摘要
目的探讨独活寄生汤对类风湿关节炎肾气虚寒证患者早期软骨破坏标志物的影响。方法将符合入选标准的2019年3月-2020年3月本院64例类风湿关节炎患者按随机数字表法分为2组,每组32例。对照组给予西医常规疗法治疗,观察组在对照组基础上加用独活寄生汤。2组均治疗8周。分别于治疗前后进行中医证候评分,采用ELISA法检测血清CRP、IL-6及软骨寡聚糖蛋白(COMP)、β-链蛋白(β-catenin)水平,记录治疗期间的不良反应,评价临床疗效。结果观察组总有效率为87.5%(28/32)、对照组为65.6%(21/32),2组比较差异有统计学意义(χ^(2)=4.27,P=0.039)。治疗后,观察组主症、次症及舌脉评分均低于对照组(t值分别为7.11、3.11、2.41,P<0.01或P<0.05);血清CRP、IL-6水平均低于对照组(t值分别为3.04、4.56,P值均<0.01);血清COMP[(12.37±1.68)μg/L比(14.24±1.88)μg/L,t=4.20]、β-catenin[(1.35±0.24)μg/L比(1.68±0.31)μg/L,t=4.76]水平均低于对照组P<0.01)。治疗期间,观察组不良反应发生率为25.0%(8/32)、对照组为18.8%(6/32),2组比较差异无统计学意义(χ^(2)=0.37,P=0.546)。结论独活寄生汤可明显降低类风湿关节炎患者炎性细胞因子水平及早期软骨破坏标志物水平,提高临床疗效且安全性较好。
Objective To investigate the effect of Duhuo Jisheng Decoction on early cartilage destruction markers in patients with rheumatoid arthritis with kidney-qi deficiency and cold syndrome.Methods A total of 64 patients with rheumatoid arthritis in our hospital from March 2019 to March 2020 who met the inclusion criteria were divided into 2 groups,according to the random number table method,with 32 in each group.The control group was given conventional western medicine therapy,and the observation group was given Duhuo Jisheng decoction on the basis of the control group.Both groups were treated for 8 weeks.TCM syndrome scores were performed before and after treatment,serum CRP,IL-6,cartilage oligosaccharide protein(COMP)andβ-catenin were detected by ELISA method,and adverse eventns during treatment were observed and compared.The clinical efficacy was evaluated.Results The total effective rate was 87.5%(28/32)in the observation group and 65.6%(21/32)in the control group,and the difference between the two groups was statistically significant(χ^(2)=4.27,P=0.039).After treatment,the main symptoms,secondary symptoms and tongue and pulse scores of the observation group were significantly lower than those in the control group(t=7.11,3.11,2.41,P<0.01 or P<0.05);serum CRP and IL-6 levels were significantly lower than those in the control group(t=3.04,4.56,P<0.01);serum COMP[(12.37±1.68)μg/L vs.(14.24±1.88)μg/L,t=4.20],β-catenin[(1.35±0.24)μg/L vs.(1.68±0.31)μg/L,t=4.76]levels were significantly lower than those in the control group(P<0.01).During the treatment,the incidence of adverse events was 25.0%(8/32)in the observation group and 18.8%(6/32)in the control group,and there was no significant difference between the two groups(χ^(2)=0.37,P=0.546).Conclusion The Duhuo Jisheng Decoction can help to reduce the levels of inflammatory cytokines and early cartilage destruction markers in patients with rheumatoid arthritis,and improve the clinical efficacy safely.
作者
刘星
夏平
周秋明
Liu Xing;Xia Ping;Zhou Qiuming(Department of Traditional Chinese Medicine,Dazu District People's Hospital,Chongqing 402360,China)
出处
《国际中医中药杂志》
2022年第12期1370-1374,共5页
International Journal of Traditional Chinese Medicine
基金
重庆市卫生计生委中医药科技计划项目(2019ZY3480)。
关键词
关节炎
类风湿
独活寄生汤
肝肾阴虚
软骨破坏标志物
Arthritis,rheumatoid
Duhuo Jisheng Decoction
Syndrome of yin deficiency of liver and kidney
Cartilage destruction marker
