通络灵酊剂联合中频导入治疗痰瘀互结型类风湿关节炎的临床观察

发布时间：2018-02-27 12:27

本文关键词： 通络灵酊剂中频导入痰瘀互结类风湿关节炎血管内皮生长因子肿瘤坏死因子-α 骨碱性磷酸酶白细胞介素-　出处：《中国实验方剂学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的:观察通络灵酊剂中频导入治疗痰瘀互结型类风湿关节炎(RA)的临床疗效及作用机制。方法:按照随机数字表法将120例痰瘀互结型RA患者分为观察组和对照组,各60例。两组患者均按照指南进行关节功能锻炼,对照组中频导入利多卡因注射液,20 min/次,1次/d;观察组中频导入通络灵酊剂,20 min/次,1次/d。观察两组患者治疗前后关节肿胀数,关节压痛数,晨僵时间,双手平均握力;记录数字疼痛分级法(NPS)评分,健康调查问答(HAQ)评分,28个关节疾病活动度(DAS28)评分;检测两组患者治疗前后血清血管内皮生长因子(VEGF),白细胞介素-10(IL-10),肿瘤坏死因子-α(TNF-α),骨碱性磷酸酶(BAP)水平;观察两组患者不良反应情况。结果:观察组临床疗效总有效率为88.33%,对照组临床疗效总有效率为71.67%,观察组优于对照组(χ~2=5.208,P0.05);治疗后观察组关节肿胀数,关节压痛数,晨僵时间均低于对照组(P0.01),双手平均握力高于对照组(P0.01);治疗后观察组NPS评分,HAQ评分,DAS28评分均低于对照组(P0.01);治疗后,观察组VEGF,TNF-α,BAP水平低于对照组(P0.01),观察组IL-10水平高于对照组(P0.01);两组患者治疗期间均无明显的不良反应发生。结论:在关节功能训练的基础上,通络灵酊剂中频导入治疗痰瘀互结型类风湿关节炎临床疗效显著并且安全,其作用机制可能与降低VEGF,TNF-α,BAP水平,提高IL-10水平有关。
[Abstract]:Objective: To observe the effect of Tongluo Ling tincture if iontophoresis in the treatment of phlegm and blood stasis type of rheumatoid arthritis (RA) clinical efficacy and mechanism. Methods: according to the random number table method, 120 cases of phlegm and blood stasis type RA patients were divided into observation group and control group, 60 cases in each group. Two patients were in accordance with the guidelines. Joint functional exercise, control group if import of lidocaine hydrochloride 20 min/ time, 1 times /d; observation group if import Ling Tongluo tincture, 20 min/, 1 /d. in two groups before and after treatment to observe the number of joint swelling, joint tenderness, morning stiffness time, average grip strength of both hands; recorded digital pain grading method (NPS) Q score, health survey (HAQ) score, 28 joint disease activity score (DAS28); detection of two groups before and after treatment of serum vascular endothelial growth factor (VEGF), interleukin -10 (IL-10), tumor necrosis factor alpha (TNF- alpha), bone alkaline phosphatase (BAP) levels were observed; two The adverse reaction of patients. Results: in the observation group, the total effective rate was 88.33%, control group total effective rate was 71.67%, the observation group than the control group (~2=5.208, P0.05); the number of observation group after treatment, joint swelling, joint tenderness, morning stiffness time were lower than the control group (P0.01), both the average grip strength is higher than that of control group (P0.01); the NPS score of the observation group after treatment, HAQ score, DAS28 score were lower than the control group (P0.01); after treatment, the observation group VEGF, TNF- alpha, BAP level is lower than the control group (P0.01), the IL-10 level of the observation group higher than the control group (P0.01); two groups of patients during treatment there were no obvious adverse reactions. Conclusion: Based on the joint function training on the spirit if import Tongluo tincture treatment of phlegm and blood stasis type the clinical curative effect and safety of rheumatoid arthritis significantly, and its mechanism may be related to lower VEGF, TNF- alpha, BAP level, improve the level of IL-10.

【作者单位】：河北省中医药科学院;河北省体育科学研究所;
【基金】：河北省中医药管理局科研计划项目(2013174)
【分类号】：R259

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