二藤蠲痹汤联合西药治疗类风湿性关节炎临床观察

Clinical Observation of Using Erteng Juanbi Decoction Combined with Western Medicine in the Treatment of Rheumatoid Arthritis

目的:分析二藤蠲痹汤联合西药治疗类风湿性关节炎的临床疗效。方法:选取我院于2017年2月~2018年8月收治的140例类风湿性关节炎患者的临床资料进行分析,分为两组。对照组采用西医常规治疗,观察组采用二藤蠲痹汤治疗,分析两组患者治疗后的临床疗效。结果:两组患者治疗前中医症候评分组间比较,差异不具有统计学意义(P>0.05)。两组患者治疗后关节疼痛、关节肿胀、屈伸不利、晨僵评分较治疗前下降,且观察组患者治疗后关节疼痛、关节肿胀、屈伸不利、晨僵评分低于对照组(P<0.05)。两组患者治疗前巨噬细胞炎性蛋白-1α(MIP-1α)、白细胞介素-17(IL-17)、核转录因子-κB受体活化因子(RNAKL)、金属蛋白酶-3(MMP-3)、骨保护素(OPG)、金属蛋白酶抑制剂-1(TIMP-1)、肿瘤坏死因子-α(TNF-α)水平组间比较,差异不具有统计学意义(P>0.05)。两组患者治疗后MIP-1α、IL-17、RNAKL、MMP-3、TNF-α水平较治疗前下降,OPG、TIMP-1水平较治疗前上升,且观察组患者治疗后MIP-1α、IL-17、RNAKL、MMP-3、TNF-α水平低于对照组,OPG、TIMP-1水平高于对照组(P<0.05)。两组患者治疗前生活质量(SF-36)评分组间比较,差异不具有统计学意义(P>0.05)。两组患者治疗后生理健康、心理健康总评分较治疗前上升,且观察组患者治疗后SF-36评分高于对照组(P<0.05)。两组患者不良反应情况比较,差异不具有统计学意义(χ~2=0.207;P=0.649)。结论:二藤蠲痹汤治疗类风湿性关节炎,能有效缓解患者症状体征,降低患者MIP-1α、RNAKL、IL-17水平,提高患者生活质量。

Objective:To analyze the clinical effect of using Erteng Juanbi Decoction combined with western medicine in the treatment of rheumatoid arthritis.Methods:Selected our hospital from February 2017 to August 2018 were the clinical data of 140 patients with rheumatoid arthritis were analyzed,and divided into 2 groups in a controlled group treated by routine western medicine,an observing group adopted Erteng Juanbi Decoction,the analysis of the two groups after treatment in patients with clinical efficacy.Results:There was no statistically significant difference between the two groups in TCM symptom evaluation before treatment(P>0.05).After treatment,the score of morning stiffness in the two groups with joint pain,joint swelling,bad flexion and extension was lower than that before treatment,and the score of morning stiffness in the observation group with joint pain,joint swelling,bad flexion and extension was lower than that in the controlled group(P<0.05).2 patients with pre-treatment macrophage inflammatory protein-1(MIP-1),interleukin-17(IL-17),nuclear transcription factor-B receptor activating factor(RNAKL),metalloprotease-3(MMP-3),osteoprotegerin(OPG),metalloprotease inhibitor-1(TIMP-1).The difference between the levels of tumor necrosis factor-necrosis factor(TNF-1)was not statistically significant(P>0.05).After treatment,the level of MIP-1 IL-17 RNAKL MMP-3 TNF-ain the two groups decreased compared with that before treatment,and the level of OPG TIMP-1 increased compared with that before treatment.The level of MIP-1 IL-17 RNAKL MMP-3 TNF-ain the observation group was lower than that in the controlled group,and the level of OPG TIMP-1 was higher than that in the controlled group(P<0.05).There was no statistically significant difference in the quality of life before treatment(SF-36)between the two groups(P>0.05).The total score of physical health and mental health of patients in the two groups after treatment was higher than that before treatment,and the SF-36 score of patients in the observation group was higher than that in the controlled group(P<0.05).There was no significant difference in adverse reactions between the two groups(χ2=0.207,P=0.649).Conclusion:Erteng Juanbi Decoction treatment of rheumatoid arthritis,can effectively relieve patients with symptoms and signs,reduce patient MIP-1αRNAKL IL-17 levels,improve quality of life of the patients.