目的 通过研究明确苗药五藤膏外敷缓解胶原诱导性关节炎（CIA）大鼠关节局部炎症和骨破坏的机制，证实苗医外治就近驱邪的作用。方法 将70只Wistar大鼠随机分为空白组、模型组、苗药五藤膏高、中、低剂量组、扶他林组及IL-17阻断组，每组10只。除空白组外，其余6组均构建CIA模型，并给予相应的外敷治疗。观察大鼠一般情况，HE染色进行病理学分析，TRAP染色检测OC生成，ELISA检测各炎症因子的含量，RT-PCR和WB分别检测RANKL的基因及蛋白表达。结果 苗药五藤膏能改善CIA大鼠破骨细胞浸润及关节病理性结构，并降低RANKL蛋白、基因表达以及TNF-α、IL-1、IL-6、IL-17含量。结论 苗药五藤膏外敷剂对CIA大鼠的治疗机制可能与降低致炎因子的分泌，抑制RANKL及OC的表达相关。

Objective By studying the mechanism of Miao medicine Wu-Teng-Gao (WTG) to relieve local joint inflammation and bone destruction, and the effect of miao medical treatment on local exorcism was confirmed.Methods 70 Wistar rats were randomly divided into blank group, model group, Miao medicine WTG high-dose, medium-dose and low-dose groups, futalin group and IL-17 blocking group, with 10 rats in each group. Except for the blank group, all six CIA models were given corresponding topical treatments. The general conditions of rats were observed during the process, HE staining for pathological analysis, TRAP staining to detect OC production, the content of inflammatory factors were determined by ELISA, RT-PCR and WB to detect the gene and protein expression of RANKL, respectively.Results Miao medicine WTG can effectively improve the osteoclast infiltration and joint pathological structure of CIA rats, and reduce the protein and gene expression of RANKL and the content of TNF-α,IL-1,IL-6,and IL-17.Conclusions The therapeutic mechanism of the Miao medicine WTG on CIA rats may be related to reducing the secretion of inflammatory factors and inhibiting the expression of RANKL and OC.

国家科学技术部国家重点研发计划“中医药现代化研究”重点专项（2017YFC1703904）：民族医药发掘整理与学术传承研究，负责人：张艺；国家自然科学基金委员会青年科学基金项目（81804127）：基于外泌体调控Th17/Treg平衡探讨苗药五藤膏治疗类风湿关节炎的作用机制，负责人：姚血明；贵州省科学技术厅临床医学研究中心项目（黔科合平台人才[2020]2202号）：贵州省中医风湿免疫病临床研究中心，负责人：马武开。