甘草附子汤加减治疗对风寒湿阻证类风湿关节炎患者中医临床症状及血清基质金属蛋白酶3、骨保护素和核因子-κB受体活化因子配体水平的影响

Effects of the Gancao Fuzi decoction on TCM clinical symptoms,serum MMP3,OPG and RANKL in patients with rheumatoid arthritis

目的:探究风寒湿阻证类风湿关节炎(Rheumatoid Arthritis,RA)用甘草附子汤加减治疗的临床疗效,并对比患者血清基质金属蛋白酶3(Matrix Metalloproteinas 3,MMP3)、骨保护素(Osteoprotegerin,OPG)和核因子-κB受体活化因子配体(Receptor Activator of Nuclear FactorκB Ligand,RANKL)水平的变化。方法:将2019年12月-2021年6月就诊的风寒湿阻证RA患者138例采用随机数字表法分为观察组和对照组,每组69例。对比治疗前和治疗2个月后两组患者中医证候积分、血清骨代谢指标(OPG、RANKL、MMP3)水平、血清相关因子[类风湿因子(Rheumatoid Factor,RF)、红细胞沉降率(Erythrocyte Sedimentation Rate,ESR)、超敏C反应蛋白(High-sensitivity C-reactive Protein,hs-CRP)]水平变化情况。结果:较治疗前,治疗2个月后两组患者血清OPG水平均有上升,且观察组高于对照组(P<0.05);两组患者部分血清骨代谢指标(RANKL、MMP3)、各项中医证候积分、血清相关因子(RF、ESR、hs-CRP)水平均下降,且观察组低于对照组(P均<0.05)。结论:甘草附子汤加减能够改善风寒湿阻证RA患者的临床症状,调节血清水平,值得推广。

Objective:To explore the clinical efficacy of the Gancao Fuzi decoction(甘草附子汤)on rheumatoid arthritis(RA),and compare level changes of serum matrix metalloproteinase 3(MMP3),osteoprotegerin(OPG)and receptor activator of nuclear factor-κB ligand(RANKL)in patients with RA of wind-cold-dampness obstruction syndrome.Methods:A total of 138 patients with RA(wind-cold-dampness obstruction syndrome)who were treated in the hospital between December 2019 and June 2021 were divided into the observation group and the control group by the random number table method,with 69 cases in each group.Before treatment and after 2 months of treatment,the scores of TCM syndrome,levels of serum bone metabolism indicators(OPG,RANKL,MMP3)and serum related factors[rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),high-sensitivity C-reactive protein(hs-CRP)]in the two groups were recorded and compared.Results:After 2 months of treatment,the level of serum OPG in the two groups was increased compared with before,and the level in the observation group was higher than the control group(P<0.05).The levels of partial serum bone metabolism indicators(RANKL,MMP3),scores of TCM syndromes and levels of serum related factors(RF,ESR,hs-CRP)were all decreased in the two groups,and the levels and scores in the observation group were lower than the control group(all P<0.05).Conclusion:The Gancao Fuzi decoction can relieve the clinical symptoms and adjust the serum indicators of patients with RA(wind-cold-dampness obstruction syndrome),therefore it is worthy of clinical promotion.