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目的:亚甲基四氢叶酸还原酶(MTHFR)基因C677T突变可使尿酸生成增多,通过试验说明痹宁汤对痛风患者的治疗作用与MTHFR基因C677T的mRNA表达的相关性。方法:由黑龙江中医药大学附属第一医院风湿科门诊于2009—2014年期间提供原发性痛风性关节炎患者40人和正常组5人。按随机、双盲、对照、平行等原则将40名患者分为试验组(中药痹宁汤组)和对照组(西药秋水仙碱组),取研究对象外周抗凝血标本,用血液总RNA提取试剂盒提取总RNA,设计特异性引物,运用逆转录聚合酶链反应(RT-PCR)法检测各组治疗前后MTHFR基因C677TmRNA的水平,全自动生化仪(BeckMan Cou Iter Unicel Dx C800)检测各组治疗前后血浆中的尿酸水平。结果:痛风性关节炎的发作与MTHFR基因C677TmRNA表达水平呈正相关(P<0.01)。结论:痹宁汤可使患者血清尿酸水平降低,可能与调节MTHFR基因C677T的mRNA的表达有关。
OBJECTIVE: The C677T mutation of methylenetetrahydrofolate reductase (MTHFR) gene can increase uric acid production. The correlation between the therapeutic effect of Bi-ning Tang on gout patients and the mRNA expression of MTHFR gene C677T was demonstrated. Methods: 40 patients with primary gouty arthritis and 5 normal persons were enrolled in the Department of Rheumatology, the First Affiliated Hospital of Heilongjiang University of TCM in 2009-2014. According to the principles of randomization, double-blind, control and parallel, 40 patients were divided into experimental group (Chinese medicine Bi-Ning Decoction group) and control group (western medicine colchicine group) Total RNA was extracted by extraction kit, and specific primers were designed. The levels of MTHFR gene C677T mRNA in each group before and after treatment were detected by reverse transcription-polymerase chain reaction (RT-PCR), and the Beckman CouIter Unicel Dx C800 Group before and after treatment of plasma uric acid levels. Results: The onset of gouty arthritis was positively correlated with the expression of MTHFR C677T mRNA (P <0.01). Conclusion: Bi-ning decoction can reduce the level of serum uric acid in patients, which may be related to the regulation of MTHFR gene C677T mRNA expression.