通络开痹片辅助治疗类风湿关节炎疗效及对患者ACPA、CRT、MyD88蛋白表达水平的影响  

Effect of Tongluo Kaibi tablet on the expression of ACPA,CRT and MyD88 protein in patients with rheumatoid arthritis

作　　者：陈永辉 丁利伟 王迪 Chen Yonghui;Ding Liwei;Wang Di(Department of Orthopaedics,Xuchang Central Hospital of Henan Province（Xuchang 461000)

机构地区：[1]河南省许昌市中心医院骨外科,许昌461000

出　　处：《陕西中医》2018年第7期931-934,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河南省科技创新人才计划项目(2015092336F)

摘　　要：目的:分析通络开痹片辅助西药治疗类风湿关节炎(RA)患者临床疗效,及对RA患者抗瓜氨酸化蛋白/肽抗体(ACPA)、钙网织蛋白(CRT)、髓样分化因子88(MyD88)蛋白表达的影响。方法:选取246例符合纳入条件的类风湿关节炎患者,随机分为对照组和观察组,每组123例。对照组采用常规西医治疗,选择抗炎、止痛、退热的非甾抗炎药物美洛昔康、改善病情药物柳氮磺吡啶联合治疗,观察组在对照组治疗基础上加用通络开痹片治疗。两组患者均连续治疗60d为1个疗程。对两组患者临床疗效进行评估并比较,比较两组患者治疗前、后临床症状中医评分、ACPA、CRT、MyD88蛋白表达变化。结果:完成治疗后,观察组总有效率明显高于对照组(P<0.05)。两组患者治疗后关节疼痛、肿胀、发热、压痛、屈伸不利、关节发热症状评分较治疗前明显降低(P<0.05),且观察组低于对照组(P<0.05)。两组治疗后ACPA、CRT、MyD88蛋白表达均较治疗前有明显降低,且观察组低于对照组(P<0.05)。两组患者治疗过程中均未收集到严重不良反应,一般不良反应率比较差异无统计学意义(P<0.05)。结论:通络开痹片可有效改善类风湿关节炎患者临床关节症状、降低对关节组织有损害的蛋白质表达水平,安全可靠地提升临床疗效,对RA患者具有较高的临床价值。Objective：to analyze the Tongluo Kaibi tablet assisted western medicine in the treatment of rheumatoid arthritis（RA）patients and the clinical curative effect of RA patients,anti citrullinated protein/peptide antibody（ACPA）,calreticulin（CRT）and myeloid differentiation factor 88（MyD88）protein expression,to explore the mechanism of Tongluo Kaibi tablet adjuvant therapy in patients with RA.Methods：246 patients with rheumatoid arthritis who met the inclusion criteria were selected.They were randomly divided into control group and observation group,123 cases in each group.The control group using conventional western medicine treatment with nonsteroidal antiinflammatory drugs,choice of anti-inflammatory,analgesic and antipyretic meloxicam,improve the condition of sulfasalazine combined with drug therapy,the observation group in the control group based on the treatment of Tongluo Kaibi tablet.Two groups of patients were treated for a period of 6 months.The clinical efficacy of the two groups was evaluated and compared.The clinical symptoms,TCM score,ACPA,CRT and MyD88 protein expression in the two groups before and after treatment were compared.Results：after the treatment,the total effective rate of disease in the control group was significantly higher than that of the control group（P〈0.05）.Two groups of patients after treatment,joint pain,swelling,fever,tenderness,flexion and extension discomfort,joint fever symptom score was significantly lower than before treatment（P〈0.05）,and the observation group was lower than the control group（P〈0.05）.After treatment,the expression of ACPA,CRT and MyD88 in the two groups was significantly lower than that before treatment,and the observation group was lower than the control group（P〈0.05）.No serious adverse reactions were collected during the treatment of the two groups,and there was no significant difference in the rate of adverse reaction（P〈0.05）.Conclusion：Tongluo Kaibi tablets can effectively improve the clinical symptoms of

关 键 词：关节炎 类风湿 中西医结合疗法 通络开痹片 

分 类 号：R593.22[医药卫生—内科学]