Objective] To observe the therapeutic effect of"Modified Simiao Pill"in the treatment of acute gouty arthritis(AGA) and to explore the mechanism of "Modified Simiao Pill"based on the"TLR4/NF-kB"signal pathway.[Methods] 108 SD male rats were randomly divided into normal group, model group, colchicine group,"Modified Simiao Pill"low,medium and high dose groups, 18 rats in each group. Except the normal group, the rest rats were established as AGA model by injecting monosodium urate(MUS) into the knee joint cavity according to Coderre method, after 4 days of treatment, the calculation of each time point tested joint swelling index, the pathological changes of synovial tissue were observed by optical microscope, and the content of IL-1βand TNF-αin joint cavity washing liquid was detected by ELISA method;Immunohistochemistry was applied to measure the expression of TLR4, NF-kB and p-NF-kB protein in synovial tissues. RT-PCR was used to detect the expression of TLR4mRNA in synovial tissues. [Results] Compared with the normal group, model group of rat knee joint swelling index was significantly increased(P<0.01), synovial tissue inflammatory changed obviously, and the expression of TLR4, NF-kB and p-NF-kB protein and TLR4mRNA in synovial tissue was significantly increased(P<0.01), the contents of IL-1βand TNF-αin the washing fluid of the joint cavity were significantly increased(P<0.01).Compared with the model group,"Modified Simiao Pill"high and medium dose group rats knee of joint swelling index decreased significantly(P<0.01), synovial tissue inflammatory changes were alleviated significantly, and the expression of TLR4, NF-kB and p-NF-kB protein and TLR4mRNA in synovial tissue was significantly decreased(P<0.01), the contents of IL-1βand TNF-αin the washing fluid of the joint cavity were significantly decreased(P<0.01).[Conclusion]"Modified Simiao Pill"may be through inhibiting the "TLR4/NF-kB"signaling pathway, thereby inhibiting the production of IL-1βand TNF-αto play a role in the treatment of AGA, and the therapeutic effect is in a dosage-dependent manner.%[目的]观察“加味四妙丸”治疗急性痛风性关节炎（ acute gouty arthritis, AGA）大鼠的疗效，并基于“ TLR4/NF-kB”信号通路探讨“加味四妙丸”作用机制。[方法]108只SD雄性大鼠，随机分为正常组、模型组、秋水仙碱组“、加味四妙丸”低、中、高剂量组，每组18只。除正常组外，其余大鼠参照Coderre造模方法膝关节腔注射尿酸钠悬浊液制作AGA模型，治疗4d后，计算各时间点受试关节肿胀指数,光学显微镜观察受试关节滑膜组织病理学变化，采用ELISA法检测关节腔冲洗液IL-1β、TNF-α的含量，免疫组化法检测关节滑膜组织 TLR4、NF-kB、p-NF-kB蛋白表达， RT-PCR法检测滑膜组织TLR4mRNA表达。[结果]与正常组比较，模型组大鼠膝关节肿胀指数显著升高（ P<0.01），关节滑膜组织炎性改变明显,滑膜组织中TLR4、NF-kB、p-NF-kB蛋白表达量和TLR4mRNA表达量显著上调（ P<0.01），关节腔冲洗液中IL-1β、TNF-α含量显著升高（ P<0.01）；与模型组比较，“加味四妙丸”中、高剂量组大鼠治疗后关节肿胀指数显著下降（ P<0.01），关节滑膜组织炎性改变明显减轻，滑膜组织中 TLR4、NF-kB、p-NF-kB蛋白表达量和TLR4mRNA表达量均显著下调（ P<0.01），关节腔冲洗液中IL-1β、TNF-α含量显著下降（ P<0.01）。[结论“]加味四妙丸”可能通过抑制“ TLR4/NF-kB”信号通路，从而抑制IL-1β、TNF-α的产生，起到治疗AGA的作用，且其疗效与药物剂量有一定相关性。
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