Dissertation > Medicine, health > Chinese Medicine > TCM Internal Medicine > Modern medicine, internal diseases

Heat Bi mechanism of action and application of particle treatment of rheumatoid arthritis

Author WangYong
Tutor ZhaoYingQian
School Hubei College of Traditional Chinese Medicine
Course Clinical basis for TCM
Keywords Re Bi granule Rheumatoid Arthritis Beriberoid Pyretic Arthralgia Clinical curative effect Mechanism
CLC R259
Type PhD thesis
Year 2008
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Background:The Rheumatoid Arthritis(RA)is one of chronic diseases which serious threat the health of the public in the current world extent with degradation of the extracellular matrix and destruction of the architecture and function of joint.The disease is one kind of refractoriness autoimmune disease with complex nosogenesis,and mechanisms of it are complicated now.Histoolgically,hyperplasia of the synovial lining cells,an inflammatory cell infiltrate composed of lymphocytes and histiocytes with scattered plasma cells and granulocytes and destructive changes of connective tissue and cartilage are seen. Synovitis is a critical pathological change and the major problem of synoviocytes hyperplasia induced by cell apoptosis disorder can lead to lasting immunological reaction of synovitis.Modern medicine has a lot of problems in the treatment of the disease. Traditional Chinese Medicine(TCM)has potential superiority to cure it. Infusion of Re Bi granule is utility recipe to Beriberoid Pyretic Arthralgia(RA)in the fundament of the change plus minus through so many years clinical experiences of my advisor Zhao Ying Qian.My topic is investigation object of Infusion of Re Bi granule,and takes the RA as the investigation cut-in point,and makes deeply investigation to the recipe in the contribution of antiinflammatory and immunoregulation,and mechanism of action of treatment of RA.Objective:To study the clinical curative effect and the mechanisms of Re Bi granule on treating RA. Methods:The study from three aspects of basic and clinical and experimental research.1.basic research:Make a systemic review of the historical origins and causes and mechanisms and prevention methods about Beriberoid Pyretic Arthralgia(active rheumatoid arthritis),discuss the treat principle and composition and efficacy of Re Bi granule,and study the experimental model.2.clinical research:The 60 Rheumatoid arthritis patients that belongs to the damp-heat type divided into 2 groups randomly as follows: Experimental group(Re Bi Granule),comparative group(Wang Bi Granule). After 8 weeks treatment,examining patients’ blood routine,urine routine, stool routine,liver function,kidney function,electrocardiogram,the blood sink(ESR),rheumatism factor(RF),the C respond protein(CRP)etc. Observing the main clinical symptom,and recording the side effect. Evaluating result and comparing the curative effect and the safety of two medicines.3.experimental research:Make SD maleness rats Adjuvant-Induced Arthritis(AA)which were derived by Freund’s complete adjuvant(CFA)as investigation object.Make Wang Bi granule as positive control medicine, and divide it into six groups(blank group,model group,control group, Infusion of Re Bi granule high dose group and midst dose group and low dose group).Observe Re Bi granule’s influence and mechanism to synoviocytes apoptosis and Bcl-2 albumen and IL-1βand TNF-α.Results:1.Re Bi granule can improve the clinical symptom,physical signs and laboratory test indexes of patients with active rheumatoid arthritis.2.Re Bi granule candistinctly heighten synoviocytes apoptosis ratio of AA rats,thereby prevent further damage to the joint and effective treat RA.3.Re Bi granule can distinctly heighten CD8~+cell’s number and reduce CD4~+cell’s number,lower CD4~+/CD8~+ ratio,adjust T cells for two-way,so as to enhance human immunity.4.Re Bi granule can distinctly lower Bcl-2 albumen’s ratio, consequently improve disorder of cell gene,lighten hyperplasia of the synovial lining cells and inflammatory cell and scattered plasma cells, control the destructive changes of connective tissue and cartilage.5.Re Bi granule can distinctly lower IL-1βand TNF-α’s ratio with better anti-inflammatory and immune regulation,and following the extension of the course,the synovial disease gradually healing.Conclusion:Re Bi granule has whole regulative effect with multi-channel, multi-link and multi-target,not only to effective treatment of rheumatoid arthritis,but can also improve the abnormal immune status. The main mechanism is heighten synoviocytes apoptosis ratio,lower CD4~+/CD8~+ ratio,down Bcl-2 protein expression,lower IL-1βand TNF-α’s ratio are three main means.

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