中文摘要：

目的 基于Act1/NF-κB信号传导通路研究新风胶囊（Xinfeng Capsule,XFC）改善类风湿关节炎患者血瘀状态的机制。方法 将76例RA患者按随机数字表法分为2组：XFC组（3粒/次,每日3次）和来氟米特（LEF）组（10 mg/次,每日1次）,每组38例,连续治疗3个月。评定两组中医证候临床疗效;ELISA法检测血清白介素-10（Interleukin-10,IL-10）、IL-6、IL-17、核因子κB激活蛋白1抗体（NF-κB activator 1,Act1）、p50、p65,血小板凝聚因子（platelet activating factor,PAF）、血小板活化因子乙酰水解酶（platelet activating factor acetyl hydrolase,PAF-AH）;评定血瘀证症状的评分;采用荧光定量PCR法检测Act1、p65、p50mRNA表达;Western blot法检测p50、p65蛋白表达。采用Spearman方法对RA患者外周血凝血指标及血瘀证总积分与IL-10、IL-6、IL-17、Act1、p50、p65之间进行相关性分析。结果 XFC组总有效率为89.5%（34/38）;LEF组总有效率为94.7%（36/38）,两组总有效率比较,差异无统计学意义（P〉0.05）。与本组治疗前比较,两组治疗后D-D、FBG、PLT、PAF、IL-17及IL-6水平下降,Act1、p50、p65mRNA表达及含量水平降低,p50、p65蛋白水平降低,血瘀证各个症状评分均降低,而PAF-AH及IL-10水平上升（P〈0.05,P〈0.01）;与LEF组比较,XFC组治疗后D-D、FBG、PLT、IL-17及IL-6水平下降,Act1、p65mRNA表达及含量水平降低,p 65蛋白表达降低,关节刺痛、舌质、皮下瘀斑及血瘀证总积分的评分均明显降低（P〈0.05,P〈0.01）。RA外周血D-D与IL-17、IL-6、Act1、p65呈正相关,与IL-10呈负相关（P〈0.05,P〈0.01）;FBG与IL-6呈正相关（P〈0.05）;PLT与IL-17呈正相关（P〈0.05）;血瘀证总积分与IL-6、Act1、p65呈正相关,与IL-10呈负相关（P〈0.05,P〈0.01）;PAF与IL-17、IL-6、Act1、p65呈正相关（P〈0.05,P〈0.01）;PAF-AH与p50呈负相关（P〈0.05）。结论 RA患者血瘀状态的发生机制及新风胶囊对血瘀状态的影响可能?

英文摘要：

Objective To observe the mechanism of Xingfeng Capsule （XFC） for improving blood stasis state in rheumatoid arthritis （RA） patients based on Actl/NF-KB signaling pathway. Methods Totally 76 RA patients were equally assigned to two groups by random digit table, the XFC group （XFC, 3 pills each time, three times per day） and the Leflunomide group （LEF, 10 mg each time, once per day）. All patients were intervened for 3 successive months. Clinical efficacy of symptoms of Chinese medicine （CM） was assessed. Serum levels of interleukin-10 （IL-10）, IL-17, IL-6, NF-KB activator 1 （Act1）, p50, p65, platelet activating factor （PAF）, platelet activating factor acetyl hydrolase （PAF-AH） were detected using ELISA. Symptoms of blood stasis syndrome （BSS） were also assessed, mRNA expressions of Act1, p50, and p65 were detected using fluorescent quantitative PCR. Protein expressions of p50 and p65 were detected using Western blot. Correlation analyses were performed in RA patients＇ peripheral blood coagulation indicators, total score of BSS, and IL-10, IL-6, IL-17, Act1, p50, p65 using Spearman. Results The total effective rate was 89.5% （34/38） in the XFC group, with no statistical difference as compared with that of the LEF group [94.7% （36/38）, P 〉0.051. Compared with before treatment in the same group, serum levels of D-dimer （DD）, fibrinogen （FBG）, platelet （PLT）, PAF, IL-17, and IL-6 all decreased, mRNA expressions and serum levels of Act1, p50, and p65 were lowered, protein expressions of p50 and p65 decreased, scores for each symptoms in BSS all decreased, serum levels of PAF- AH and IL-10 increased in the two groups after treatment （P 〈0.05, P 〈0.01 ）. Compared with the LEF group, serum levels of DD, FBG, PLT, IL-17, and IL-6 decreased, mRNA expressions and serum levels of Act1 and p65 were lowered, protein expression of p65 decreased, scores for joint prickling pain, tongue proper, subcutaneous ecchymosis, and BSS total score all decreased in the X