健脾活血法对类风湿关节炎患者血清促肾上腺皮质激素与血管内皮生长因子水平的影响

Effect of Strengthening Pi and Activating Blood Circulation Therapy on Serum Levels of Adrenocorti-cotrophic Hormone and Vascular Endothelial Growth Factor in Rheumatoid Arthritis Patients

目的观察健脾活血法对类风湿关节炎(RA)患者血清促肾上腺皮质激素(ACTH)与血管内皮生长因子(VEGF)水平的影响。方法随机选择门诊类风湿关节炎患者70例,中药组(30例)用健脾活血法结合辨证加味治疗;西药组(20例)用消炎痛结合甲氨喋呤治疗;中西医组(20例)综合两种方法治疗,疗程均为3个月。治疗前后各采取空腹血清测定ACTH与VEGF水平。结果总有效率中药组为80.0%,西药组为85.0%,中西医组为95.0%,以中西医组疗效为优(P<0.05)。血清ACTH水平:3组治疗后均比治疗前升高(P<0.05或P<0.01),中西医组优于中药组与西药组(P<0.01);VEGF含量:3组治疗后均比治疗前降低(P<0.01),中西医组优于中药组与西药组(P<0.01)。结论健脾活血中药能显著升高RA患者血清ACTH水平,降低血清VEGF含量,具有类似西药的改善病情作用。

Objective To observe the effect of strengthening Pi and activating blood circulation therapy （SPAB） on serum levels of adrenocorticotrophic hormone （ACTH） and vascular endothelial growth factor （VEGF） in rheumatoid arthritis （RA） patients. Methods Seventy RA patients were randomly assigned to 3 groups. The 30 in the Chinese medicine （CM） group were treated with SPAB; the 20 in the Western medicine （WM） group were treated with indomethacin and methopterin; and the 20 in the CM-WM group were treated with the combination of the therapy in the above two groups, and the course of treatment was 3 months for all. Serum levels of ACTH and VEGF were determined before and after treatment. Results The total effective rate in the CM group was 80.0 %, WM group 85.0 % and CM-WM group 95.0 %, the last one showed the best efficacy （P〈0.05）. Serum level of ACTH increased and level of VEGF decreased after treatment in all groups （P〈 0.05 or P 〈 0.01 ）, but the increment/decrement in the CM-WM group was higher than that in the other two groups （P〈0.01）, while comparison between that in the CW group and WM group showed insignificant difference. Conclusion SPAB therapy has the effect in alleviating the condition of RA, similar to that of Western medicine, it can increase the serum level of ACTH and decrease the serum level of VEGF remarkably in RA patients.