Evaluation Of The Therapeutic Effect Of Promoting Blood Circulation To Removing Blood Stasis On Rheumatoid Arthritis And Its Correlated Laboratory Research

1 Objects1.1 To evaluate the therapeutic effect of promoting blood circulation to removing blood stasis(P method) on rheumatoid arthritis by clinical observation.1.2 To study the clinical effects and the influence on ERK/MAPK pathway of compound danshen root injection,methotrexate(MTX) injection and a kind of MEK1/2 inhibitor named U0126 on adjuvant arthritis of rats.Discuss the role of ERK/MAPK pathway in this kind of arthritis.2 Methods2.1 Clinical research2.1.1 41 patients of rheumatoid arthritis were treated by P method;their clinical symptoms, physical signs and laboratory data before and after the treatment were noted and compared.2.1.2 41 patients of rheumatoid arthritis were treated by P method;their clinical symptoms, physical signs and laboratory data which compose the ACR20 evaluation criterion before and after the treatment were noted and compared.The ACR20 rate of this study was compared to other similar studies.2.2 Empirical study2.2.1 To induce the adjuvant arthritis(AA) model on Wistar rats by Freund's complete adjuvant(FCA).The control group,model group,high dose danshen group,low dose danshen group,MTX group and U0126 group were treated respectively,measure the swelling degree of the hind paws each other day.2.2.2 To induce the adjuvant arthritis(AA) model on Wistar rats by Freund's complete adjuvant.The control group,model group,high dose danshen group,low dose danshen group,MTX group and U0126 group were treated respectively,detect the expression of pERK1/2 in the synovial membrane after treated.3 Results 3.1 Clinical research3.1.1 The main clinical symptoms and laboratory data of the 41 RA patients were improved significantly after the treatment of P method,without manifest side effect.The total effective rate is 95%.3.1.2 The clinical symptoms and laboratory data of the 41 RA patients were improved significantly after the treatment of P method,without manifest side effect.The rate of ACR20 is 65.85%,ACR50 is 9.76%.Compared with other clinical research in China,the rate of ACR20 is conformity.3.2 Empirical study3.2.1 The degree of hind paws swelling was maximized in the day 20^th after injected FCA, compared with the control group the difference was significant.Then the swelling tend to fade away with autotherapy.The right paw have been injected,its swelling degree was lower than model group significantly 20 day after therapy in high dose and low dose danshen groups(P＜0.05).The left paw have not been injected,only the MTX group shows the evident therapeutic effect.3.2.2 The level of pERK in model group is higher than control group,in MTX group there is no marked change,the level in low dose danshen group is degraded significantly,but in high dose danshen group and U0126 group the level are all increased obviously.4 conclusions4.1 The method of promoting blood circulation to removing blood stasis(P method) was effective in treating RA.4.2 P method in treating RA could improve the rate of ACR20,and the effect is conformity compared with other classic methods.4.3 Arthritis of hind paws could be induced by FCA.To the inflammation with nonspecific immunity induced by chemical stimulus,compound danshen root injection was effective, but to the inflammation with specific immunity,the effect of MTX was better.U0126 might have no therapeutic effect on arthritis.4.4 The expression of pERK is increased in synovium of knee joint of AA rats.There are different effects on this pathway due to different therapy and dose.Traditional Chinese drug may have bilateral effect on this pathway.Inhibitor of this signal transduction pathway may not an effective material in treating adjuvant arthritis.