| Gout is a group of metabolic diseases caused by the disorder of steroid metabolism and the continuous increase of blood uric acid concentration which leads to the deposition of soft tissue of urate crystals.In recent years,patients have become younger,and the average age of patients is 48.28 years old.The incidence of gout is significantly increased.It is estimated that the number of gout patients in China will exceed 100 million in 2020.Now gout has become the second largest metabolic disease in China.Chinese herbal compound has obvious curative effect in treating gout.It has been highly praised by the ancient doctors.It brings good news to patients with gouty arthritis.Objective:Using literature research to explore the characteristics of traditional Chinese medicine treatment on gout,combined with the clinical experience of old Chinese medicine practioners to summarize prescriptions of clinical treatment of gouty arthritis,named as the Jiangsuanchubi recipe.And the effect of this prescription on gout arthritis was studied.Method:1.Using CNKI and PubMed databases to search for relevant literature on traditional Chinese medicine for treating gouty ’arthritis,and standardize normalizing the data,using frequency analysis,cluster analysis and other methods for statistical analysis,study the characteristics of gout medication,determine the core drug group,and combine the old TCM practioners clinical medication experience to determine the Jiangsuanchubi recipe.2.A pathological model of acute gouty arthritis was established by injecting sodium urate solution into the posterior right medial malleolus shin tarsus articular cavity of male rats.Sixty rats were randomly divided into control group,GA group,colchicine group and Jiangsuanchubi recipe low,medium and high-dose groups.Drug continued intervention for 8 days,the swelling of the joint was recorded before and after the molding.The concentration of aNAG,β-gal,SOD,UA in serum and IL-6 and IL-8 in the joint fluid was observed through ELISA assay.3.By using UHPLC-QTOF-MS technology combined with literature and database search,it is speculated that the chemical composition of Jiangsuanchubi recipe.And through the means of network pharmacology,it is speculated that the effective components and mechanism of action of Jiangsuanchubi recipe in the treatment of gouty arthritis.4.The THP-1 cell inflammatory model was used,and the effects of Jiangsuanchubi recipe on ASC,Caspase-1 and IL-1β were analyzed,as well as exploring the effect of Jiangsuanchubi recipe on gouty arthritis.Result:1.After cluster analysis,the core drug group can be summarized.According to the rules of clinical medication,the old Chinese medicine practitioners finally adjusted the results to be:Smilacis glabrae rhizoma,Paeoniae radix rubra,Polygoni cuspidati et radix,Cremastrae pseudobulbus pleiones pseudobulbus,Rhei radix et rhizome,Clematidis radix et rhizoma,Angelicae pubescentis radix,Phellodendri chinensis cortex,Atractylodis rhizoma,Glycyrrhizae radix rhizome,Codonopsis radix,Angelicae sinensis radix,which was named as Jiangsuanchubi recipe.2.Compared with the control group,the joint swelling degree and the contents of aNAG,β-gal,UA,IL-6 and IL-8 of the GA group were increased,the contents of SOD were decreased.The joint swelling degree and the contents of αNAG,β-gal,UA,IL-6,IL-8 were decreased and the contents of SOD were increased in Jiangsuanchubi recipe medium group.3.Using UHPLC-QTOF-MS technology to analyze the overall performance of Jiangsuanchubi recip,a total of 139 ingredients were identified.Network pharmacology predicts that the effect of Jiangsuanchubi recipe on gouty arthritis is closely related to the occurrence of NOD-like receptor pathways.4.Compared with the control group,the expression of ASC,Caspase-1 and IL-1β in the model group was significantly increased,suggesting successful modeling.Compared with the model group,the expressions of ASC,Caspase-1 and IL-1β protein in the colchicine group and the low-,medium-and high-dose Jiangsuanchubi recipe groups were decreased.Conclusion:1.Chinese medicine treatment of gouty arthritis is mainly based on heat-clearing drugs,the taste of the drug is mainly bitter,the drug is cold and warm;the drug is mainly based on liver.2.Jiangsuanchubi recipe possesses the effects of improving joint swelling,anti-inflammatory and antioxidant,and could be used to treat gout arthritis.3.UHPLC-QTOF-MS technology combined with network pharmacology can predict the mechanism of action of Chinese herbal compound.4.Jiangsuanchubi recipe can effectively reduce the expression of ASC,Caspase-1 and IL-1β protein,suggesting that Jiangsuanchubi recipe can effectively achieve the treatment of gouty arthritis by inhibiting the activation of NLRP3 inflammasome complex through the NOD-like receptor pathway.This study provides guidance for the clinical use of gouty arthritis,and hopes to bring the gospel to the majority of patients. |
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