RESUMO
Rheumatoid arthritis （RA） is a systemic chronic auto-inflammatory disease， characterized by infiltration of inflammatory cells， pannus formation， articular cartilage destruction， and bone matrix destruction. Therefore， improving articular cartilage destruction has an important impact on the treatment of RA. Chinese medicine has a good application effect in improving cartilage destruction of RA due to its characteristics of multiple components， multiple targets， high activity and low side effects. Based on this， the author reviewed relevant literature to summarize the relevant research and mechanism of Chinese medicine and its active components in improving RA cartilage destruction. The results showed that Chinese medicine and its active components can improve RA cartilage destruction by regulating inflammatory factors， phosphatidylinositol 3-kinase/protein kinase B， Wnt/β- catenin， nuclear factor-κB， mitogen-activated protein kinase， Janus kinase 2/signal transduction and activator of transcription 3/ vascular endothelial growth factor， microRNAs， fibroblastic synovial cells.
RESUMO
Objective:To investigate the effect of Duhuo Jisheng Decoction on early cartilage destruction markers in patients with rheumatoid arthritis with kidney-qi deficiency and cold syndrome.Methods:A total of 64 patients with rheumatoid arthritis in our hospital from March 2019 to March 2020 who met the inclusion criteria were divided into 2 groups, according to the random number table method, with 32 in each group. The control group was given conventional western medicine therapy, and the observation group was given Duhuo Jisheng decoction on the basis of the control group. Both groups were treated for 8 weeks. TCM syndrome scores were performed before and after treatment, serum CRP, IL-6, cartilage oligosaccharide protein (COMP) and β-catenin were detected by ELISA method, and adverse eventns during treatment were observed and compared. The clinical efficacy was evaluated.Results:The total effective rate was 87.5% (28/32) in the observation group and 65.6% (21/32) in the control group, and the difference between the two groups was statistically significant ( χ2=4.27, P=0.039). After treatment, the main symptoms, secondary symptoms and tongue and pulse scores of the observation group were significantly lower than those in the control group ( t=7.11, 3.11, 2.41, P<0.01 or P<0.05); serum CRP and IL-6 levels were significantly lower than those in the control group ( t=3.04, 4.56, P<0.01); serum COMP [(12.37±1.68) μg/L vs. (14.24±1.88) μg/L, t=4.20], β-catenin [(1.35±0.24) μg/L vs. (1.68±0.31) μg/L, t=4.76] levels were significantly lower than those in the control group ( P<0.01). During the treatment, the incidence of adverse events was 25.0% (8/32) in the observation group and 18.8% (6/32) in the control group, and there was no significant difference between the two groups ( χ2=0.37, P=0.546). Conclusion:The Duhuo Jisheng Decoction can help to reduce the levels of inflammatory cytokines and early cartilage destruction markers in patients with rheumatoid arthritis, and improve the clinical efficacy safely.