摘要
目的:探讨当归四逆汤对类风湿性关节炎患者骨代谢及炎症细胞因子水平的影响。方法:选取2017年1月-2021年6月滕州市中医医院收治的306例类风湿性关节炎患者,应用随机数字表法将306例患者分为观察组(n=153)和对照组(n=153)。对照组行常规西药治疗,观察组在对照组基础上加用当归四逆汤治疗,对比两组的治疗总有效率、临床证候、骨代谢指标及炎症细胞因子水平。结果:观察组的治疗总有效率(92.81%)高于对照组(76.47%),差异有统计学意义(P<0.05)。治疗前两组晨僵时间、压痛关节数和肿胀关节数相比差异均无统计学意义(P>0.05);治疗后,两组的三项指标均下降,且观察组晨僵时间短于对照组、压痛关节数和肿胀关节数均少于对照组,差异均有统计学意义(P<0.05)。治疗前两组的N-端骨钙素(N-MID)、总Ⅰ型胶原氨基端延长肽(T-PⅠNP)、25羟维生素D[25(OH)D]及β-胶原降解产物(β-CTX)四项骨代谢指标相比差异均无统计学意义(P>0.05);治疗后,两组的N-MID、T-PⅠNP、25(OH)D较治疗前均上升,且观察组均高于对照组,β-CTX较治疗前均下降,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗前两组的环氧合酶(COX-2)、肿瘤坏死因子(TNF-α)、巨噬细胞集落刺激因子(M-CSF)、白介素-17(IL-17)、白介素-27(IL-27)及白介素-32(IL-32)六项炎症细胞因子水平相比差异均无统计学意义(P>0.05);治疗后,两组的六项指标均较治疗前下降,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:当归四逆汤可有效缓解类风湿性关节炎患者临床症状,改善骨代谢状态,缓解炎症反应,效果优异,值得推广。
Objective:To investigate the effect of Danggui Sini Decoction on bone metabolism and inflammatory cytokine levels in patients with rheumatoid arthritis.Method:A total of 306 patients with rheumatoid arthritis admitted to Tengzhou Chinese Medicine Hospital from January 2017 to June 2021 were selected and divided into observation group(n=153)and control group(n=153)by random number table method.The control group was treated with conventional western medicine,and the observation group was treated with Danggui Sini Decoction on the basis of the control group,and the total efficiency of treatment,clinical symptoms,bone metabolic indexes and inflammatory cytokine levels were compared between the two groups.Result:The total effective rate of treatment in the observation group(92.81%)was higher than that in the control group(76.47%),the difference was statistically significant(P<0.05).There were no significant differences in the time of morning stiffness,the number of pressure painful joints and the number of swollen joints between the two groups before treatment(P>0.05);after treatment,all three indexes decreased in both groups,the time of morning stiffness of the observation group was shorter than that of the control group,and the number of pressure painful joints and the number of swollen joints were less than those of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the four bone metabolic indexes of N-terminal osteocalcin(N-MID),total typeⅠcollagen amino-terminal extension peptide(T-PⅠNP),25 hydroxyvitamin D[25(OH)D]andβ-collagen degradation product(β-CTX)(P>0.05);after treatment,N-MID,T-PⅠNP and 25(OH)D increased in both groups compared with those before treatment,and those in the observation group were higher than those in the control group,β-CTX decreased compared with those before treatment,and that in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).Befo
作者
陈昶
CHEN Chang(Tengzhou Chinese Medicine Hospital,Shandong Province,Tengzhou 277500,China)
出处
《中国医学创新》
CAS
2023年第4期102-106,共5页
Medical Innovation of China
关键词
当归四逆汤
类风湿性关节炎
骨代谢
炎症细胞因子
Danggui Sini Decoction
Rheumatoid arthritis
Bone metabolism
Inflammatory cytokines
