中西医联合治疗幼年特发性关节炎合并特应质  

Treatment of juvenile idiopathic arthritis combined with atopy by using Chinese traditional and Western medicine

作　　者：夏敏[1] 秦凤 薛海燕[1] 卢燕鸣[1] 徐凌云[1] 吴鸿洲[2] 蔡宇波[1] 曹兰芳[1] 孔宪明[1] 张炜奇[1] 

机构地区：[1]上海交通大学医学院附属仁济医院儿科,200001 [2]上海市中西医结合医院中医内科,200082

出　　处：《中华实用儿科临床杂志》2016年第9期671-674,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：上海市中医药事业三年行动发展计划（重大研究）（zysnxd-CC-zdyj030）

摘　　要：目的明确中西医联合治疗幼年特发性关节炎（JIA）合并特应质患儿的疗效。方法收集上海交通大学医学院附属仁济医院儿科2012年12月至2013年12月门诊和住院部的新发JIA病例，分为JIA合并特应质中西医组（特应质中西医组，14例）、JIA合并特应质西医组（特应质西医组，15例）和JIA非特应质西医组（非特应质西医组，36例），另设立健康对照组（25例）。采用交叉比较，先比较有无特应质对于西医疗法的反应，再比较在西医基础上加用中医对于JIA合并特应质的疗效。采用美国风湿病学院（ACR）制定的ACR30标准评定疗效，采用酶联免疫反应法测定血清IL-1β、IL-6和IL-17水平。结果随访6个月，随访期间有10例患儿退出研究，最终55例完成研究。1．入组时，特应质中西医组和特应质西医组的红细胞沉降率（ESR）分别高于非特应质西医组[（33．89±20．11）mm／1h比（17．35±10．71）mm／1h，t=2．13，P〈0．05；（36．22±15．56）mm／1h比（17．35±10．71）mm／1h，t=2．23，P〈0．05]。2．入组时，IL-1β水平在非特应质西医组为（0．94±0．68）ng／L、特应质组（包括中西医组和西医组）为（1．22±0．80）ng／L、健康对照组为（0．30±0．11）ng／L，组间比较差异均有统计学意义（P均〈0．01）；IL-6水平在非特应质西医组为（1．40±0．98）ng／L、特应质组为（1．66±0．99）nVL、健康对照组为（0．73±0．44）ng／L，组间比较差异均有统计学意义（P均〈0．01）；IL-17水平在非特应质西医组为（0．90±0．61）ng／L、特应质组为（1．41±0．81）ng/L、健康对照组为（0．29±0．24）ng／L，组间比较差异均有统计学意义（P均〈0．01）；此外，特应质组的IL-17也高于非特应质西医组（t=2．71，P〈0．01）。3．随访第3个月，非特应质西医组达到ACR30、ACR50好转标准患儿分别为17例（54．8％）和Objective To confirm the therapeutic effect of traditional Chinese medicine （TCM） on juvenile idiopathic arthritis （JIA）. Methods Patients who were newly diagnosed as JIA between December 2012 and Decem- ber 2013 in Renji Hospital, School of Medicine, Shanghai Jiaotong University were enrolled in this study. All patients were divided into 3 groups. Group one was briefed as atopy - TCM group, which had 14 patients with both JIA and ato- py, and was treated with TCM integrated medicine; group two was briefed as atopy - Western medicine group, which had 15 patients with both JIA and atopy, and was treated with Western medicine alone ;and group three was briefed as non- atopy- Western medicine group, which had 36 patients with JIA, and was treated by Western medicine alone. And 25 healthy children were enrolled as healthy control group. First the effect of atopy on JIA patients who received Western medicine were compared, and then the effects of TCM on patients with JIA and atopy. The clinical effect was evaluated by using ACR 30 method which was made by American College of Rheumatology and the serum level of inter- leukin （IL） - 1 [5, IL -6, IL - 17 were studied by way of enzyme - linked immnnosorbent assay. Results All the pa- tients were followed up for at least 6 months among whom 55 completed the follow - up, and 10 withdrew. （ 1 ） When enrolled, atopy - TCM group and atopy - Western medicine group had higher levels of erythrocyte sediment rates （ESR） than non - atopy - Western medicine group respectively [ （33.89 ± 20. 11 ） ram/1 h vs （ 17.35 ± 10.71 ） ram/1 h,t=2.13,P〈0.05,and （36.22±15.56） ram/1 hvs （17.35±10.71） mm/1 h,t=2.23,P〈0.053.（2） When enrolled, IL - 113 of non -atopy Western group, atopy groups （including TCM and Western medicine group） and healthy control group were （0.94 ± 0.68 ） ng/L, （ 1.22 ± 0.80 ） ng/L, （ 0.30 ± 0.11 ） rig/L, respectively （ all P 〈 0.01 ） ; IL - 6 of non - atopy Western group, atopy groups and healthy cont

关 键 词：幼年特发性关节炎 特应质 中西医结合治疗 细胞因子 

分 类 号：R725.9[医药卫生—儿科]