| 宋在鑫,柳清泳,王晓军,李晓博,盛 刚.补肾通络汤联合甲氨蝶呤对类风湿关节炎患者炎症细胞因子、骨代谢标志物及血管新生相关因子的影响[J].,2020,(19):3774-3778 |
| 补肾通络汤联合甲氨蝶呤对类风湿关节炎患者炎症细胞因子、骨代谢标志物及血管新生相关因子的影响 |
| Effect of Bushen Tongluo Decoction Combined with Methotrexate on Inflammatory Cytokines, Bone Metabolism Markers and Angiogenesis Related Factors in Patients with Rheumatoid Arthritis |
| 投稿时间：2020-03-08 修订日期：2020-03-31 |
| DOI：10.13241/j.cnki.pmb.2020.19.038 |
| 中文关键词: 类风湿关节炎 补肾通络汤 甲氨蝶呤 炎症因子 骨代谢 血管新生因子 |
| 英文关键词: Rheumatoid arthritis Bushen Tongluo decoction Methotrexate Inflammatory cytokines Bone metabolism Angiogenic factor |
| 基金项目:陕西省中医药管理局基金项目（JCMS1259） |
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| 摘要 目的：探究补肾通络汤联合甲氨蝶呤治疗类风湿关节炎患者的临床效果。方法：选取2017年9月到2018年6月我院收治并确诊的79例类风湿关节炎患者，按照随机数字表法将其分为对照组39例和研究组40例，对照组仅接受甲氨蝶呤治疗，研究组在对照组基础上联合补肾通络汤治疗，治疗3个月后比较临床疗效、炎症细胞因子、骨代谢标志物、血管新生相关因子水平、28个关节疾病活动度积分(DAS28)及不良反应。结果：研究组治疗总有效率为90.00%，明显高于对照组的71.79%（P＜0.05）；研究组治疗3个月后白细胞介素-1(IL-1)、白细胞介素-6(IL-6) 、肿瘤坏死因子-α(TNF-α)、骨碱性磷酸酶 (B-ALP)、碱性成纤维细胞生长因子（bFGF）、血管内皮生长因子（VEGF）水平以及DAS28积分均低于对照组（P＜0.05）；研究组治疗3个月后25羟维生素D［25( OH) D］、Ⅰ型前胶原羧基端前肽 (PICP)、甲状旁腺激素(PTH)、转化生长因子-β1（TGF-β1）水平高于对照组；研究组不良反应发生率为17.50%，与对照组的25.64%比较无差异（P＞0.05）。结论：补肾通络汤联合甲氨蝶呤治疗类风湿关节炎患者能够有效控制炎性反应，实现对骨代谢的调节，且能够对新生血管增生形成有效抑制，同时不会增加不良反应，值得推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical effect of Bushen Tongluo decoction combined with methotrexate in the treatment of patients with rheumatoid arthritis. Methods: 79 patients with rheumatoid arthritis who were admitted and diagnosed in our hospital from September 2017 to June 2018 were selected. According to random number table method, the patients were divided into 39 cases of control group and 40 cases of study group, control group patients were treated with methotrexate alone, the study group was treated with Bushen Tongluo decoction on the basis of the control group. 3 months after treatment, the clinical efficacy, inflammatory cytokines, bone metabolism markers, angiogenesis related factors, 28 joint disease activity scores (DAS28) and adverse reactions were compared. Results: The total effective rate of treatment in the study group was 90.00%, which was significantly higher than that in the control group 71.79% (P<0.05). 3 months after treatment, the levels of interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), bone alkaline phosphatase (B-ALP), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and DAS28 scores in the study group were all lower than those in the control group (P<0.05). 3 months after treatment, the levels of 25-hydroxyvitamin D [25 (OH) D], carboxyterrninal propeptide of type I pmcollagen (PICP), parathyroid hormone (PTH), transforming growth factor β1(TGF-β1) were higher than those in the control group. The incidence of adverse reactions in the study group was 17.50%, no significant difference compared with 25.64% in the control group (P>0.05). Conclusion: Bushen Tongluo decoction combined with methotrexate for the treatment of rheumatoid arthritis patients can effectively control the inflammatory response, achieve the regulation of bone metabolism, and effectively inhibit the formation of neovascularization, without increasing adverse reactions, which is worthy of promotion and application. |
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