三黄一龙汤联合MTX对类风湿关节炎湿热痹阻型患者血清白细胞介素-1、6、17表达的影响  

Effect of Sanhuang Yilong Decoction Combined MTX on the Expression of Serum IL-1,IL-6,and IL-17 in Rheumatoid Arthritis Patients of Accumulated Dampness-heat Syndrome

作　　者：刘德芳[1] 罗勇[1] 晏姣[1] 邹薇[1] 郭明阳[1] 呼永河[1] 杨敏[1] 张俊[1] 贠明东[1] 李昆[2] 杨梅[1] 李华[3] 

机构地区：[1]中国人民解放军成都军区总医院中西医结合风湿科,成都610083 [2]中国人民解放军成都军区总医院中心实验室,成都610083 [3]中国人民解放军成都军区总医院肿瘤科,成都610083

出　　处：《中国中西医结合杂志》2015年第1期33-36,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81072455);全军医学科研"十二五"计划课题(No.BWS11J067);四川省卫生厅课题(No.120573);成都军区总医院科研基金项目(No.2013YG-B111)

摘　　要：目的通过检测类风湿关节炎(RA)湿热痹阻型患者治疗前后血清中白细胞介素(IL)-1、IL-6、IL-17的表达水平,探索苦寒燥湿法配方三黄一龙汤联合甲氨蝶呤(MTX)对RA细胞因子IL-1、IL-6、IL-17表达的影响。方法选择2011年1月—2013年1月成都军区总医院中西医结合风湿科住院的RA湿热痹阻型患者90例作为研究对象,采用SPSS 11.5统计软件产生的随机数字表分为治疗组45例,对照组45例,治疗组用重剂苦寒燥湿药配方三黄一龙汤联合MTX治疗,对照组用MTX治疗。采用ELISA法检测治疗前、治疗2周、治疗4周时血清中IL-1、IL-6、IL-17的表达水平,并检测治疗前后的ESR、CRP及DAS28评定。结果治疗2、4周时,治疗组较对照组ESR、CRP、DAS28明显降低,差异均有统计学意义(P<0.05,P<0.01);治疗4周时,治疗组IL-1、IL-6、IL-17、ESR、CRP、DAS28较治疗前及对照组同期均明显降低,差异均有统计学意义(P<0.01)。结论三黄一龙汤联合MTX在2周内有改善炎性指标,4周内抑制细胞因子IL-1、IL-6、IL-17表达的作用。Objective To study the effect of bitter-cold herbs easing dampness method（ BCHEDM） plus Sanhuang Yilong Decoction（ SYD） combined with methotrexate（ MTX） on expression levels of interleukin-1（ IL-1）,IL-6,and IL-1 7 in rheumatoid arthritis（ RA） patients of accumulated dampness-heat syndrome（ ADHS）. M ethods From January 2 0 1 1 to January 2 0 1 3 recruited were 9 0 RA inpatients of ADHS at Department of Integrative M edicine on Rheumatoid Disease,General Hospital of Chengdu M ilitary Region.They were assigned to the treatment group（ 4 5 cases） and the control group（ 4 5 cases） according to the random digit table produced by SPSS 1 1. 5 Software. Patients in the treatment group were treated by heavy bitter-cold herbs plus SYD combined with M TX,while those in the control group were treated by M TX alone. Expressional levels of IL-1,IL-6,and IL-1 7 in serum were detected by enzyme linked immunosorbent assay（ ELISA） before treatment,at week 2 and 4 after treatment. Erythrocyte sedimentation rate（ ESR）,C-reactive protein（ CRP）,and disease activity score in 2 8 joints（ DAS2 8） were detected as well. Results After two or four weeks of treatment,ESR,CRP,and DAS2 8 decreased more in the treatment group than in the control group with statistical difference（ P 〈 0. 0 5,P 〈 0. 0 1）. After four weeks of treatment,IL-1,IL-6,IL-1 7,ESR,CRP,and DAS2 8 in the treatment group were all lower than before treatment and those of the control group at corresponding time points with statistical difference（ P 〈 0. 0 1）. Conclusion SYD combined M TX could play roles of improving inflammatory indices within 2 weeks, and inhibiting the expression of IL-1, IL-6, and IL-1 7 within 4weeks.

关 键 词：类风湿关节炎 湿热痹阻 苦寒燥湿 细胞因子 

分 类 号：R259[医药卫生—中西医结合]