摘要
目的：观察中药熏蒸联合Inf Iiximab治疗类风湿性关节炎疗效,并探讨其疗效与TNF-α基因-238位点单核苷酸多态性的相关性。方法：随机选取2014年8月至2016年4月于我院内分泌科诊及住院部就诊的脑中风患者110例,以甲氨蝶呤片基础治疗基础上采用中药熏蒸联合Inf Iiximab治疗类风湿性关节炎。治疗前和最后一次治疗后,采用28处关节疾病活动度（DAS28）和健康评估问卷（HAQ）评定,作为RA患者疗效的评定标准。采用高通量荧光PCR检测TNF-α基因-238位点单核苷酸多态性。结果：中药熏蒸联合Inf Iiximab治疗RA,治疗后DAS28评分和HAQ评分均比治疗前低（P〈0.05）,说明中药熏蒸联合Inf Iiximab能有效治疗RA。而在TNF-α基因-238位点单核苷酸多态性中仅GG基因型治疗后DAS28评分和HAQ评分均低于治疗前（P〈0.05）,而AA基因型和AG基因型在这两项评分中差异均无统计学意义（P〉0.05）。中药熏蒸联合Inf Iiximab治疗后临床缓解情况,TNF-α基因-238位点单核苷酸GG型84例,AG型5例,AA型2例,GG型的临床缓解率显著高于AG型（χ^2=26.134,P=0.000〈0.05）和AA型（χ^2=44.872,P=0.000〈0.05）。结论：中药熏蒸联合Infliximab能有效治疗RA,且其疗效与TNF-α基因-238位点的单核苷酸基因多态性可能相关,其中对GG型治疗效果最佳,而AG型和AA型疗效反应则相对较差。
Objective：To observe the curative effect of Chinese medicinal fumigation combined with Inf Iiximab in the treatment of rheumatoid arthritis,and to explore the correlation between the curative effect and the single nucleotide polymorphism of-238 gene TNF-α locus.Methods：There were 110 cases of stroke patients in endocrinology clinic and inpatient department in our hospital during August 2014 to April 2016.The rheumatoid arthritis patients were treated with Chinese medicinal fumigation combined with Inf Iiximab on the basis of Methotrexate Tablets.And 28 joint disease activity（ DAS28） and health assessment questionnaire（ HAQ） were used to assess the efficacy of RA patients before and after the treatment.Detection of single nucleotide polymorphism of-238 gene in TNF-α gene was performed by high throughput fluorescence PCR.Results：The DAS28 score and HAQ score were lower after treatment（ P〈0.05）,which showed that Chinese medicinal fumigation combined with Inf Iiximab can effectively treat RA.And in TNF-α gene 238 single nucleotide polymorphisms,only GG genotype＇s DAS28,HAQ scores dropped after treatment（ P〈0.05）,and AA and AG genotypes had no significant differences in the two scores（ P〉0.05）.As for Chinese medicinal fumigation treatment combined with Inf Iiximab clinical remission,there were 84 cases of TNF-α gene 238 nucleotide GG genotype,5cases AG type and 2 cases AA type,GG type of clinical remission rate was significantly higher than that of AG（ χ^2= 26.134,P= 0.000 0.05） and the AA type（ χ^2= 44.872 P = 0.000 0.05）.Conclusion：Chinese medicinal fumigation and infliximab can be effective in the treatment of RA,and its efficacy may be related to 238 locus and TNF-α gene single nucleotide polymorphism,which could be the best treatment of GG genotype,but the treatment of AG and AA genotype are relatively poor.
出处
《世界中医药》
CAS
2016年第8期1443-1446,共4页
World Chinese Medicine
基金
新疆自治区自然科学基金项目(编号:2014ZRQN11)
