阳和汤加味对踝关节结核患者三角形外固定踝关节融合术后炎症因子水平的影响

Effect of Modified Yanghe Decoction Inflammatory Factor Level of Ankle Joint Tuberculosis Patients After Triangular Ankle Arthrodesis External Fixation

目的:观察阳和汤加味对踝关节结核患者三角形外固定踝关节融合术后炎症因子水平的影响。方法:将100例踝关节结核病患者随机分为观察组及对照组。对照组采用三角形外固定踝关节融合术进行治疗,观察组采用阳和汤加味联合三角形外固定踝关节融合术治疗。治疗结束3个月后对患者临床疗效进行评价,记录两组患者发热消失时间、骨密度恢复时间及脓肿吸收时间。治疗前后采用疼痛视觉模拟评分法(visual analogue scale,VAS)对患者疼痛情况进行调查。治疗前后采用酶联免疫吸附法检测患者血中白细胞介素-18(interleukin-18,IL-18)及IL-10水平,并检测患者红细胞沉降率(electroslag remelting,ESR)、C反应蛋白(C-reactionprotein,CRP)及T细胞亚群分布水平。结果:观察组有效率为98.00%,显著高于对照组(P<0.05);治疗后两组患者血中IL-10、IL-18、ESR及CRP水平均较治疗前明显降低,且差异有统计学意义(P<0.05),治疗后观察组患者血中IL-10、IL-18、ESR及CRP水平显著低于对照组(P<0.05)。治疗后两组患者VAS评分均较治疗前显著降低(P<0.05),且观察组患者VAS评分显著低于对照组(P<0.05)。治疗后观察组患者CD_4^+T细胞及CD_4^+/CD_8^+均显著高于对照组(P<0.05),且CD_8^+T细胞显著低于对照组(P<0.05)。观察组患者发热消失时间、骨密度恢复时间及脓肿吸收时间均显著低于对照组(P<0.05)。结论:踝关节结核患者采用三角形外固定踝关节融合术联合阳和汤加味治疗,可有效提高患者临床疗效,并改善患者体内炎症因子水平。

Objective:To analyze the effect of modified Yanghe Decoction on ankle tuberculosis after triangular external fixation and its influence on inflammatory factors.Methods:From June 2014 to January 2018,100 patients with ankle joint disease were randomly divided into observation group and control group;the control group was treated with triangle external fixation ankle joint fusion;the observation group was treated with triangle external fixation ankle joint fusion combined with Yanghe decoction.All of the patients were treated for 3 months.The clinical efficacy of the two groups was evaluated,and the fever disappearance time,bone mineral density recovery time and abscess absorption time were recorded.VAS system was used to investigate the pain before and after treatment;serum IL-18 and IL-10 levels were detected by ELISA before and after treatment.ESR,CRP and T cell subsets were detected.Results:The effective rate of the observation group was 98.00%,which was significantly higher than that of the control group(P<0.05),and the levels of IL-10,IL-18,ESR and CRP in the two groups were significantly lower than those in the control group(P<0.05).The VAS scores of the two groups were significantly lower(P<0.05),and the VAS scores of the observation group were significantly lower than those of the control group(P<0.05).After treatment,the CD4+T cells and CD4+/CD8+in the observation group were significantly higher than those in the control group(P<0.05),and the CD8+T cells were significantly lower than those in the control group(P<0.05);the disappearance time of fever,the recovery time of bone density and the absorption time of abscess in the observation group were significantly lower than those in the control group(P<0.05).Conclusions:Yanghe Decoction can effectively improve the clinical efficacy of patients,and improve the level of inflammatory factors in patients with ankle tuberculosis after triangular external fixation.