藏医脉泻治疗对90例类风湿关节炎患者疗效及血清细胞因子的影响

Effects of Tibetan Medicine Mai Xie Therapy on 90 Patients with Rheumatoid Arthritis and Serum Cytokines

目的:探讨采用藏医脉泻疗法治疗类风湿关节炎的疗效及对细胞因子IL-2、IL-10、IL-17、TNF-α的影响。方法:对90例类风湿关节炎患者采用藏医脉泻治疗,4周为1个疗程,对比治疗前后患者症状和体征变化,实验室指标包括血沉(ESR)、C-反应蛋白(CRP)和类风湿因子(RF)的改变,以及对细胞因子白细胞介素2(IL-2)、白细胞介素10(IL-10)、白细胞介素17(IL-17)、肿瘤坏死因子α(TNF-α)的影响。结果:90例类风湿关节炎患者经4周脉泻疗法治疗后,其总有效率达91.1%,临床症状和体征较治疗前均有明显好转,在关节压痛数、关节肿胀数、晨僵时间、双手平均握力和疼痛评价方面较治疗前有明显改善,差异有统计学意义(P<0.05);患者ESR、CRP和RF水平均降低,且ESR和CRP水平下降明显,同治疗前比较差异有统计学意义(P<0.05);患者血清中的IL-2、IL-17、TNF-α水平较治疗前均降低,IL-10水平较治疗前升高,其中IL-2、IL-10、TNF-α改变显著,与治疗前比较差异有统计学意义(P<0.05)。结论:采用藏医脉泻疗法治疗类风湿关节炎,临床应用疗效比较满意,其内在机制可能影响部分相关细胞因子。

Objective:To investigate the Effects of Tibetan Medicine Mai Xie Therapy on rheumatoid arthritis and its influence on cytokines IL-2,IL-10,IL-17 and TNF-α.Methods:90 patients with rheumatoid arthritis were treated with Tibetan medicine maixie for 4 weeks.The changes of symptoms and signs were compared before and after treatment.The laboratory indexes included changes of ESR,CRP and rheumatoid factor(RF),as well as cytokine interleukin-2(IL-2),interleukin-10(IL-10),interleukin-17(IL-17)and Tumor necrosis factor alpha(TNF-α).Results:The total effective rate of 90 patients with rheumatoid arthritis was 91.1%after 4 weeks of maixie therapy.The clinical symptoms and signs were improved significantly compared with those before treatment were compared.In terms of joint tenderness,joint swelling,morning stiffness time,average grip strength of both hands and pain evaluation,the difference was significant(P<0.05).The levels of ESR,CRP and RF were all decreased,and the levels of ESR and CRP were significantly decreased compared with those before treatment(P<0.05).The levels of IL-2,IL-17 and TNF-alpha in serum of patients were lower than those before treatment,and the levels of IL-10 were higher than those before treatment,among which the changes of IL-2,IL-10 and TNF-αwere significant.There was a significant difference before treatment(P<0.05).Conclusion:The therapeutic effect of Tibetan medicine maixie therapy on rheumatoid arthritis is satisfactory.It can significantly improve clinical symptoms,signs and laboratory indicators.The effect on some cytokines may be its internal mechanism for the treatment of rheumatoid arthritis.