摘要
目的观察双苓双黄汤口服、芷芥散外洗治疗类风湿性关节炎的临床效果。方法选择126例类风湿关节炎患者,按照随机数字表法分为对照组(n=63)和观察组(n=63)。对照组患者给予常规西药口服,观察组在对照组基础上加用双苓双黄汤口服、芷芥散外洗,对比两组临床治疗的有效率、视觉模拟评分法(visual analogue scale,VAS)评分、中医证候积分变化、疾病活动性(DAS28)、关节肿痛数,监测血清中风湿相关实验室指标[红细胞沉降率(ESR)、类风湿因子(RF)]、炎症因子[脂肪因子趋化素(Chemerin)、基质金属蛋白酶-3(MMP-3)]、骨代谢相关指标[骨保护素(OPG)、核因κB受体活化因子配体(RANKL)]水平,记录用药的不良反应。结果对照组的有效率82.46%(47/57)明显低于观察组的有效率94.64%(53/56)(χ^(2)=4.120,P<0.05);治疗12周后,观察组的关节疼痛VAS评分、中医证候积分、疾病活动度(DAS28)评分明显低于对照组(P<0.05);两组患者的关节肿痛数随着治疗时间的延长逐渐减少,治疗4周、治疗8周、治疗12周后,观察组的关节肿痛数明显少于对照组(P<0.05);治疗12周后,观察组的血清中ESR、RF、Chemerin、MMP-3、RANKL水平明显低于对照组,OPG水平明显高于对照组(P<0.05)。两组不良反应比较,差异无统计学意义(P>0.05)。结论双苓双黄汤口服、芷芥散外洗治疗可能通过抑制类风湿性关节炎患者血清中Chemerin、MMP-3等炎症因子表达及调节RANKL、OPG平衡而减轻软骨炎性损伤、修复骨组织病变,从而更利于减轻症状,控制病情进展,安全性高。
Objective To observe the clinical effect of oral Shuangling Shuanghuang decoction and external washing of Zhi Jie powder in the treatment of rheumatoid arthritis.Methods A total of 126 patients with rheumatoid arthritis were divided into control group(n=63)and observation group(n=63)according to random number table method.The control group was given conventional western medicine orally,and the observation group was additionally given Shuangling Shuanghuang tang orally and Zhi Jie powder external washing on the basis of the control group.The clinical efficacy,visual analogue scale(VAS)score,changes of TCM syndrome score,disease activity(DAS28),joint swelling and pain of the two groups were compared.The levels of rheumatism related laboratory indexes[erythrocyte sedimentation rate(ESR),rheumatoid factor(RF)],inflammatory factors[adipocytokine chemerin(Chemerin),matrix metalloproteinase-3(MMP-3)],bone metabolism related indexes[osteoprotectin(OPG),receptor activator of nuclear factor kappa-B ligand(RANKL)]were monitored in serum,and the adverse reactions were recorded.Results The effective rate of control group(82.46%,47/57)was significantly lower than that of observation group(94.64%,53/56)(χ~2=4.120,P<0.05).After 12 weeks of treatment,the VAS score,TCM syndrome score and disease activity DAS28 score of the observation group were significantly lower than those of the control group(P<0.05).The number of joint swelling and pain in the two groups decreased gradually with the extension of treatment time.After 4 weeks,8 weeks and 12 weeks,the number of joint swelling and pain in the observation group was significantly less than that in the control group(P<0.05).After 12 weeks of treatment,the serum levels of ESR,RF,Chemerin,MMP-3 and RANKL in the observation group were significantly lower than those in the control group,and the level of OPG was significantly higher than that in the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Shuangling Shuangh
作者
徐威
余利军
吴华杰
XU Wei;YU Li-jun;WU Hua-jie(Comprehensive Ward of Chun'an County Hospital of Traditional Chinese Medicine,Hangzhou,Zhejiang 311700,China;不详)
出处
《中国地方病防治》
CAS
2022年第6期518-523,共6页
Chinese Journal of Control of Endemic Diseases
基金
浙江省青年人才基金项目(2021ZQ080)。
关键词
类风湿关节炎
脾虚湿热证
中医内外合治
炎性损伤
骨破坏修复
Rheumatoid Arthritis
Dampness-heat syndrome of spleen deficiency
Internal and external treatment of TCM
Inflammatory injury
Bone damage repair
