雷公藤多苷治疗膝关节急性滑膜炎效果及作用机制分析

Application and Mechanism of Tripterygium Glycosides in the Treatment of Acute Synovitis of Knee Joint

目的:探讨雷公藤多苷在膝关节急性滑膜炎(ASK)治疗中的应用效果及作用机制。方法:随机数字表分组法将符合诊断及纳入标准的78例ASK患者分为两组。对照组采用微波疗法联合艾瑞昔布片进行治疗;观察组在对照组基础上加服雷公藤多苷。对比两组临床效果、疼痛缓解程度、肿胀及关节功能评分;测定并分析两组治疗前及治疗1周、2周后滑液中hs-CRP、IL-1、MMP-3、TNF-α水平。结果:持续2周治疗后,观察组临床效果及疼痛程度分级改善情况明显优于对照组(P<0.05),肿胀、关节功能评分明显低于对照组(P<0.05)。治疗1周后和治疗2周后,观察组滑液中hs-CRP、IL-1、MMP-3、TNF-α水平均明显低于对照组(P<0.05)。结论:雷公藤多苷治疗ASK临床效果显著,可有效缓解关节肿胀、疼痛等症状,改善膝关节功能,治疗机理可能与其良好的抗炎作用有关。

Objective:To explore the effect and mechanism of tripterygium glycosides in the treatment of acute synovitis(ASK) of knee joint.Methods:78 ASK patients who met the diagnostic and inclusion criteria were divided into two groups by the random number table grouping method.The control group was treated with microwave therapy combined with ericoxib tablets;the observation group was supplemented with tripterygium glycosides on the basis of the control group.The clinical effects,pain relief,swelling and joint function scores were compared between two groups.The levels of hs-CRP,IL-1,MMP-3 and TNF-α in synovial fluid were measured before treatment and 1 week and 2 weeks after treatment.Results:After 2 weeks of treatment,the clinical improvement and the improvement of pain grade in the observation group were significantly better than those of the control group(P<0.05),swelling and joint function scores were significantly lower than the control group(P<0.05).After 1 week and 2 weeks after treatment,the levels of hs-CRP,IL-1,MMP-3 and TNF-α in the synovial fluid of the observation group were significantly lower than those of the control group(P<0.05).Conclusion:The clinical effect of tripterygium glycosides in the treatment of ASK is significant,which can effectively alleviate joint swelling,pain and other symptoms,and improve knee joint function,which may be related to its good anti-inflammatory effect.