补阳还五汤治疗活动期多发性大动脉炎的临床疗效及对血管内皮功能的改善作用

Curative efficacy of buyang huanwu decoction in treating patients with Takayasu arteritis at active stage and its improvement on vascular endothelial injury

目的 探讨补阳还五汤联合环磷酰胺治疗活动期多发性大动脉炎（Takayasu arteritis,TA）的临床疗效及对血管内皮损伤改善作用。方法 选取2015年1月~2016年4月于武警北京总队医院接受治疗的88例活动期多发性大动脉炎患者作为研究对象,采用随机数字表法分为对照组42例和观察组46例。对照组给予环磷酰胺治疗,观察组在对照组基础上联合补阳还五汤治疗。2组共治疗4 w。疗程结束后,比较2组治疗总有效率、红细胞沉降率（erythrocyte sedimentation rate,ESR）、C反应蛋白（C reactive protein,CRP）及血管内皮损伤指标水平,并比较不良反应发生情况。结果 观察组患者治疗总有效率高于对照组（89.1%vs.71.4%,P〈0.05）。治疗后,与对照组相比,观察组患者ESR、CRP及血管内皮生长因子（vascular endothelial growth factor,VEGF）、内皮素-1（endothelin-1,ET-1）等血管内皮损伤指标水平明显降低,组间比较差异均有统计学意义（P〈0.05）。2组不良反应发生率分别为26.1%和21.4%,组间比较无明显差异。结论 补阳还五汤联合环磷酰胺治疗活动期多发性大动脉炎的治疗有效率高,且不良反应发生率无明显增加。

Objective To investigate the curative efficacy of buyang huanwu decoction in combination with cyclophosphamide in treating patients with Takayasu arteritis （ TA） at active stage and its improvement on vascular endothelial injury. Methods 88 patients with TA at active stage who received therapy in The Hospital of Beijing Armed Police Corps from January 2015 to April 2016 were selected as research objects. According to herapeutic schemes, those patients were divided into the control group （n = 42） and the observation group （ n, = 46 ） . The control group was given cyclophosphamide, while the observation group was given cyclophosphamide in combination with buyang huanwu decoction. Then, the total therapeutic efficacy ratio, laboratory-related indices and indices of vascular endothelial injury were compared between the two groups. During the treatment, ncidence of adverse reactions were compared. Results The observation group had a total therapeutic efficacy ratio of 89. 1% , which was statistically higher than that of 71. 4% in the control group （ P 〈 0. 05 ）. After the treatment, in comparison with the control group, laboratory-related indices of erythrocyte sedimentation rate （ESR） , C reactive protein （CRP） and vascular endothelial injury indices of vascular endothelial growth factor （ VEGF）, endothelin-1 （ET-1） in the observation group were statistically lower （all P 〈 0. 05 ）. During the treatment, the incidence of adverse reactions in the observation group was 26. 1% , which was statistically same with that of 21. 4% in the control group. Conclusion Cyclophosphamide in combination with buyang huanwu decoction is effective for patients with TA at active stage with a high total therapeutic efficacy ratio. And it can significantly improve aboratory-related indices and vascular endothelial injury without increasing incidence of adverse reactions.