| 杨 帆,许 超,俞烨晨,周凯伦,蔡 辉.桂枝芍药知母汤联合甲氨蝶呤对类风湿性关节炎患者中医证候评分、血清炎性因子及免疫球蛋白的影响[J].,2020,(24):4641-4645 |
| 桂枝芍药知母汤联合甲氨蝶呤对类风湿性关节炎患者中医证候评分、血清炎性因子及免疫球蛋白的影响 |
| Effect of Guizhi Shaoyao Zhimu Decoction Combined with Methotrexate on TCM Syndrome Score, Serum Inflammatory Factors and Immunoglobulin in Patients with Rheumatoid Arthritis |
| 投稿时间：2020-06-13 修订日期：2020-07-07 |
| DOI：10.13241/j.cnki.pmb.2020.24.009 |
| 中文关键词: 桂枝芍药知母汤 甲氨蝶呤 类风湿性关节炎 疗效 炎性因子 免疫球蛋白 |
| 英文关键词: Guizhi Shaoyao Zhimu Decoction Methotrexate Rheumatoid arthritis TCM syndrome score Inflammatory factors Immunoglobulin |
| 基金项目:江苏省中医药管理局基金项目（YB201927） |
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| 中文摘要: |
| 摘要 目的：探讨桂枝芍药知母汤联合甲氨蝶呤对类风湿性关节炎（RA）患者血清炎性因子、中医证候评分及免疫球蛋白的影响。方法：选取2018年1月~2019年10月期间我院接收的RA患者136例。根据随机数字表法分为对照组（n=68）和研究组（n=68）。对照组给予甲氨蝶呤治疗，研究组在对照组基础上联合桂枝芍药知母汤治疗。比较两组患者的疗效、中医证候评分、血清炎性因子[肿瘤坏死因子-α（TNF-α）、白介素-17（IL-17）、白介素-1β（IL-1β）]水平、风湿四项检查指标[类风湿因子（RF）、C反应蛋白（CRP）、抗链球菌溶血素"O"(ASO)、血沉（ESR）]水平及免疫球蛋白[免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）]水平。结果：研究组治疗2个月后的临床总有效率91.18%（62/68）高于对照组的77.94%（53/68）（P<0.05）。两组治疗2个月后关节肿胀程度、关节屈伸不利程度、畏恶风寒、晨僵证候评分均下降，且研究组低于对照组（P<0.05）。两组治疗2个月后血清TNF-α、IL-1β、IL-17水平均下降，且研究组低于对照组（P<0.05）。两组治疗2个月后IgA、IgM、IgG水平均下降，且研究组低于对照组（P<0.05）。两组治疗2个月后RF、ESR、CRP、ASO水平均下降，且研究组低于对照组（P<0.05）。结论：RA患者在甲氨蝶呤的基础上联合桂枝芍药知母汤治疗，可有效降低患者血清炎性因子、风湿四项检查指标、免疫球蛋白水平，改善患者临床症状，疗效显著。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of Guizhi Shaoyao Zhimu Decoction Combined with methotrexate on the TCM syndrome score, serum inflammatory factors and immunoglobulin in patients with rheumatoid arthritis (RA). Methods: 136 RA patients who were admitted to our hospital from January 2018 to October 2019 were selected. Patients were divided into control group (n=68) and study group (n=68) according to the random number table method. The control group was treated with methotrexate, and the study group was treated with Guizhi Shaoyao Zhimu Decoction on the basis of the control group. The therapeutic effect, TCM syndrome score, serum levels of inflammatory factors [tumor necrosis factor - α (TNF-α), interleukin-17 (IL-17), interleukin-1 β (IL-1 β)], four indexes levels of rheumatism [rheumatoid factor (RF), C-reactive protein (CRP), antistreptolysin "O" (ASO), erythrocyte sedimentation rate（ESR）] and the levels of Immunoglobulin [immunoglobulin A (IGA), immunoglobulin G (IgG), immunoglobulin M (IgM)]were compared between the two groups. Results: The total clinical effective rate of the study group after 2 months was 91.18% (62/68) higher than 77.94% (53/68) of the control group (P<0.05). After 2 months of treatment, the degree of joint swelling, the degree of joint flexion and extension disadvantageous, the degree of aversion to wind and cold and the degree of morning stiffness in the two groups decreased, and the score of the study group was lower than that in the control group (P<0.05). The levels of Serum TNF-α, IL-1 β, IL-17 in the two groups were all decreased after 2 months of treatment, and the level in the study group was lower than that in the control group (P<0.05). The levels of IgA, IgM and IgG were all decreased in the two groups after 2 months of treatment, and the level in the study group was lower than that in the control group (P<0.05). The levels of RF, ESR, CRP and ASO were all decreased in the two groups after 2 months of treatment, and the level in the study group was lower than that in the control group (P<0.05). Conclusion: On the basis of methotrexate treatment, RA patients combined with Guizhi Shaoyao Zhimu Decoction can effectively reduce the level of serum inflammatory factors, rheumatism four test indicators, immunoglobulin, improve the clinical symptoms of patients, with significant effect. |
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