消疕通络汤治疗银屑病关节炎湿热痹阻证的效果及对血清IL-6、TNF-α水平的影响

Effect of Xiaobi Tongluo Decoction in the Treatment of Psoriatic Arthritis with Damp-heat Arthralgia Syndrome and Its Influence on Serum IL-6 and TNF-α Levels

目的:探讨消疕通络汤治疗银屑病关节炎(PsA)湿热痹阻证的效果及对血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的影响。方法:选取2020年1月-2021年1月佳木斯市中医院收治的60例PsA湿热痹阻证患者,按照随机数字表法将其分为对照组和观察组,每组30例。对照组采用西药治疗,观察组在对照组的基础上加用消疕通络汤治疗。比较两组疗效、银屑病皮损面积和严重程度指数(PASI)评分、关节压痛数、关节肿胀数、红细胞沉降率(ESR)、C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及不良反应发生情况。结果:观察组总有效率为86.67%,高于对照组的63.33%,差异有统计学意义(P<0.05)。治疗后,观察组PASI评分、关节压痛数、关节肿胀数均低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组ESR、CRP、IL-6、TNF-α水平均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:消疕通络汤治疗PsA湿热痹阻证能提高效果,缓解关节压痛、肿胀,降低ESR、CRP、IL-6、TNF-α水平,减轻炎症反应。

Objective:To investigate the effect of Xiaobi Tongluo Decoction in the treatment of psoriatic arthritis (PsA) with damp-heat arthralgia syndrome and its influence on serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels.Method:A total of 60 patients with damp-heat arthralgia syndrome of PsA treated in Jiamusi Hospital of Traditional Chinese Medicine from January 2020 to January 2021 were selected,and they were divided into control group and observation group according to random number table method,with 30 cases in each group.The control group was treated with western medicine,and the observation group was treated with Xiaobi Tongluo Decoction on the basis of the control group.The efficacy,psoriatic lesions area and severity index (PASI) score,joint tenderness ratio,joint swelling ratio,erythrocyte sedimentation rate (ESR),C reactive protein (CRP),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) levels and the incidence of adverse reactions were compared between two groups.Result:The total effective rate of the observation group was 86.67%,which was higher than 63.33% of the control group,the difference was statistically significant (P<0.05).After treatment,the PASI score,the proportion of joint tenderness and joint swelling in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).After treatment,the levels of ESR,CRP,IL-6 and TNF-α of both groups were lower than those before treatment,and those of the observation group were lower than those of the control group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of adverse reactions between two groups (P>0.05).Conclusion:Xiaobi Tongluo Decoction can improve the curative effect of PsA with damp-heat arthralgia syndrome,relieve joint tenderness and swelling,reduce ESR,CRP,IL-6,and TNF-α levels,and reduce inflammation.