| Objective1.Evaluate the therapeutic effect of the Meridian-sinew release therapy for rheumatoid arthritis knee joints by observing the changes in the efficacy evaluation of TCM syndromes before and after treatment,inflammatory indicators,visual analog scale,disease activity scores,and infrared heat image.2.By detecting the expression of Hippo signaling pathway-related proteins and genes in the synovial tissue of the knee joints of rheumatoid arthritis patients before and after treatment and the content of Treg and Th17 cells in joint fluid,the changes of RA-FLSs proliferation and invasion ability were observed,and the meridian tendon was discussed The effect of Meridian-sinew release therapy on rheumatoid arthritis.Methods1.Clinical research:Select RA diagnostic criteria that complied with ACR/EULAR in 2009,according to the inclusion,exclusion,exclusion,and shedding criteria,80 patients with rheumatoid arthritis who have knee pain randomly divide them into control and treatment groups.40 cases in each group.The control group was treated with western medicine,and the treatment group was treated with western medicine + Meridian-sinew release therapy.The changes of erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor and VAS,DAS28 scores of the two groups of patients were observed before and after 6 months of treatment,infrared thermography was performed,and the clinical efficacy was evaluated according to the TCM syndrome score.2.Experimental study:According to the case selection criteria,12 patients with RA who met the experimental requirements were selected and divided into the control group and the treatment group.The control group was treated with Western medicine,and the treatment group was treated with Western medicine + Meridian-sinew release therapy.After 6 months,the synovial fluid was collected and synovial tissue specimens from the diseased knee joint were taken under the microscope to prepare synovial fibroblasts(RA-FLSs).The following experiments were performed respectively:①Western Blot detected the changes of MST1/2 and YAP/TAZ protein expression in RA-FLSs before and after treatment in both groups;②RT-PCR detected the changes of MST1/2 and YAP/TAZ mRNA levels in RA-FLSs before and after treatment in both groups;③Flow Cytometry was used to analyze the changes of Treg and Th17 cells in joint fluid before and after treatment in both groups;④Transwell test detected the change of RA-FLSs invasion ability level before and after treatment in both groups;Statistical analysis of the experimental results.Results1.Clinical study:There were no differences in the temperature,inflammation index(ESR,CRP,RF),VAS,and DAS28 scores of the knee joints of two groups before treatment(P>0.05),and they were lower than those of the same group after treatment.And the reduction was more obvious in the treatment group,and the difference was statistically significant(P<0.05).The evaluation of TCM efficacy after treatment in the two groups was improved compared with that before treatment,and the treatment group was better than the control group,the difference was statistically significant(P<0.05).2.Experimental study:①There was no significant difference in the expression levels of MST1/2 and YAP/TAZ protein in RA-FLSs between the two groups before treatment(P>0.05);after treatment,the expression of MST1/2 protein was higher than that in the same group before treatment,and the treatment group was more than the control The increase in the group was more obvious,and the difference was statistically significant(P<0.05);after treatment,the YAP/TAZ protein expression levels of the two groups were lower than before the treatment of the same group,and the treatment group decreased more significantly than the control group,the difference was statistically significant Academic significance(P<0.05).②The MST1/2 and YAP/TAZ mRNA expression levels of RA-FLSs in the two groups before treatment were not statistically significant(P>0.05);after treatment,the MST1/2 mRNA expression levels were higher than those in the same group before treatment,and the treatment group was compared with the control The increase in the group was more obvious,and the difference was statistically significant(P<0.05);after treatment,the YAP/TAZ mRNA expression levels of the two groups of patients were lower than before the treatment of the same group,and the treatment group decreased more significantly than the control group,the difference was statistically significant Academic significance(P<0.05).③There was no statistically significant difference in the percentage of CD4+CD25+Foxp3+ Treg cells and CD4+IL-17A+ Th17 cells in CD4+ cells in the joint fluid of the two groups of RA patients before treatment(P>0.05).After treatment,the percentage of CD4+CD25+Foxp3+ Treg cells in both groups was higher than before treatment,and the growth of the treatment group was more obvious than that of the control group(P<0.05);and the percentage of CD4+IL-17+ Th17 cells after treatment in both groups the content was lower than before treatment,and the treatment group decreased more significantly than the control group(P<0.05).④ There was no statistically significant difference in FLSs invasion ability between two groups of RA patients before treatment(P>0.05).The FLSs invasion ability of both groups after treatment was lower than before treatment,and the treatment group was more significantly reduced than the control group(P<0.05).⑤There was no significant difference in FLSs proliferation ability between the two groups of RA patients before treatment(P>0.05).The FLSs proliferation ability of the two groups after treatment was lower than before treatment,and the treatment group decreased more significantly than the control group(P<0.05).Conclusion1.Clinical research:Meridian-Sinew Release Therapy can significantly reduce inflammation in the knee joint of patients with rheumatoid arthritis,relieve knee joint swelling,pain,fever and other symptoms,and can reduce disease activity.This therapy is a new type of visualization and minimally invasive diagnosis and treatment technology,especially suitable for patients with poor drug treatment and stubborn joint swelling and pain.It is worthy of clinical application.2.Experimental research:Meridian-Sinew Release Therapy may adjust the balance of Th17 cells and Treg cells by increasing the level of MST1/2 and reducing the level of YAP/TAZ,and effectively improve the immune disorder in the joint.This therapy also may improve the biological behavior of RA-FLSs by reducing YAP/TAZ levels,significantly reducing the proliferation and invasive ability,thereby delaying the disease progression of RA. |
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