摘要
目的:观察消痹散熏洗联合药膏贴敷治疗寒湿痹阻型类风湿性关节炎(RA)的疗效与安全性。方法:80例寒湿痹阻型RA患者随机分为对照组(40例,采用甲氨蝶呤^(+)来氟米特治疗)和观察组(40例,在对照组基础上加用消痹散熏洗联合药膏贴敷治疗),连续治疗2个月。比较两组临床疗效和不良反应,以及治疗前后患者证候积分、关节VAS评分、血清CD4^(+)CD25^(+)CD127^(-)Treg、CD4^(+)IL^(-)17A^(+)Th17细胞百分比及实验室相关指标变化。结果:观察组总有效率高于对照组(P<0.05)。治疗后,两组证候积分、关节VAS评分、血清CRP、IL^(-)6、ESR、RF、抗CCP水平均较前降低(P<0.05),且观察组上述指标明显低于对照组(P<0.05)。治疗后两组CD4^(+)CD25^(+)CD127^(-)Treg比例均较前升高,CD4^(+)IL^(-)17A^(+)Th17比例及Th17/Treg均较前降低(P<0.05);且观察组各项指标均优于对照组(P<0.05)。两组总不良反应发生率差异无统计学意义(P>0.05)。结论:在常规治疗基础上给予消痹散熏洗联合药膏贴敷治疗,可更明显地缓解寒湿痹阻型RA患者局部炎症反应,减轻疼痛,恢复机体正常的免疫功能,疗效好,安全性高。
Objective:To observe the therapeutic effect and safety of Xiaobi powder fumigation and washing combined with ointment application in the treatment of patients with rheumatoid arthritis(RA)of cold^(-)dampness^(-)blocking type.Methods:Totally 80 cases of RA patients with cold^(-)dampness blockage type were divided into the control group(40 cases,treated with methotrexate^(+)leflunomide)and observation group(40 cases,given Xiaobi powder fumigation and washing combined with ointment application on the basis of the control group)according to the random number table method,all treated for 2 months.The clinical efficacy after treatment,symptom score,joint VAS score,the percentage of serum CD4^(+)CD25^(+)CD127^(-)Treg,CD4^(+)IL^(-)17 A^(+)Th17 cells and the levels of related laboratory indexes before and after treatment were compared between the two groups.Results:The total effective rate after treatment in the observation group was higher than that in the control group(P<0.05).Compared with before treatment,the syndrome scores,the joint VAS score,serum levels of CRP,IL^(-)6,ESR,RF and anti^(-)CCP after treatment in the two groups decreased(P<0.05),and the above indicators in the observation group were lower(P<0.05).After treatment,the ratio of CD4^(+)CD25^(+)CD127^(-)Treg in the two groups increased than before,while the ratio of CD4^(+)IL^(-)17 A^(+)Th17 and Th17/Treg decreased than before(P<0.05),and those indicators in the observation group were more obvious than before(P<0.05).There was no statistical difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion:Xiaobi powder fumigation and washing combined with ointment application on the basis of conventional treatment can more obviously alleviate the local inflammatory reaction in patients with cold^(-)dampness^(-)blocking RA,relieve pain,restore normal immune function of the body,and it has good efficacy and high safety.
作者
于昊新
戴思思
费秀丽
姚卫国
刘琨
Yu Haoxin;Dai Sisi;Fei Xiuli;Yao Weiguo;Liu Kun(Department of Nephrology,Shanghai No.6 People's Hospital Jinshan Branch,Shanghai 201599,China)
出处
《药物流行病学杂志》
CAS
2022年第4期227-231,共5页
Chinese Journal of Pharmacoepidemiology
基金
2020年上海市金山区科委课题项目(编号:2020328)。
