积法测量双后肢的足趾关节肿胀度；采用足趾关节苏木精-伊红（HE）染色计算细胞凋亡数；采用免疫印迹法(Western Blotting，WB)检测Bcl-2、PI3K、Bax的蛋白表达情况。结果：对照组未见足趾肿胀情况，给药1 d模型组、低剂量组、中剂量组和高剂量组间比较,差异无统计学意义（P>0.05），给药7~28 d各剂量给药组肿胀度均低于模型组（P<0.05），至14~28 d中、高剂量组的肿胀度显著低于低剂量组（P<0.05），而28 d高剂量组的肿胀度又明显低于中剂量组（P<0.05）。足趾关节HE染色中，对照组、模型组、低剂量组、中剂量组和高剂量组中的细胞凋亡数呈逐渐上升的趋势（P<0.05）。PI3K和Bcl-2蛋白在模型组中表达上调，经过给药治疗，随着剂量的逐渐升高而下调（P<0.05）；而Bax蛋白的表达情况则与PI3K相反，随着剂量的增加而上调（P<0.05）。结论：当归拈痛汤能有效改善类风湿关节炎大鼠足趾关节肿胀度，促进滑膜细胞的细胞凋亡数进而抑制滑膜细胞增殖的进程，而PI3K通路对细胞凋亡的调控起到关键的作用。

English Summary:

To observe the changes of the toe joint of the rats with rheumatoid arthritis (RA) and the effects on the expression of the apoptotic pathway of synovial cells.Methods:Except the control group, a total of 50 male Wistar rats were to establish collagen induced arthritis (collagen induced, arthritis, CIA) model, and randomly divided into model group, low dose group, middle dose group and high dose group; the medicine was given after rheumatoid arthritis model was successfully established.The control group and model group were given 6.5 g/kg normal saline, and low dose group, middle dose group and high dose group were given gavage Danggui Niantong Decoction of 6.5 13, 19.5, g/kg.The time of intervention was 28 days.The swelling degree of toe joints was measured by volumetric method, and the number of apoptotic cells was calculated by HE staining of toe joints, and the protein expression of Bcl-2, PI3K and Bax was detected by Western blotting (WB).Results:1）The control group had no toe swelling, compared with the drug 1 d model group, low dose group, middle dose group and high dose groups, there were without statistically significant difference (P>0.05).The administration of the first 7 d-28 d in each dosage group swelling degree was lower than the model group (P<0.05).The swelling degree of the middle and high dose of 14 d-28 d was significantly lower than that in low dose group (P<0.05), and the high dose of 28 d group was higher than that of the swelling degree of the middle dose group (P<0.05).2）In the HE staining of toe joints, the number of apoptotic cells in the control group, model group, low dose group, middle dose group and high dose group increased gradually (P<0.05).3）WB detection showed that the expression of PI3K and Bcl-2 in the model group was upregulated.After administration, the expression of Bax protein was decreased (P<0.05), while the expression of Bax protein was opposite to that of PI3K, and increased with the increase of dose (P<0.05).Conclusion:Danggui Niantong Decoction can effectively improve the joint swelling of rheumatoid arthritis rats, promote the apoptosis of synovial cells and inhibit the process of synovial cell proliferation, and the PI3K pathway plays a key role in the regulation of apoptosis.

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