导痰汤加减治疗类风湿关节炎的疗效观察及对患者免疫功能IL-17和OPG水平的影响

Curative Observation of Treating Rheumatoid Arthritis Patients with Modified Daotan Decoction and the Effect on Immune Function,IL-17 and OPG Levels

目的:观察导痰汤加减对类风湿关节炎(RA)伴肿胀患者免疫、白细胞介素-17(IL-17)及骨保护因子(OPG)水平的影响。方法:选取2014年5月至2015年5月我院80例RA患者作为研究对象,根据病情和患者个人意愿分为两组,观察组49例行西医内科常规治疗联合中医导痰汤加减治疗,对照组31例行单纯西医内科治疗,观察两组治疗效果、治疗前后免疫功能、IL-17及OPG水平变化情况。结果:观察组治疗总有效率(95.92%)显著高于对照组(80.65%,差异有统计学意义(P<0.05)。观察组治疗后CD3+、CD8+显著高于对照组,CD4+和CD4+/CD8+显著低于对照组,差异有统计学意义(P<0.05)。观察组治疗后IL-17为(15.29±3.37)pg/ml,显著低于治疗前和对照组治疗后,OPG为(2463.17±201.49)pg/ml,显著高于治疗前和对照组治疗后,差异均有统计学意义(P<0.05)。结论:导痰汤加减治疗类风湿性关节炎疗效显著,能显著改善患者关节肿痛症状,控制炎症,提高机体免疫功能。

Objective： To study the effect of Modified Daotan Decoction on immune,interleukin-17（ IL-17） and osteoprotegerin（ OPG） levels in patients with rheumatoid arthritis（ RA） complicated by swelling. Methods： 80 cases of patients with RA who were admitted into our hospital from May 2014 to May 2015 were selected as the study objects. According to the pathogenetic condition and patients＇ own will,they were divided into two groups. 49 cases in the observation group were treated with routine therapy of western medicine combined with traditional Chinese medicine of Modified Daotan Decoction. 31 cases in the controlled group were treated with western medicine alone. The curative effects,immune function before and after treatment,changes of IL-17 and OPG levels in the two groups were observed. Results： The total effective rate in the observation group（ 95. 92%） was significantly higher than that in the controlled group（ 80. 65%）（ P 0. 05）. After treatment,CD3＋and CD8＋in the observation group were significantly higher than those in the controlled group while CD4＋and CD4＋/ CD8＋were significantly lower than those in the controlled group（ P0. 05）. After treatment,IL-17（ 15. 29±3. 37） pg / ml in the observation group was significantly lower than that before the treatment and that in the controlled group after treatment while OPG（ 2463. 17±201. 49） pg / ml was significantly higher than that before treatment and those in the controlled group after treatment（ P0. 05）. Conclusions： The effect of Modified Daotan Decoction in the treatment of RA is significant. It can significantly alleviate joint pain symptoms in patients,control inflammation and improve immune function.