新风胶囊联合黄芩清热除痹胶囊改善类风湿关节炎湿热痹阻证患者感受的关联规则分析

Effect of Xinfeng capsule combined with Huangqin Qingre Chubi capsule on rheumatic arthritis association rules analysis of self-perception of patient

目的运用关联规则分析和佐剂性关节炎(AA)湿热证大鼠模型,观察新风胶囊(XFC)联合黄芩清热除痹胶囊(HQC)改善类风湿关节炎(RA)湿热痹阻证患者感受(SPP)的作用。方法纳入安徽中医药大学第一附属医院风湿免疫科住院RA湿热痹阻证患者208例,填写SPP评分量表,运用关联规则分析XFC联合HQC对SPP、免疫炎症指标的影响。复制AA湿热证大鼠模型,观察XFC+HQC对AA大鼠体质量(W)、足跖肿胀度(E)、关节炎指数(AI)及炎症指标的影响。结果(1)与正常组相比,RA湿热痹阻证患者湿热痹阻证候积分、脾虚湿盛证候积分、28个关节的疾病活动度(DAS28)评分、视觉模拟评分量表(VAS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)和补体C4均显著上升(P<0.05)。经XFC联合HQC治疗后,上述指标改善。(2)相关性分析结果显示,RA湿热痹阻证患者DAS28评分与RF呈正相关(P<0.05),湿热痹阻证候积分与IgA、IgG、抗环瓜氨酸肽抗体(CCP-AB)、脾虚湿盛证候积分呈正相关(P<0.05),SAS评分与ESR、RF、C3呈正相关(P<0.05)。(3)关联规则分析显示,XFC+HQC与湿热痹阻证候积分、SAS、DAS28评分、ESR、CRP、IgG改善的支持度均大于70%、置信度均大于80%、提升度均大于1。(4)动物实验结果表明,与NC组相比,AA湿热证模型大鼠W、白细胞介素10(IL-10)显著下降(P<0.05),E、AI、CRP、RF、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)显著升高(P<0.05);经XFC联合HQC治疗后,指标显著改善。结论XFC联合HQC可以降低RA湿热痹阻证患者免疫炎症指标及AA湿热证大鼠关节肿胀及炎症指标,从而改善RA患者SPP,提高生活质量。

Objective To observe the effect of Xinfeng Capsule(XFC)combined with Huangqin Qingre Chubi capsule(HQC)on improving self-perception of patient(SPP)of Rheumatoid Arthritis(RA)patients with damp heat syndrome.Methods Two hundred and eight RA patients with dampness heat obstruction syndrome were enrolled in the department of rheumatology and immunology of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine.The SPP score scale was filled in.The association rules were used to analyze the influence of XFC combined with HQC on spp and immune inflammation indexes.The effects of XFC+HQC on body weight(W),plantar swelling(E),arthritis index(AI)and inflammatory indexes of AA rats were observed.Results(1)Compared with the normal group,the scores of dampness heat obstruction syndrome,spleen deficiency and dampness excess syndrome,DAS28 score,VAS score,SAS score,SDS score,ESR,CRP,RF,IgA,IgG and C4 of RA patients with dampness heat obstruction syndrome were significantly increased(P<0.05).After treatment with XFC and HQC,the above indexes were improved.(2)Spearman correlation analysis showed that DAS28 score was positively correlated with RF(P<0.05),the score of damp heat syndrome was positively correlated with IgA,IgG,CCP-AB,spleen deficiency and dampness excess syndrome(P<0.05),and SAS score was positively correlated with ESR,RF and C3(P<0.05).(3)Association rule analysis showed that XFC+HQC and spp damp heat bi syndrome score,SAS,DAS28 score,laboratory indicators ESR,CRP,IgG improvement of support were more than 70%,confidence were more than 80%,promotion were more than 1.(4)The results of animal experiments showed that W and IL-10 decreased significantly in AA model of damp heat syndrome compared with NC group(P<0.05),E,AI,CRP,RF,IL-1β,IL-6,TNF-αsignificantly increased(P<0.05);After XFC combined with HQC treatment,the index was significantly improved.Conclusion XFC combined with HQC can reduce the immune inflammation index of RA patients with damp heat syndrome and the joint swelling and inflammation index of AA rats with damp heat syndrome,so as to improve the SPP of RA patients and improve the quality of life.