姜黄素联合甲氨蝶呤治疗类风湿关节炎骨破坏的疗效观察

Effects of curcumin capsule with methotrexate on bone erosion in rheumatoid arthritis

[目的]探讨姜黄素联合甲氨蝶呤对寒湿痹阻型类风湿关节炎(RA)骨破坏的干预作用。[方法]将符合标准的128例RA患者随机分为对照组和治疗组,每组64例,对照组口服甲氨蝶呤,治疗组在服甲氨蝶呤基础上加用姜黄素口服治疗,疗程12周,观察改良疾病活动性评分体系(DAS)28评分、炎性指标及对成骨细胞骨代谢相关因子骨保护素(OPG)、核因子-κB受体活化因子配体(RANKL)的影响。[结果]治疗组与对照组比较,治疗后DAS28评分、血小板计数(PLT)、肿瘤坏死因子-α(TNF-α)、RANKL、RANKL/OPG比值均较治疗前显著下降(P<0.05),且治疗组比对照组下降更明显,血红蛋白(HGB)、OPG较治疗前明显升高(P<0.05),以治疗组升高水平较好。[结论]姜黄素联合甲氨蝶呤可有效改善RA寒湿痹阻患者的关节及全身症状,且能改善骨破坏,对RANK/RANKL/OPG系统有明显干预作用。

[Objective] To observe the effects of curcumin capsule with methotrexate on bone erosion in rheumatoid arthritis. [Methods]Totally 128 inpatients and outpatients of RA were randomly assigned to the treatment group(prescribed curcumin capsule and MTX for64 cases) and the control group(prescribed with MTX alone for 64 cases),the effect of disease activity score in 28 joints(DAS28),laboratory related indices rheumatoid factor and the levels of OPG and RANKL were observed after 12-week treatment. [Results] After treatment,the levels of DAS28,PLT,TNF-α,RANKL and RANKL/OPG were significantly lower than before treatment(P<0.05),and the control group was higher than treatment group(P<0.05),and the levels of HGB,OPG was significantly increased than before treatment in both groups(P<0.05),and the control group was worse than treatment group(P<0.05). [Conclusion] Curcumin capsule with methotrexate could effectively improve joints and systemic symptoms in RA patients and regulate bone erosion induced by RANK/RANKL/OPG system.