OBJECTIVE To investigate the clinical efficacy and Th17 cell differentiation mechanism of Tenghuang Jiangu capsule on postmenopausal osteoporosis(PMOP) with kidney deficiency and blood stasis.

METHODS This study selected PMOP patients who visited the outpatient and inpatient departments in Affiliated Hospital of Gansu University of Chinese Medicine from April 2021 to October 2022, the PMOP patients were randomly divided into control group and monitoring group. On the basis of health education, the control group was given calcium carbonate D3 particles(one bag each time, once a day)+calcitriol capsule(0.25 μg orally, one capsule at a time, twice a day)+risedronate sodium tablets(5 mg orally, one tablet each time, once a day)+salmon calcitonin(50 IU intramuscular injection, once a day). Based on the control group, monitoring group was given Tenghuang Jiangu capsule(orally, 5 capsules each time, twice a day). Before and 6 months after treatment, traditional scale for determining traditional Chinese medicine(TCM) syndromes scores, the efficacy of TCM symptom in two groups of patients were detected. Meanwhile, the key molecules expression of TNF-α/IL-6/ JAK2/STAT3 pathway in two groups of patients were detected by ELISA, the expression levels of RoRγt, IL-17 of Th17 cell marker molecule were also measured by ELISA.

RESULTS According to the diagnostic criteria of western medicine, the diagnostic criteria of TCM syndrome differentiation, and the inclusion and exclusion criteria, there were 60 patients who ultimately met the western medicine diagnostic criteria of PMOP and had a TCM syndrome type of kidney deficiency and blood stasis. Compared with before treatment, the total scores of TCM symptoms of both groups decreased after 6 months of treatment(P<0.01), and the scores monitoring group was significantly lower than those in control group(P<0.05). After 6 months of treatment, the total effective rate of the control group was 63.33%, and the total effective rate of the monitoring group was 86.67%, and the curative effect of the monitoring group was significantly better than that in control group(P<0.05). After 6 months of treatment, the expression levels of IL-6, IL-6R, JAK2, STAT3, TNF-α were decreased, the expression levels of IL-33 were increased in both groups(P<0.05 or P<0.01), and the expression levels of JAK2, STAT3, TNF-α in the monitoring group were significantly decreased than those in control group(P<0.05 or P<0.01). After 6 months of treatment, the expression levels of RoRγt, IL-17 of Th17 cell marker molecule were decreased in both groups(P<0.01), and the expression levels of RoRγt, IL-17 of Th17 cell marker molecule in the monitoring group were significantly decreased than those in control group(P<0.05).

CONCLUSION Tenghuang Jiangu capsule can improve the symptoms of PMOP patients with kidney deficiency and blood stasis, which can more effectively improve TCM syndrome scores the efficacy of TCM symptom. The mechanism may be related to the inhibition of TNF-α/IL-6/JAK2/STAT3 pathway, so as to inhibit the TH17 cell differentiation of postmenopausal osteoporosis.