阳和汤加减辅助治疗脊柱结核的疗效及对血清TNF-α,IFN-γ及IL-17的影响

Effect of Using Modified Yanghe Decoction in the Adjuvant Treatment of Spinal Tuberculosis and Its Influence on Serum TNF-α,IFN-γand IL-17

目的:观察阳和汤加减辅助治疗脊柱结核的疗效及对血清肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素-17(IL-17)的影响。方法:将68例脊柱结核患者随机均分为研究组(阳和汤联合常规治疗治疗)和对照组(常规治疗)。比较两组治疗效果、治疗相关指标(手术时间、术中出血量、病椎愈合时间),比较两组术后6个月时神经功能恢复情况(ASIA脊髓损伤神经学分级),比较术前、术后及术后6个月时疼痛程度及后凸角度[视觉模拟评分法(VAS)、Cobb法],比较术前及术后6个月时生化指标(TNF-α,IFN-γ、IL-17)水平。结果:两组显效率比较无显著差异(P>0.05)。两组手术时间、术中出血量比较无显著差异(P>0.05),研究组病椎愈合时间明显低于对照组(P<0.05)。术后6个月,两组ASIA脊髓损伤神经学分级比较无显著差异(P>0.05)。术后及术后6个月时,两组VAS评分、Cobb角水平及生化指标(TNF-α、IFN-γ、IL-17)水平均较术前显著下降,研究组VAS评分及生化指标(TNF-α、IFN-γ、IL-17)水平均明显低于同期对照组(P<0.05),两组Cobb角水平比较无显著差异(P>0.05)。结论:阳和汤加减辅助治疗脊柱结核的疗效显著,能够有效降低TNF-α、IFN-γ、IL-17水平,利于患者恢复。

Objective:To study the effect of using Modified Yanghe Decoction in the adjuvant treatment of spinal tuberculosis and its effects on serum tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ) and interleukin-17(IL-17).Methods:68 patients with spinal tuberculosis were randomly and evenly divided into a study group(Yanghe Decoction combined with conventional treatment) and a controlled group(conventional treatment).The therapeutic effects and treatment-related indexes(operative time,intraoperative blood loss,healing time of diseased vertebrae) were compared between the two groups.The neurological function recovery(neurological grading of ASIA spinal cord injury) was compared between the two groups at 6 months after operation.Pain level and kyphosis angle [visual analogue scale(VAS),Cobb method] were compared between the two groups before operation,after operation and at 6 months after operation,and the levels of biochemical indicators(TNF-α,IFN-γ,IL-17) were compared before operation and at 6 months after operation.Results:There was no significant difference in the marked effective rate between the two groups(P>0.05).There were no significant differences in the operative time and intraoperative blood loss between the two groups(P>0.05),and the healing time of diseased vertebrae in the study group was significantly lower than that in the controlled group(P<0.05).At 6 months after operation,there was no significant difference in the neurological grading of ASIA spinal cord injury between the two groups(P>0.05).After operation and at 6 months after operation,the VAS score,Cobb angle and levels of biochemical indicators(TNF-α,IFN-γ,IL-17) in the two groups were significantly decreased compared with those before operation,and the VAS score and levels of biochemical indicators(TNF-α,IFN-γ and IL-17) in the study group were significantly lower than those in the controlled group(P<0.05),and there was no significant difference in Cobb angle between the two groups(P>0.05).Conclusion:Using Modified Yanghe Decoction has significant efficacy in the adjuvant treatment of spinal tuberculosis,and it can effectively reduce the levels of TNF-α,IFN-γ and IL-17 and facilitate the recovery of patients.