筋骨通胶囊治疗髋关节受累型幼年特发性关节炎临床研究

Clinical Study on Jingutong Capsule Treating Juvenile Idiopathic Arthritis with Hip Joint Involvement

目的观察筋骨通胶囊治疗髋关节受累型幼年特发性关节炎(JIA)的临床疗效.方法选择来我院就诊的JIA患儿44例,随机分为治疗组、对照组各22例.对照组予以白芍总苷+甲氨蝶呤药物口服,治疗组在对照组基础上加用我院自制中成药筋骨通胶囊,同时2组均予以髋关节推拿按摩治疗.治疗4月后,比较治疗前后的中医证候积分及临床疗效、骨密度值(BMD)、视觉模拟评分(VAS)、主要体征(晨僵时间、指地距、枕墙距、Schober征)、疾病活动指标及血清炎症因子水平变化情况.结果治疗后治疗组左、右髋BMD没有明显变化(P>0.05),而对照组左、右两髋的BMD较治疗前明显下降(P<0.05),治疗组明显高于对照组(P<0.01).中医证候积分及临床疗效的变化,治疗组疗效明显优于对照组(P<0.01);治疗组VAS评分结果优于对照组(P<0.01);治疗组指地距、枕墙距、晨僵时间、Schober征改善情况优于对照组(P<0.01);治疗组红细胞沉降率(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP抗体),血清白细胞介素IL-1,IL-17、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶MMP-3和MMP-14水平明显下降(P<0.01),优于对照组(P<0.01).结论筋骨通胶囊治疗JIA有显著疗效.

OBJECRTIVE To observe the clinical effect of Jingutong capsule on the treatment of juvenile idiopathic arthritis (JIA) with hip joints involvement. METHODS 44 cases of JIA patients in our hospital were randomly divided into the treatment group (22 cases) and the control group (22 cases). In the control group, the total glucosides of paeony and methotrexate were taken orally. The treatment group was given Jingutong capsule, a self made Chinese patent medicine of our hospital, on the basis of the control group. In addition, both groups were also given Chinese traditional massage on hips. After 4 months' treatment, TCM syndrome grade, clinical curative effect, bone mineral density (BMD), visual analogue scale (VAS), main signs (morning stiffness time, the finger floor distance, occipito wall gap, Schober sign), disease activity index and changes of the serum inflammatory factors level were compared before and after the treatment. RESULTS After treatment, BMD of left and right hip in the treatment group was not significantly changed ( P >0.05), while BMD of left and right hip in control group was significantly lower than that before treatment (P<0.05). The curative effect of the treatment group was significantly better than that of the control group (P<0.01). As to TCM syndrome grade and clinical efficacy, the treatment group was significantly superior to the control group (P<0.01). The VAS score in the treatment group was better than that in the control group (P<0.01), and the improvement of finger floor distance, occipito wall gap, morning stiffness time and Schober sign in the treatment group were much more significant than that in the control group (P<0.01). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti cyclic citrullinated peptide antibody (anti CCP), serum IL-1, IL-17, tumor necrosis factor-α(TNF-α), the levels of matrix metalloproteinase 3 (MMP 3) and matrix metalloproteinase 14 (MMP 14) decreased much more significantly in the treatment group (P<0.01) than that in the control group (P<0.01). CONCLUSION Jingutong capsule has a significant effect on the treatment of JIA.