[Objectives]To explore the effects of Guizhi Shaoyao Zhimu Decoction on laboratory indicators and immune functions of patients with rheumatoid arthritis.[Methods]A total of 110 patients with rheumatoid arthritis admit...[Objectives]To explore the effects of Guizhi Shaoyao Zhimu Decoction on laboratory indicators and immune functions of patients with rheumatoid arthritis.[Methods]A total of 110 patients with rheumatoid arthritis admitted to the Second Department of Orthopedics,the Affiliated Chinese and Western Medicine Hospital of Nanjing,Nanjing University of Chinese Medicine from December 2014 to December 2016 were selected as the research objects and divided into a control group and an observation group using the random number table method,with 55 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Guizhi Shaoyao Zhimu Decoction on the basis of the control group.Both groups were treated for one month.The clinical effects,improvement of clinical symptoms,laboratory indicators and immune function indicator levels between the two groups were compared;the incidence of adverse reactions in the two groups was counted.[Results]The total effective rate of the observation group was 92.73%,higher than that of the control group(78.18%)(P<0.05).Compared with that before treatment,after one month of treatment,the grip strength of the two groups increased,and the observation group was greater than the control group(P<0.05);the morning stiffness time and 20 m walking time of both groups were shortened,and the observation group was shorter than the control group(P<0.05);the number of joint tenderness,joint swelling,ESR,MPV,PDW,serum CRP,plasma IgA,IgG,IgM,RF levels in both groups decreased,and the observation group was lower than the control group(P<0.05);the serum C3 levels in both groups increased,and the observation group was higher than the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 0.00%,which was lower than that in the control group(10.91%,P<0.05).[Conclusions]Using Guizhi Shaoyao Zhimu Decoction to treat rheumatoid arthritis can improve the laboratory indicators of patients,and enhance their immune functions,improve the curative effect,and the safety is high.展开更多
目的系统评价常用的5种中药汤剂治疗类风湿关节炎(RA)的疗效及安全性。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CNKI、WanFang Data和VIP数据库,搜集蠲痹汤、乌头汤、白虎加桂枝汤、桂枝芍药知母汤和独活寄...目的系统评价常用的5种中药汤剂治疗类风湿关节炎(RA)的疗效及安全性。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CNKI、WanFang Data和VIP数据库,搜集蠲痹汤、乌头汤、白虎加桂枝汤、桂枝芍药知母汤和独活寄生汤等5种中药汤剂联合甲氨蝶呤、美洛昔康等常规疗法治疗RA的随机对照试验(RCT),检索时限均从建库至2024年1月1日,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 17软件进行网状Meta分析。结果共纳入35个RCT,包括3316例患者。网状Meta分析结果显示,与单纯常规疗法相比,5种中药汤剂+常规疗法均显著提高临床总有效率(P<0.05),蠲痹汤+常规疗法、桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低类风湿因子(RF)水平(P<0.05),蠲痹汤+常规疗法、乌头汤+常规疗法、桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低C-反应蛋白(CRP)水平和血清红细胞沉降率(ESR)(P<0.05),桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低不良反应发生率(P<0.05)。累积概率排序结果显示,桂枝芍药知母汤+常规疗法对提高临床总有效率、降低RF水平、降低不良反应发生率的效果均最佳,乌头汤+常规疗法对降低CRP水平的效果最佳,蠲痹汤+常规疗法对降低血清ESR效果最佳。结论中药汤剂与常规疗法联合应用治疗RA的效果显著优于单纯常规疗法,在改善指标方面,可选择桂枝芍药知母汤或蠲痹汤联合常规疗法;在提高安全性方面,可选择桂枝芍药知母汤或独活寄生汤联合常规疗法。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。展开更多
目的探讨桂枝芍药知母汤(GSZMT)通过丝裂原活化蛋白激酶(Mitogen-activated protein kinase,MAPKs)、激活子蛋白-1(activator protein 1,AP-1)干预佐剂性关节炎(AA)大鼠作用机制的研究。方法酶联免疫吸附法(ELISA)法检测外周血与足跖软...目的探讨桂枝芍药知母汤(GSZMT)通过丝裂原活化蛋白激酶(Mitogen-activated protein kinase,MAPKs)、激活子蛋白-1(activator protein 1,AP-1)干预佐剂性关节炎(AA)大鼠作用机制的研究。方法酶联免疫吸附法(ELISA)法检测外周血与足跖软组织核因子κB(NF-κBp65)表达,反转录实时定量PCR法(RT-qPCR)检测MAPKs(ERK1,ERK2,JNK,P38)mRNA表达,HE染色检测踝关节病理,免疫组织化学(IHC)法及免疫组织荧光法(IHF)检测踝关节及周围组织AP-1(c-jun,c-fos)、沉默调节蛋白1(Sirt1)的表达。结果与正常对照组比较,模型对照组NF-κBp65、MAPKs、AP-1蛋白表达均显著增高(P<0.01),Sirt1表达显著降低(P<0.01);与模型对照组比较,GSZMT组NF-κBp65、MAPKs、、AP-1蛋白表达均显著降低(P<0.01),Sirt1表达显著增高(P<0.01)。结论GSZMT能有效降低AA大鼠NF-κBp65、MAPKs、AP-1等炎症蛋白的表达,改善踝关节及周围组织的炎症表现,其治疗作用机理可能是通过降低MAPKs和AP-1途径的炎症蛋白,促进Sirt1蛋白表达实现的。展开更多
目的:系统评价桂枝芍药知母汤联合西药治疗急性痛风性关节炎的安全性和疗效。方法:计算机检索PubMeb、The Cochrane Library、EMBASE、Web of Science、国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(C...目的:系统评价桂枝芍药知母汤联合西药治疗急性痛风性关节炎的安全性和疗效。方法:计算机检索PubMeb、The Cochrane Library、EMBASE、Web of Science、国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)和中国生物医学文献数据库(CBM),搜索桂枝芍药知母汤联用西药与单用西药治疗急性痛风性关节炎的疗效与安全性临床随机对照试验,并用改良后的Jadad量表对纳入的文献质量进行初步评价,利用Revman5.3软件进行Meta分析。结果:共纳入7篇文献,共498例患者。Meta分析结果显示:中西药联用观察组患者总有效率明显高于西药对照组,差异有统计学意义(RR=1.20,95%CI为1.12~1.28,P<0.000 01);中西药联用观察组在降低BUA(MD=-61.35,95%CI为-93.17~-29.53),CRP(MD=-1.83,95%CI为-2.56~-1.11),ESR(MD=-3.93,95%CI为-6.60~-1.26),关节肿胀积分(SMD=-2.89,95%CI为-3.36~-2.43)和关节疼痛积分(SMD=-3.11,95%CI为-3.87~-2.35)的效果明显优于西药对照组,差异有统计学意义(P<0.05);中西药联用干预的观察组不良反应发生率明显低于西药对照组(P<0.05)。结论:桂枝芍药知母汤联合西药治疗急性痛风性关节炎的疗效和安全性明显优于单用西药,但受纳入研究质量和数量的限制,仍需更多高质量的临床随机对照试验来证实上述结论。展开更多
基金Supported by the 12th Five-Year TCM Key Discipline Construction Project of Jiangsu Province(Su Zhong Yi Zheng[2013]No.30).
文摘[Objectives]To explore the effects of Guizhi Shaoyao Zhimu Decoction on laboratory indicators and immune functions of patients with rheumatoid arthritis.[Methods]A total of 110 patients with rheumatoid arthritis admitted to the Second Department of Orthopedics,the Affiliated Chinese and Western Medicine Hospital of Nanjing,Nanjing University of Chinese Medicine from December 2014 to December 2016 were selected as the research objects and divided into a control group and an observation group using the random number table method,with 55 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Guizhi Shaoyao Zhimu Decoction on the basis of the control group.Both groups were treated for one month.The clinical effects,improvement of clinical symptoms,laboratory indicators and immune function indicator levels between the two groups were compared;the incidence of adverse reactions in the two groups was counted.[Results]The total effective rate of the observation group was 92.73%,higher than that of the control group(78.18%)(P<0.05).Compared with that before treatment,after one month of treatment,the grip strength of the two groups increased,and the observation group was greater than the control group(P<0.05);the morning stiffness time and 20 m walking time of both groups were shortened,and the observation group was shorter than the control group(P<0.05);the number of joint tenderness,joint swelling,ESR,MPV,PDW,serum CRP,plasma IgA,IgG,IgM,RF levels in both groups decreased,and the observation group was lower than the control group(P<0.05);the serum C3 levels in both groups increased,and the observation group was higher than the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 0.00%,which was lower than that in the control group(10.91%,P<0.05).[Conclusions]Using Guizhi Shaoyao Zhimu Decoction to treat rheumatoid arthritis can improve the laboratory indicators of patients,and enhance their immune functions,improve the curative effect,and the safety is high.
文摘目的探讨桂枝芍药知母汤(GSZMT)通过丝裂原活化蛋白激酶(Mitogen-activated protein kinase,MAPKs)、激活子蛋白-1(activator protein 1,AP-1)干预佐剂性关节炎(AA)大鼠作用机制的研究。方法酶联免疫吸附法(ELISA)法检测外周血与足跖软组织核因子κB(NF-κBp65)表达,反转录实时定量PCR法(RT-qPCR)检测MAPKs(ERK1,ERK2,JNK,P38)mRNA表达,HE染色检测踝关节病理,免疫组织化学(IHC)法及免疫组织荧光法(IHF)检测踝关节及周围组织AP-1(c-jun,c-fos)、沉默调节蛋白1(Sirt1)的表达。结果与正常对照组比较,模型对照组NF-κBp65、MAPKs、AP-1蛋白表达均显著增高(P<0.01),Sirt1表达显著降低(P<0.01);与模型对照组比较,GSZMT组NF-κBp65、MAPKs、、AP-1蛋白表达均显著降低(P<0.01),Sirt1表达显著增高(P<0.01)。结论GSZMT能有效降低AA大鼠NF-κBp65、MAPKs、AP-1等炎症蛋白的表达,改善踝关节及周围组织的炎症表现,其治疗作用机理可能是通过降低MAPKs和AP-1途径的炎症蛋白,促进Sirt1蛋白表达实现的。
