川羌除痹汤联合西药对类风湿性关节炎患者免疫功能及Th1/Th2型细胞因子的影响

Effects of Chuanqiang Chubi decoction and western medicine on immune function and Th1/Th2 cytokines in patients with rheumatoid arthritis

目的:观察川羌除痹汤联合西药对类风湿性关节炎患者免疫功能及Th1/Th2型细胞因子的影响。方法:将84例类风湿性关节炎(RA)患者随机分为观察组(42例)和对照组(42例),对照组给予塞来昔布、来氟米特治疗,观察组在对照组的基础上给予川羌除痹汤治疗,疗程均为8周。记录两组中医症候积分、晨僵持续时间、关节压痛数与关节肿胀数、细胞免疫功能及Th1/Th2型细胞因子的变化,并对两组的临床疗效进行比较。结果:治疗组总有效率92.86%显著优于对照组总有效率73.81%,差异有统计学意义(P<0.05)。治疗后,两组中医症候积分、关节压痛数、晨僵持续时间、关节肿胀数明显降低,观察组以上指标低于对照组(P<0.05)。治疗后,两组CD3^+、CD4^+、CD4^+/CD8^+均明显增加,CD8+明显降低,观察组以上指标均优于对照组(P<0.05)。治疗后,两组IL-6、TNF-α明显降低,IL-4、IL-10明显增加,观察组以上指标均优于对照组(P<0.05)。结论:川羌除痹汤可显著改善RA患者临床症状,缓解疼痛,并改善细胞免疫功能,调节Th1/Th2型细胞因子表达,抑制炎症反应,其疗效优于单纯的西医疗法。

Objective:To observe the effect of Chuanqiang Chubi decoction combined with western medicine on immune function and Th1/Th2 cytokines in patients with rheumatoid arthritis.Methods:84 patients with RA were randomly divided into observation group and control group each 42 cases. The control group was treated with celecoxib and leflunomide. The observation group was treated with Chuanqiang Chubi decoction on the basis of the control group. The course of treatment was 8 weeks. The scores of TCM symptoms,the duration of morning stiffness,the number of tenderness and joint swelling,the changes of cellular immune function and Th1/Th2 cytokines in the two groups were recorded,and compare the clinical effects of the two groups. Results:The total clinical effective rate of the observation group 92.86%was significantly higher than that of the control group 73.81%(P<0.05).After treatment,the scores of TCM symptoms,the duration of morning stiffness,the number of tenderness and swelling of joints in the two groups were significantly lower than those before treatment.The above indexes in the observation group were lower than those in the control group after treatment,and the difference was statistically significant(P<0.05).After treatment,the levels of CD3+,CD4+,CD4+/CD8+ in the two groups were significantly higher than those before treatment,and the levels of CD8+ in the observation group were significantly lower than those before treatment.After treatment,the levels of CD3^+,CD4^+,CD4^+/CD8^+ in the observation group were higher than those in the control group,and the levels of CD8+ in the control group had statistical significance(P<0.05).After treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α) and interleukin-4(IL-4) and interleukin-10(IL-10) in the two groups were significantly lower than those before treatment.After treatment,the levels of IL-6,TNF-α in the observation group were lower than those in the control group,and the levels of IL-4 and IL-10 were higher than those in the control group,with statistical significance(P<0.05).Conclusion:Chuanqiang Chubi decoction can significantly improve the clinical symptoms,relieve pain,improve cellular immune function,regulate the expression of Th1/Th2 cytokines and inhibit inflammatory reaction in RA patients.Its efficacy is better than that of western medicine alone.