小剂量泼尼松片单用及联合顽痹康丸对风湿性多肌痛患者疼痛症状及血清炎症因子水平的影响比较

Comparison on effects of low-dose prednisone tablets alone and combined with wanbikang pills on pain symptoms and serum inflammatory factor levels in patients with polymyalgia rheumatica

目的探究小剂量泼尼松片单用及联合顽痹康丸对风湿性多肌痛患者疼痛症状及血清炎症因子水平的影响,为中药制剂治疗风湿性多肌痛提供理论依据。方法选择2020年7月-2023年12月本院收治的67例风湿性多肌痛患者为研究对象,随机数表法分为对照组(小剂量泼尼松片单用)及观察组(小剂量泼尼松片联合顽痹康丸治疗)两组,观察组3例、对照组2例未能坚持完成治疗,予以剔除。最终观察组30例,对照组32例。比较两组疗效,治疗前、治疗后视觉模拟疼痛评分(VAS)、上肢失举度、激素用量、血常规、尿常规、肝肾功能及血沉(ESR)、C-反应蛋白(CRP)、白介素-6(IL-6)变化,对比两组不良反应及复发率。结果治疗前、治疗4周后、治疗8周后、治疗12周后对照组、观察组VAS评分、上肢失举度、ESR、CRP、IL-6比较存在明显的交互、组间和时间差异(P<0.05);治疗4周后、治疗8周后、治疗12周后观察组均低于对照组(P<0.05)。治疗8周后、12周后观察组激素用量较对照组明显低(P<0.05)。治疗前、治疗4周后两组血小板计数、血红蛋白、谷丙转氨酶、血肌酐、尿素氮比较,差异无统计学意义(P>0.05)。治疗后观察组不良反应总发生率、治疗后半年复发略低于对照组(P>0.05)。结论小剂量泼泥松片联合顽痹康丸治疗风湿性多肌痛可提高患者治疗效果,有效缓解患者疼痛症状、抑制机体炎症反应,减少治疗后患者激素用量,安全性高。

Objective To explore the effects of low-dose prednisone tablets alone and combined with Wanbikang pills on pain symptoms and serum inflammatory factor levels in patients with polymyalgia rheumatica,and to provide a theoretical basis for the treatment of polymyalgia rheumatica with traditional Chinese medicine.Methods From July 2020 to December 2023,67 patients with polymyalgia rheumatica who were diagnosed and treated at Henan Luoyang Bone Setting Hospital were enrolled as study subjects.They were randomly divided into a control group(low-dose prednisone tablets alone)and an observation group(low-dose prednisone tablets combined with Wanbikang pills).Three cases in the observation group and two cases in the control group failed to adhere to complete the treatment and were excluded.Ultimately,30 patients were included in the observation group and 32 in the control group.The efficacy of the two groups,pre-treatment and post-treatment visual analog pain scores(VAS),upper limb disability,hormone dosage,blood routine,urine routine,liver and kidney function,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),interleukin-6(IL-6),and the adverse reactions and recurrence rate were compared.Results There were significant interaction,group,and time differences in VAS scores,upper limb disability,ESR,CRP,and IL-6 between the control and observation groups before treatment and at 4,8,and 12 weeks after treatment(P<0.05).The observation group had lower levels than the control group at 4,8,and 12 weeks after treatment(P<0.05).The hormone dosage at 8 and 12 weeks after treatment in the observation group was significantly lower than in the control group(P<0.05).There were no significant differences in platelet count,hemoglobin,alanine transaminase(ALT),blood creatinine,and blood urea nitrogen(BUN)between the two groups before treatment and at 4 weeks after treatment(P>0.05).The overall incidence of adverse effects and recurrence rate at 6 months after treatment in the observation group was slightly lower than in the control group(P>0.05).Conclusions The combination of low-dose prednisone tablets with Wanbikang pills for the treatment of polymyalgia rheumatica can improve patient treatment outcomes,effectively alleviate pain symptoms,suppress systemic inflammatory responses,reduce post-treatment hormone dosage,and is associated with high safety.