通络灵酊剂联合中频导入治疗痰瘀互结型类风湿关节炎的临床观察  

Effect of Tongluoling Tincture Combined with Intermediate Frequency Import in Patients with Phlegm-blood Stasis Type Rheumatoid Arthritis

作　　者：马建辉 刘博华 王丽丽 

机构地区：[1]河北省中医药科学院,石家庄050031 [2]河北省体育科学研究所,石家庄050011

出　　处：《中国实验方剂学杂志》2017年第21期179-183,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河北省中医药管理局科研计划项目(2013174)

摘　　要：目的:观察通络灵酊剂中频导入治疗痰瘀互结型类风湿关节炎(RA)的临床疗效及作用机制。方法:按照随机数字表法将120例痰瘀互结型RA患者分为观察组和对照组,各60例。两组患者均按照指南进行关节功能锻炼,对照组中频导入利多卡因注射液,20 min/次,1次/d;观察组中频导入通络灵酊剂,20 min/次,1次/d。观察两组患者治疗前后关节肿胀数,关节压痛数,晨僵时间,双手平均握力;记录数字疼痛分级法(NPS)评分,健康调查问答(HAQ)评分,28个关节疾病活动度(DAS28)评分;检测两组患者治疗前后血清血管内皮生长因子(VEGF),白细胞介素-10(IL-10),肿瘤坏死因子-α(TNF-α),骨碱性磷酸酶(BAP)水平;观察两组患者不良反应情况。结果:观察组临床疗效总有效率为88.33%,对照组临床疗效总有效率为71.67%,观察组优于对照组(χ~2=5.208,P<0.05);治疗后观察组关节肿胀数,关节压痛数,晨僵时间均低于对照组(P<0.01),双手平均握力高于对照组(P<0.01);治疗后观察组NPS评分,HAQ评分,DAS28评分均低于对照组(P<0.01);治疗后,观察组VEGF,TNF-α,BAP水平低于对照组(P<0.01),观察组IL-10水平高于对照组(P<0.01);两组患者治疗期间均无明显的不良反应发生。结论:在关节功能训练的基础上,通络灵酊剂中频导入治疗痰瘀互结型类风湿关节炎临床疗效显著并且安全,其作用机制可能与降低VEGF,TNF-α,BAP水平,提高IL-10水平有关。Objective： To observe the clinical curative effect and the mechanism of Tongluoling tincture combined with intermediate frequency import in patients with phlegm-blood stasis type rheumatoid arthritis （RA）. Method： The 120 patients with phlegm-blood stasis type RA were randomly divided into control group （60 cases） and observation group （60 cases） by random number table. Both groups took joint function exercise according to guide, and patients in control group received intermediate frequency import of lidocaine injection, 20 rain/time, 1 time/day, while patients in observation group received intermediate frequency import of Tongluoling tincture, 20 min/time, 1 time/day. The swollen joint count, tender joint count, morning stiff time, and mean grip strength were observed before and after treatment in both groups; numeric pain scale （NPS） scores, health assessmentquestionnaire （HAQ） scores, disease activity score using 28 joint counts （DAS28） were recorded before and after treatment in two groups. Levels of interleukin （IL） -6, IL-10, tumor necrosis factor （TNF） -α, and bone alkaline phosphatase （BAP） were detected before and after treatment. In addition, the adverse reactions were observed in two groups. Result： The total rate of clinical effect was 88.33% in observation group, higher than 71.67% in control group （X2 = 5. 208, P 〈 0.05） . After treatment, swollen joint count, tender joint count, and morning stiff time in observation group were lower than those in control group （P 〈 0. 01 ） ; mean grip strength in observation group was higher than that in control group （P 〈 0. 01 ） ; scores of NPS, HAQ and DAS28 in observation group were lower than those in control group （P 〈 0.01 ） ; levels of vascular endothelium growth factor （VEGF）, TNF-α, and BAP in observation group were lower than those in control group （P 〈 0.01 ） , while level of IL-IO in observation group was higher than that in control group （P 〈 0. 01 ）. There were no obv

关 键 词：通络灵酊剂 中频导入 痰瘀互结 类风湿关节炎 血管内皮生长因子 肿瘤坏死因子-α 骨碱性磷酸酶 白细胞介素-10 

分 类 号：R287[医药卫生—中药学] R259[医药卫生—中医学]