清热养阴除湿丸治疗强直性脊柱炎对外周血细胞因子的影响

Cytokine Influence of QINGREYANGYINCHUSHIWAN for Ankylosing Spondylosis

目的:探讨清热养阴除湿丸治疗活动期强直性脊柱炎(AS)的作用机理。方法采用随机分组、对照,将120例活动期AS患者分为两组,并设健康志愿者30例为正常组。试验组90例予清热养阴除湿丸12g,口服3次/d,对照组30例给予柳氮磺吡啶(SSZ)1g,口服2次/d,治疗6个月。检测治疗前后外周血中IL-1、IL-6、IL-10、TNF-α水平,同时观测血沉(ESR)、C反应蛋白(CRP)、Bath AS活动指数(BASDAI)、Bath AS功能指数(BASFI)改善情况。用放射免疫法检测血清中IL-1、IL-6、TNF-α表达,用酶联免疫法检测血清IL-10表达。结果:治疗前试验组、对照组两组与正常组比较IL-6、TNF-α水平升高,差异有统计学意义(P<0.05);治疗后试验组IL-6、TNF-α水平下降,与正常组比较,差异无统计学意义(P>0.05)。对照组治疗后IL-6、TNF-α水平与治疗前比较,差异无统计学意义(P>0.05)。试验组、对照组两组ESR、CRP、BASDAI、BASFI治疗前后比较均有改善,差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05)。结论:清热养阴除湿丸对降低AS患者外周血中IL-6、TNF-α的水平有一定作用,并可有效降低ESR、CRP,改善疾病活动指标。作用机理可能与降低异常升高的细胞因子,减少致炎因子的产生,调节免疫失衡有关。

Objective ： To discuss the mechanism of QINGREYANGYINCHUSHIWAN （QRYYCSW） in treating patients in active stage of ankylosing spondylosis（AS）. Methods ：120 patients with AS were randomly divided into tow groups. The control group was set up including 30 cases of the health. The 90 patients in the treated group were treated with QRYYCSW（ 12g a time and 3 times daily） ,and the 30 patients in the control group were treated with sulfasalazine （SSZ） （ lg a time and twice a day）. The period of treatment was six-months. Observe the changes of IL - 1 ,IL -6,IL - 10,TNF - α,and the levels of ESR and CRP, Bath Ankylosing Spondylitis Disease Activity Index （BASDAI）, Bath Ankylosing Spondylitis Functional Index （BASFI）. The levels of IL- 1 ,IL- 6 ,TNF-α in serum were assaysd by Farr. The levels of IL- 10 in serum were assaysd by ELISA. Results ：The levels of IL - 6 and TNF - α in both groups of patients with AS are higher than the normal group before treatment（ P 〈 0. 05）. The levels of IL -6 and TNF - α in treated groups are reduced as normal level（P 〉0. 05）. There was no significant difference in the control group after treatment （ P 〉 0.05 ）. ESR, CRP, Symptoms, BASDAI and BASFI decreased significantly in both groups after treatment （ P 〈 0.05 ）. There was no significant difference between two groups. （ P 〉 0. 05 ） Conclusion ： It is indicated that QRYYCSW has some effects on reducing the levels of IL - 6 and TNF - α, it has better effect on reducing the levels of ESR and CRP,it can improve symptoms and signs of patients with AS in active stage. The mechanism of treatment may be related to that QRYYCSW can control the secretion of cytokine and inflammatory factors.