中药熏蒸治疗类风湿性关节炎的疗效及对细胞因子的影响

Efficacy of Traditional Chinese Medicine Fumigation in Treating Rheumatoid Arthritis and its Impact on Cytokines

【目的】探讨中药熏蒸治疗类风湿性关节炎(RA)的疗效及对细胞因子的影响。【方法】114例RA患者,随机分为两组,对照组给予甲氨蝶呤片治疗,观察组在此基础上加用中药熏蒸辅助治疗。比较两组关节症状、28处关节疾病活动度(DAS28)积分的变化及治疗前后红细胞沉降率(ESR)、抗环瓜氨酸肽抗体(CCP-AB)、C反应蛋白(CRP)、类风湿因子(RF)、α1-酸性糖蛋白(α1-AGP)、白细胞介素-35(IL-35)、白细胞介素-17(IL-17)的水平。【结果】两组治疗前各项指标比较,差异均无统计学意义(P>0.05)。治疗后,两组关节症状积分、DAS28积分较治疗前均明显下降(P<0.05),且观察组均低于对照组(P<0.05)。治疗后,两组IL-35较治疗前均明显升高(P<0.05),且观察组明显高于对照组(P<0.05);两组ESR、CCP-AB、CRP、RF、α1-AGP、IL-17较治疗前均明显下降,且观察组治疗后ESR、CCP-AB明显低于对照组(P<0.05)。【结论】中药熏蒸可降低RA患者ESR、CRP、RF等的表达,改善关节疼痛、肿胀、压痛、功能障碍等症状。

【Objective】To investigate the effect of traditional Chinese medicine fumigation on alleviating joint symptoms of rheumatoid arthritis(RA)patients and its impact on cytokines.【Methods】A total of 114 RA patients were randomly divided into two groups.Patients in the control group received methotrexate tablet treatment,while patients in the observation group received additional traditional Chinese medicine fumigation therapy.The changes in joint symptoms,Disease Activity Score of 28 joints(DAS28),erythrocyte sedimentation rate(ESR),cyclic citrullinated peptide antibodies(CCP-AB),C-reactive protein(CRP),rheumatoid factor(RF),α1-acid glycoprotein(α1-AGP),interleukin-35(IL-35),and interleukin-17(IL-17)levels before and after treatment in both groups were compared.【Results】There were no significant differences in any of the indices between the two groups before treatment(P>0.05).After treatment,the scores of joint symptoms and DAS28 in both groups significantly decreased compared to before treatment(P<0.05).These scores in the observation group were lower than those in the control group(P<0.05).Post-treatment,IL-35 levels in both groups significantly increased(P<0.05),while level of IL-35 in the observation group was higher than that in the control group(P<0.05).CCP-AB,ESR,CRP,RF,α1-AGP,and IL-17 levels significantly decreased after treatment in both groups,and levels of ESR and CCP-AB were significantly lower in the observation group compared to the control group(P<0.05).【Conclusion】TCM fumigation can reduce the expression of ESR,CRP,and RF in RA patients through improving symptoms such as joint pain,swelling,tenderness,and functional impairment.