排毒尪痹汤结合扶他林治疗类风湿性关节炎的疗效评价及对血清TNF-α、IL-1β、VEGF因子水平影响的研究

Therapeutic Evaluation of Using Paidu Wangbi Decoction Combined with Voltaren in the Treatment of Rheumatoid Arthritis and Study on the Influence of Serum TNF-α,IL-1β and VEGF Levels

目的:观察排毒尪痹汤结合扶他林对类风湿性关节炎(Rheumatoid Arthritis-RA)的治疗效果及对患者血清肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)、血管内皮生长因子(VEGF)表达水平的影响。方法:选取2014年8月~2016年10月新疆医科大学第一附属医院的100例RA患者,随机分为2组,每组50例,对照组采用扶他林治疗,治疗组采用扶他林联合排毒尪痹汤治疗。连续治疗4周为1疗程,治疗两个疗程之后,观察并比较两组患者的临床症状和实验室检测的各指标水平变化及临床治疗效果。结果:治疗前,两组患者的临床症状指标:晨僵时间,关节疼痛程度和数目、关节肿胀程度和数目、步行15分钟的时间、双手握力,实验室检测指标:TNF-α、IL-1β、VEGF,对比差异无统计学意义(P>0.05);治疗后,两组的上述两项各指标均较治疗前明显改善(P<0.05),且治疗组较对照组改善更为明显(P<0.05)。在临床治疗效果方面对比,治疗组的治疗总有效率为92%,明显高于对照组的76%(P<0.05)。结论:排毒尪痹汤结合扶他林的中西医结合治疗方案能明显降低患者的机体炎症水平,缓解临床症状,总体治疗效果相对较好,值得临床推广。

Objective： To explore the therapeutic effect using Paidu Wangbi Decoction combined with Voltaren in the treatment of rheumatoid arthritis and the influence on the expression of serum tumor necrosis factor（ TNF-α）,interleukin-1β（ IL-1β）,vascular endothelial growth factor（ VEGF）. Methods： 100 cases with RA of The First Affiliated Hospital of Xinjiang Medical University from August 2014 to October 2016,were selected and randomly divided into two groups,50 cases in each group.The controlled group was treated with voltaren,and the treatment group were treated with voltaren combined with Paidu Wangbi Decoction. Continuous treatment for 4 weeks was a course of treatment. After two courses of treatment,the clinical symptoms,laboratory indexes and clinical effects of the two groups were observed and compared. Results： Before the treatment,clinical symptoms of the two groups of patients： the time of morning stiffness,the degree and number of joint pain,the degree and number of joint swelling,the time of walking 15 min,hand grip strength; laboratory indexes： TNF-α,IL-1β,VEGF; there was no statistical difference between the two groups（ P0. 05）. After treatment,the above indexes in the two groups were significantly improved（ P0. 05） than those before treatment,and the treatment group was more obvious than the controlled group（ P0. 05）.In the aspect of clinical treatment,the total effective rate of the treatment group was 92%,which was significantly higher than that of the controlled group（ 76%）（ P0. 05）. Conclusion： Integrated traditional Chinese and western medicine treatment plan of Paidu Wangbi Decoction combined with Voltaren can obviously reduce the inflammation level of the patients and relieve the clinical symptoms,and the overall therapeutic effect is relatively good,and it is worthy of clinical promotion.