基于波形蛋白信号通路分析四妙散对肩周炎临床疗效提升及炎性反应的作用OA
The effect of Simiao San on scapulohumeral periarthritis and its influence on inflammatory response based on vimentin signaling pathway
目的:基于波形蛋白信号通路分析四妙散在改善肩周炎患者炎性反应与肩关节功能方面的作用.方法:选取2021年5月-2023年12月广州医科大学附属第二医院中医骨科收治的160例肩周炎患者,分为对照组和观察组,每组80例,对照组和观察组分别采用美洛昔康和四妙散治疗,治疗后比较两组患者的视觉模拟评分法(visual analogue scale,VAS)评分、欧洲肩关节协会Constant-Murley肩关节功能评分系统(Constant-Murley score,CMS)评分及肩关节波形蛋白及转化生长因子-β1(transforming growth factor-β1,TGF-β1)表达水平.对体外培养的成纤维细胞样滑膜细胞株进行分组,检测和对比各组的波形蛋白、TGF-β1及超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)表达水平.结果:治疗前两组患者静息状态及运动状态时VAS评分的差异无统计学意义(P＞0.05),治疗后观察组患者VAS评分均低于对照组(P＜0.05).治疗前两组患者主观评价指标及客观评价指标评分的差异均无统计学意义(P＞0.05),治疗后观察组患者的CMS评分均显著高于对照组(P＜0.05).治疗前两组肩关节波形蛋白、TGF-β1及hs-CRP表达水平的差异无统计学意义(P＞0.05),治疗后观察组肩关节波形蛋白、TGF-β1及hs-CRP表达水平均更低(P＜0.05).相比于对照组,其他各组波形蛋白、TGF-β1及hs-CRP表达水平均更低(P＜0.05).四妙散应用剂量越高,波形蛋白、TGF-β1及hs-CRP表达水平越低(P＜0.05).波形蛋白抑制剂组与JAK2抑制剂组波形蛋白、TGF-β1及hs-CRP表达水平的差异无统计学意义(P＞0.05).波形蛋白抑制剂联合四妙散时,应用剂量越高,波形蛋白、TGF-β1及hs-CRP表达水平越低(P＜0.05).结论:四妙散可通过抑制波形蛋白信号通路减轻肩周炎患者炎性反应,并改善患者的肩关节功能.
Objective:To analyze the effect of Simiao San(四妙散)in ameliorating inflammatory response and shoulder joint function of scapulohumeral periarthritis patients based on vimentin signaling pathway.Methods:A total of 160 scapulohumeral periarthritis patients who were treated in the Department of Traditional Chinese Medicine Orthopedics of the Second Affiliated Hospital of Guangzhou Medical University from May 2021 to December 2023 were selected and divided into the control group and the observation group,and they were given Meloxicam and Simiao San,respectively.After treatment,the visual analogue scale(VAS)score,European Shoulder Association CMS score,and the expression levels of shoulder joint vimentin and TGF-β1 were compared between the two groups.The fibroblast-like synovial cell lines cultured in vitro were grouped,and the expression levels of vimentin,TGF-β1,and hs-CRP in both groups were detected and compared.Results:Before treatment,there was no statistically significant difference in VAS scores of patients between the two groups in resting and exercise states(P＞0.05).After treatment,the VAS scores of patients in the observation group were lower than those in the control group(P＜0.05).Before treatment,there was no statistically significant difference in subjective and objective evaluation index scores of patients between the two groups(P＞0.05).After treatment,the CMS scores of patients in the observation group were significantly higher than those in the control group(P＜0.05).Before treatment,there were no statistically significant differences in the expression levels of vimentin,TGF-β1,and hs-CRP in the shoulder joint of patients between the two groups(P＞0.05).After treatment,the expression levels of vimentin,TGF-β1,and hs-CRP in the shoulder joint of patients in the observation group were lower than the control group(P＜0.05).The expression levels of vimentin,TGF-β1,and hs-CRP in the other groups were all lower than the control group(P＜0.05).It showed that the higher the dosage of Simiao San,the lower the expression levels of vimentin,TGF-β1 and hs-CRP(P＜0.05).There were no significant differences in the expression levels of vimentin,TGF-β1,and hs-CRP between the vimentin inhibitor group and the JAK2 inhibitor group(P＞0.05).It showed that the when vimentin inhibitors were combined with Simiao San,the higher the application dose,the lower the expression levels of vimentin,TGF-β1 and hs-CRP(P＜0.05).Conclusion:Simiao San can alleviate inflammatory reactions and improve shoulder joint function of scapulohumeral periarthritis patients by inhibiting vimentin signaling pathway.
黄振勇;朱名豪;袁钰莹;谭永振
广州市白云区鹤龙街道卫生服务中心,广东 广州,510440广州医科大学附属第二医院,广东 广州,510260广州医科大学附属第二医院,广东 广州,510260||广州医科大学中西医临床学院,广东 广州,510180广州医科大学附属第二医院,广东 广州,510260
医药卫生
波形蛋白信号通路四妙散肩周炎炎性反应肩关节功能
Vimentin signaling pathwaySimiao SanScapulohumeral periarthritisInflammatory responseShoulder joint function
《中医临床研究》 2026 (11)
143-148,6
广州市三级名中医工作室建设项目(穗卫函[2023]77号)广州市中医药和中西医结合科技项目(NO.20212A011022).
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