| Theoretical researchAcute gouty arthritis(AGA) is acute inflammation caused by monosodium urate(MSU) deposit on the joint. See more at over 40 years age men or women after menopause, but because the living standards increasing now, onset age increasingly younger. Acute gouty arthritis onset nasty, long duration and repeated attacks, deferment painless. Serious ones as a result of the long-term uric acid sodium crystal deposition in soft tissue, joint and bone, can cause fibrous tissue hyperplasia, foreign body nodules cause gout stone shape, and cause bone destruction, joint deformity. Gouty arthritis clinical manifestations most has the following characteristics:(1) More with the triggers, such as: Eating lots of high protein, high purine food for a long time, surgical infection, over fatigue, cold, etc.(2) Joint pain is more cutting or tear like, accompanied by redness, swelling, heat, pain and activities, etc., make the patient unbearable.(3) Have certain self-limiting, symptoms within a few days can relieve itself, and with joint parts of skin itching and desquamation.(4) With high uric acid hematic disease.(5) Often develops in the first plantar toe joints.For the etiology and pathogenesis of acute gouty arthritis, modern medicine can’t fully explained. Now people think acute gouty arthritis is because of purine metabolic disorders, leading to produce too much uric acid in the body or the discharge is insufficient, because the blood vessels in the joints is less, the liquid hydrogen ion concentration is higher, in the material acid mucopolysaccharides is rich, more easily make uric acid deposition in joint tissues, causing inflammation.The ancient doctor early recorded for the etiology and pathogenesis of acute gouty arthritis. The disease belongs to "poliomyelitis" in TCM. Yuan·Danxi Zhu the first time point out "gout" in the “Gezhiyulun”: "Gout, most because of blood heat, have boiling themselves, then cold water, or made wetland night pain, line in Yin also." Qing dynasty Peiqin Lin "Leizhengzhizai", " gout, one of Tongbi syndrome also... because of the wind cold dampness Yubi Yinfen at the beginning, heat long will cause pain, more drama in the night." Think of gout is largely due to inadequate natural endowment or along with malnutrition, lead to deficiency of Vital qi, or the day after tomorrow eat rich men’s taste and the spleen and kidney disorders, for a long time can cause many viscera deficient, thus produce phlegm turbidity, dampness, blood stasis, etc., long hot, toxic heat, heat storage in viscera form product; If it triggers by being cold, damp and hot, seven emotions, tired, thick flavour, trauma, can lead to heat phlegm Yu Ji and lingers in joints, the body meridian, joint swelling and hot muscle pain, rejected touch, activities limited and other symptoms.At present western medicine for the treatment of acute gouty arthritis for: Give priority to with medication and comply with local physical methods, such as cold treatment. Instruct patients at the same time adjust the lifestyle and eating habits, avoid high purine food intake. For gout serious and affect the joint function, gout stone giant or tophus canker stone can take surgery to eliminate gout. Now for acute gouty arthritis medication use non-steroidal anti-inflammatory drugs(NSAIDs), colchicine and glucocorticoids, etc. Mainly through anti-inflammatory and immune inhibitory effect, control the onset symptoms. But these drug side effects, easy to appear gastrointestinal ulcer or bleeding, bone marrow suppression, liver cell damage, patients with toxic effects such as allergies and cardiovascular system, difficult to adhere to long-term use, illness should not be controlled, and the recurrence rate is high, can’t block and effect a radical cure disease process.The doctor of traditional Chinese medicine for the treatment of acute gouty arthritis has a long history and certain curative effect. The main treatment method is the combination therapy of traditional Chinese medicine. In the process of treatment according to the patient’s health and etiology and pathogenesis of different targeted choose corresponding compound treatment with syndrome differentiation, good curative effect and side effects are small to the body, so more people start to look for the treatment of traditional Chinese medicine.Up middle and down Common Use Gout Soup derived from “Danxixinfa”, with the effect of clearing the hot and humid, Xuanchang Qi activity, promoting blood circulation to remove blood stasis, dredging collaterals and kill the pain, different degrees of improvement of acute gouty arthritis patients symptoms such as swelling pain, has obtained obvious curative effect in treatment of acute gouty arthritis clinical application. From the existing literature, the clinical and experimental research of Up middle and down Common Use Gout Soup in the treatment of acute gouty arthritis is not yet perfect. This topic belongs to part of the research project in the tutor professor Liya Zhou "Twelfth Five " science and technology of Jilin province department of education, mainly through the modern pharmacology research, adopts animal experiment method, analysis of the Up middle and down Common Use Gout Soup’s mechanism of anti-inflammatory action to arthritis inflammatory factor expression level change, provide experimental basis for the clinical application of Up middle and down Common Use Gout Soup. Experiment researchObjective: Through the establishment of acute gouty arthritis model in rats, from the dynamic observation of Up middle and down Common Use Gout Soup on the treatment of acute gouty arthritis rats, at the same time, key observation on the influence of gouty arthritis on expression of rat inflammatory factor, IL- 6, IL- 1 TNF-α, prove 3 general gout soup protective effect of prevention and treatment of gouty arthritis.Methods: 60 male Wistar rats randomly divided into 6 groups, each group of 10:(1) Normal control group, with 10 m L/kg saline lavage;(2) Acute gouty arthritis model group, with 10 m L/kg saline lavage;(3) Up middle and down Common Use Gout Soup low, medium and high dose group, with a concentration of 50 g/L respectively, 200 g/L, 400 g/L 3 general gout soup 10 ml/kg to fill the stomach;(4) Indomethacin, positive control group with indomethacin 10 ml/kg to fill the stomach. Before building 48 hours, every 24 hours to fill Up middle and down Common Use Gout Soup low-high doses and indomethacin 10 ml/kg to fill the stomach, second after1 hour the treatment building model, according to the Coderre classic methods, will lie on back fixed after anesthesia in rats, will bend the left ankle, ammonites and two bone ridges, after local disinfection, between two bone-like with a syringe needle, after feeling a sense of air leakage, 50 u l, uric acid sodium injection solution to summon the joint capsule on the side into the standard, preparation of acute gouty arthritis model. Blank control group left ankle injection volume of physiological saline, etc. Executed after 48 hours. Above the Up middle and down Common Use Gout Soup and Indomethacin contrast treatment, observation rat gait, determination of ankle swelling degree, ELISA method to test the serum IL- 1, IL- 6, TNF alpha level.Result:(1) Up middle and down Common Use Gout Soup has obvious anti-inflammatory analgesic action. Can significantly improve acute gouty arthritis model in rats gait and suppress ankle swelling degree, high dose group is better than that of indomethacin, and less side effect, no adverse reaction in rats.(2) Up middle and down Common Use Gout Soup can significantly inhibit the acute gout model articular expression of inflammatory factor, IL- 6, IL- 1 the TNF-α, which play the role of anti-inflammatory swelling.Conclusion: Up middle and down Common Use Gout Soup treating acute gouty arthritis has obvious anti-inflammation, detumescence and analgesia action, its mechanism may be through inhibiting synovial cells’ synthesis of IL- 6, IL- 1 TNF-αand exert its anti-inflammatory effects. |
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