新风胶囊对活动期类风湿关节炎患者的疗效及对血小板参数 血小板CD59的影响

Effects of Xinfeng Capsule on Platelet Parameters CD59 and Therapeutic Effect on Rheumatoid Arthritis Patients in Active Phase

目的:观察新风胶囊对活动期类风湿关节炎(rheumatoid arthritis,RA)患者的疗效及对血小板参数[血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)、血小板分布宽度(PDW)]、血小板CD59的影响。方法:检测60例活动期RA患者血小板参数、血小板CD59及各活动性指标(ESR、α1-AGP、CRP、RF),并将60例RA患者按随机数字表分为新风胶囊实验组35例和正清风痛宁对照组25例,治疗1个疗程后,观察两组的疗效和血小板参数、血小板CD59、各活动性指标的变化,另设正常对照组20例并检测上述指标。结果:①与正常对照组相比,活动期RA患者PLT、PCT、MPV显著升高,CD59显著降低(P<0.01或P<0.05);两治疗组总有效率相比无显著差异,但实验组显效率显著高于对照组(P<0.05);治疗后新风胶囊组及正清风痛宁组患者ESR、α1-AGP、CRP、RF显著降低,CD59显著升高(P<0.01或P<0.05);与正清风痛宁对照组相比,新风胶囊组PLT、PCT、ESR显著降低,CD59显著升高(P<0.01或P<0.05)。②PLT、PCT与IgG、ESR、CRP、RF、关节疼痛、关节肿胀呈正相关关系,PLT还与关节压痛和晨僵时间呈正相关,与CD59呈负相关(P<0.01或P<0.05)。结论:活动期RA患者血小板参数PLT、PCT显著升高,且与CD59、ESR、CRP、RF、IgG和关节疼痛、关节肿胀、关节压痛、晨僵时间具有相关性,提示PLT、PCT可以作为反映RA活动性的一项客观指标;新风胶囊能降低活动期RA患者PLT、PCT及炎症活动指标,其机制可能与提高血小板CD59的水平,抑制过亢免疫反应有关。

Objective：To observe effects of Xinfeng Capsule （XFC） on platelet parameters（ platelet count, thrombocytocrit, mean platelet volume,platelet distribution width）, CD59 and therapeutic effect on rheumatoid arthritis（RA） patients in active phase. Methods ： To detect platelet parameters, CD59 and reactive indexes （ ESR, α1 - AGP, CRP, RF） of 60 RA patients in active phase. And 60 RA patients in active phase were divided into XFC treated group （35 examples ）, Zhengqingfengtongning （ZQF） control group（25 examples） according to random digits table. After a course of treatment ,observed therapeutic effect and the changes of platelet parameters, CD59, reactive indexes of two groups. Setted up a normal control （20 examples） group and detected above - mentioned indexes. Observed platelet ultrastructure of two exam- pies with transmission electron microscope of per groups, Results ：①Compared with normal control group, PLT, PCT, MPV of RA patients in active phase were obviously increased and CD59 was obviously decreased （ P 〈 0.01 or P 〈 0, 05 ）, Platelet ultrastructure was obviously damaged, ②The total effective rate of two treated groups had no significant deviation （P 〉 0. 05）. But the excellence rate of XFC exceeded control group （ P 〈 0, 05 ）, After being treated, ESR, α1 - AGP, CRP,RF were obviously decreased and CD59 was obviously increased in XFC group and ZQF group（P 〈 0, 01 or P 〈 0. 05）. Platelet ultrastructure was obviously improved. Compared with ZQF group, PLT, PCT, ESR were obviously decreased and CD59 was obviously increased in XFC group（ P 〈 0. 01 or P 〈 0.05 ）, And platelet ultrastructure of XFC group was better than ZQF group. ③PLT, PCT were positively correlated with IgG, ESR, CRP, RF, arthrpain, arthrocele. PLT was positively correlated with arthrtenderness, morning stiffness time and CD59 was negatively correlated with it （ P 〈 0. 01 or P 〈 0. 05 ）. Conclusion ： PLT, PCT of RA patients in active phase were increased, and have correlation with CD59, IgG, ESR, CRP, RF, arthrpain, arthrocele, arthrtenderness, morning stiffness time. It suggests that PLT, PCT can reflect reactiveness of RA as a objective index. XFC can decrease PLT, PCT and reactive indexes of inflammation of rheumatoid arthritis patients in active phase. The mechanism of action may be relating to that XFC can increase CD59 and inhibit excessive immunoreaction.