补肾通络汤对类风湿关节炎骨代谢标志物的影响

Effects of Bushen Tongluo decoction on bone metabolic markers in the patients with rheumatoid arthritis

目的观察补肾通络汤对类风湿关节炎(RA)骨代谢标志物的影响。方法62例RA患者采用计算机随机数字表分为治疗组和对照组,各31例,治疗组予补肾通络汤治疗,对照组予金乌骨通胶囊治疗,4周后观察两组疗效,治疗前后观察RA病情评价(DAS28评分)积分,炎症指标(ESR、CRP)及骨代谢指标(PINP、β-CTX、N-MID、VitD)水平。结果治疗组治疗后总有效率87.1%,对照组总有效率77.4%,治疗组治疗后总有效率优于对照组(P<0.05)。两组治疗后DAS28积分、ESR、CRP均较本组治疗前明显降低(P<0.05),治疗组治疗后DAS28评分、CRP改善水平优于对照组(P<0.05)。两组治疗后PINP、β-CTX、VitD较本组治疗前明显改善(P<0.05,P<0.01),且治疗组治疗后优于对照组(P<0.05)。β-CTX与疾病活动性指标CRP、ESR、DAS28呈正相关(r=0.512、0.457、0.601,P<0.05),VitD与疾病活动性指标CRP、ESR、DAS28呈负相关(r=-0.536、-0.521、-0.621,P<0.05)。结论补肾通络汤可有效调节患者骨代谢水平,缓解关节疼痛症状,控制病情。

Objective To observe the effects of bushen tongluo decoction on bone metabolic markers in the patients with rheumatoid arthritis(RA).Methods A total of 62 RA patients were divided into a treatment group and a control group,31 cases in each according to the random number table.In the treatment group,bushen tongluo decoction was used.In the control group,jinwu gutong capsules were prescribed.After 4 weeks,the therapeutic effects were observed,DAS 28 score,inflammatory indicators(ESR and CRP)and bone metabolic markers(PINP,β-CTX,N-MID and VitD)were recorded before and after treatment.Results The total effective rate was 87.1%in the treatment group and was 77.4%in the control group.The result in the treatment group was better than the control group(P<0.05).DAS28 score,ESR and CRP were reduced obviously in the two groups(P<0.05).The improvements in DAS28 score and CRP in the treatment group were better than the control group(P<0.05).The levels of PINP,β-CTX and VitD were all improved in the two groups(P<0.05)and the improvements in the treatment group were better than the control group(P<0.05).The improvement inβ-CTX presented the positive correlation with the disease activity indicators(CRP,ESR and DAS28)(r=0.512,0.457,0.601,P<0.05),and VitD presented the negative correlation(r=-0.536,-0.521,-0.621,P<0.05).Conclusion Bushen tongluo decoction effectively regulates the levels of bone metabolic markers,relieves joint pain and controls the disease in RA patients.