薏苡仁汤加味联合针刺对高尿酸血症伴痛风患者(风寒湿痹型)体液免疫、微炎状态和血清DKK1、PICP、RANKL水平影响

Effects of Modified Yiyiren Decoction(薏苡仁汤加味)Combined with Acupuncture on Humoral Immunity,Micro Inflammation Status and Serum DKK1,PICP and RANKL Levels in Patients with Hyperuricemia and Gout(Wind Cold Dampness Arthralgia Type)

目的探讨薏苡仁汤加味联合针刺对高尿酸血症伴痛风患者(风寒湿痹型)体液免疫、微炎状态和血清DKK1、PICP、RANKL水平影响。方法选择88例高尿酸血症伴痛风且中医辨证类型诊断为“风寒湿痹证”的患者作为研究对象,所有纳入病例的就诊时间为2020年1月—2022年3月。2年间符合纳入标准的88例高尿酸血症伴痛风患者共分为两组,分别为对照组和试验组,分组方法采用随机法。对照组采用基础治疗及针刺疗法,试验组在对照组的基础上服用薏苡仁汤加味,7 d为1治疗周期,共治疗8个周期,治疗结束后统计疗效。对比对照组和试验组治疗前后血清免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、Dickkopf-1(DKK1)、核因子kB受体活化因子配体(RANKL)、Ⅰ型前胶原羧基端肽(PICP)以及血尿酸(UA)、血肌酐(Scr)、尿素氮(Bun)含量。结果试验组治疗总有效率90.91%相较于对照组75.00%显著更高(P<0.05);治疗后两组患者UA、Scr、Bun含量均低于治疗前,且试验组UA、Scr、Bun含量相较于对照组显著更低(P<0.05);治疗后两组患者IgG、IgA、IgM含量均低于治疗前,且试验组IgG、IgA、IgM含量相较于对照组显著更低(P<0.05);治疗后两组患者血清IL-6、IL-1β、TNF-α含量均低于治疗前,且试验组血清IL-6、IL-1β、TNF-α含量相较于对照组显著更低(P<0.05);治疗后两组患者血清DKK1、PICP、RANKL水平均低于治疗前,且试验组血清DKK1、PICP、RANKL水平相较于对照组显著更低(P<0.05),差异有统计学意义。结论薏苡仁汤加味联合针刺对高尿酸血症伴痛风患者(风寒湿痹型)有较好的疗效,可显著改善机体体液免疫,减轻微炎症状态,同时减轻骨破坏严重程度,避免不良预后。

Objective To investigate the effect of Modified Yiyiren Decoction(薏苡仁汤加味)combined with acupuncture on humoral immunity,micro-inflammatory state and serum DKK1,PICP and RANKL levels in patients with hyperuricemia and gout(wind-cold-dampness-arthralgia type).Methods A total of 88 patients with hyperuricemia and gout who were diagnosed as“wind-cold-damparthralgia type”by TCM syndrome differentiation were selected as the subjects of this study.During the two years,88 patients with hyperuricemia and gout who met the inclusion criteria were divided into two groups,the control group and the experimental group.The grouping method was randomized.The control group was given basic treatment and acupuncture therapy,while the experimental group was given the Modified Yiyiren Decoction on the basis of the control group,7 days as a treatment cycle,a total of 8 cycles of treatment,and the curative effect was calculated after the treatment.To compare of serum IgG,IgA,IgM,IL-6,IL-1β,TNF-α,DKK1,RANK,PICP and UA,Scr,Bun content.Results The total effective rate of treatment in the experimental group was 90.91%,which was significantly higher than that in the control group,which was 75.00%(P<0.05);after treatment,the levels of UA,Scr,and Bun in both groups of patients were lower than before treatment,and the levels of UA,Scr,and Bun in the experimental group were significantly lower than those in the control group(P<0.05);after treatment,the contents of IgG,IgA,and IgM in the two groups were lower than those before treatment,and the contents of IgG,IgA,and IgM in the experimental group were significantly lower than those in the control group(P<0.05);after treatment,the serum IL-6,IL-1βand TNF-αcontents of the experimental group were significantly lower(P<0.05);the levels of serum DKK1,PICP and RANKL in the experimental group were significantly lower(P<0.05),and the difference was statistically significant.Conclusion Modified Yiyiren Decoction combined with acupuncture has a good curative effect on hyperuricemia patients with gout(wind-cold-damp-arthralgia type),which can significantly improve the body's humoral immunity,reduce the micro-inflammatory state,reduce the severity of bone destruction,and avoid poor prognosis.