蠲痹汤加减对风寒湿痹型类风湿关节炎患者关节液中炎症因子,血清MMP-3,OPG及RANKL的影响

发布时间：2018-01-06 03:34

本文关键词：蠲痹汤加减对风寒湿痹型类风湿关节炎患者关节液中炎症因子,血清MMP-3,OPG及RANKL的影响　出处：《中国实验方剂学杂志》2017年22期 　论文类型：期刊论文

【摘要】：目的:探讨风寒湿痹型类风湿关节炎(RA)应用蠲痹汤加减治疗的临床效果,及对患者关节液中炎症因子、生活质量的影响。方法:选取天津中医药大学第一附属医院2015年1月—2017年1月收治的134例RA患者,采用随机数字表法均分为两组。两组患者均给予相同的非药物治疗,对照组在此基础上予以美洛昔康+甲氨喋呤治疗,观察组予蠲痹汤加减治疗。比较两组患者中医证候疗效,治疗前后理化指标、关节液炎症因子水平、生活质量评分及血清基质金属蛋白酶-3(matrix metalloproteinase-3,MMP-3),骨保护素(osteoprotegerin,OPG)及核转录因子-κB受体活化因子(receptor activator for nuclear factor-κB ligand,RANKL)表达水平,并观察不良反应。结果:治疗12周后,观察组中医证候疗效有效率为94.0%,对照组为82.1%,观察组优于对照组(P0.05)。与治疗前比较,两组患者治疗12周后红细胞沉降率(erythrocyte sedimentation tate,ESR)值及血清C反应蛋白(C-reactive protein,CRP),类风湿因子(rheumatoid factor,RF)水平均明显降低(P0.05),且观察组下降更明显(P0.05)。两组患者治疗12周后关节液肿瘤坏死因子(tumor necrosis factor,TNF)-α,白细胞介素(interleukin,IL)-17水平均明显低于治疗前(P0.05),观察组降低更明显(P0.05)。与治疗前相比,两组患者治疗12周后生理健康总评(physical component summary,PCS),心理健康总评(mental component summary,MCS)评分均明显上升(P0.05),观察组升高更明显(P0.05),与治疗前比较,两组患者治疗后MMP-3及RANKL水平降低,OPG水平升高(P0.05)。与对照组比较,观察组治疗后RANKL水平明显降低(P0.05)。结论:风寒湿痹型RA应用蠲痹汤加减治疗更能有效缓解或消除患者的症状体征、减轻机体炎症反应,延缓病情进展,提高生活质量,疗效更优。
[Abstract]:Objective: To investigate the wind cold dampness type of rheumatoid arthritis (RA) clinical application effect of Juanbi decoction, and on inflammatory factors in patients with synovial fluid, affecting the quality of life. Methods: 134 RA patients were selected in First Hospital Affiliated to Tianjin Medical University from January 2015 to January 2017 and were randomly divided into two groups of two groups of patients. Non drug treatment were given the same, the control group were given meloxicam + methotrexate treatment, the observation group were given Juanbi decoction. Compared two groups of patients before and after treatment of TCM syndrome curative effect, physical and chemical indicators, the level of inflammatory factors in synovial fluid, quality of life score and serum matrix metalloproteinases (matrix metalloproteinase-3, -3 MMP-3), osteoprotegerin (osteoprotegerin, OPG) and nuclear factor kappa B receptor activator (receptor activator for nuclear factor- ligand RANKL K B, the expression of water) Ping, the adverse reactions were observed. Results: after 12 weeks of treatment, the observation group of TCM syndrome rate was 94%, 82.1% in the control group, the observation group than the control group (P0.05). Compared with before treatment, two groups of erythrocyte sedimentation rate of 12 weeks of treatment (erythrocyte sedimentation Tate, ESR) value and serum C reactive protein (C-reactive protein, CRP), rheumatoid factor (rheumatoid, factor, RF) levels were significantly reduced (P0.05), and the observation group decreased significantly (P0.05). Two groups of patients with synovial fluid tumor necrosis factor after 12 weeks of treatment (tumor necrosis factor, TNF) - alpha, interleukin (interleukin IL, -17) were significantly lower than before treatment (P0.05), the observation group was significantly lower (P0.05). Compared with before treatment, physical health overall after 12 weeks of treatment in the two groups (physical component, summary, PCS), mental health score (mental component summary MCS (P0) score were significantly increased .05), the observation group increased more significantly (P0.05), compared with before treatment, MMP-3 and RANKL decreased in two groups after treatment, elevated levels of OPG (P0.05). Compared with the control group, the level of RANKL decreased significantly after treatment in observation group (P0.05). Conclusion: the wind cold dampness type RA application of Juanbi Decoction the treatment can eliminate or alleviate the patient's symptoms and signs, reduce the inflammation and delay the progress of the disease, improve the quality of life, better curative effect.

【作者单位】：天津中医药大学第一附属医院;
【基金】：天津市卫生局中医、中西医结合科研项目(07061)
【分类号】：R259
【正文快照】： [网络出版地址]http://kns.cnki.net/kcms/detail/11.3495.R.20170906.1358.046.html[网络出版时间]2017-09-06 13:58类风湿关节炎(RA)是一种以对称性滑膜炎、病因未明为主的慢性进展性、系统性、自身免疫性疾病[1]。主要临床表现有晨僵、关节畸形与功能障碍及多关节受累等。

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