桂芍知母汤对类风湿关节炎患者血清TNF-α和趋化因子CX3CL1的影响  

Effect of Guishao Zhimu Decoction on serum TNF-α and chemokine CX3CL1 in rheumatoid arthritis patients

作　　者：程立[1] 周腊梅[1] 蒋雪峰[1] 陆莉君[1] Li Cheng;La-mei Zhou;Xue-feng Jiang;Li-jun Lu(Department of Rheumatology, Wuxi Hospital of Traditional Chinese Medicine,Wuxi, Jiangsu 214071, China)

机构地区：[1]江苏省无锡市中医医院风湿病科,江苏无锡214071

出　　处：《中国现代医学杂志》2017年第20期65-68,共4页China Journal of Modern Medicine

基　　金：江苏省无锡市科技计划项目(No:SE01N101)

摘　　要：目的探讨桂芍知母汤对类风湿关节炎(RA)患者血清肿瘤坏死因子α(TNF-α)和趋化因子CX3CL1水平的影响。方法选取2012年1月-2014年1月该院门诊就医的64例RA患者为研究对象,并随机分为观察组和对照组,两组各32例。对照组给予美洛昔康15 mg/次,1次/d和甲氨蝶呤15 mg/次,1次/周;观察组患者在此基础上加用桂芍知母汤1剂/d,500 ml水煎服。比较两组治疗前后血清TNF-α和CX3CL1水平。结果治疗12周后,观察组血清TNF-α和CX3CL1分别为(39.3±21.3)和(76.2±35.4)pg/ml,低于治疗前的(75.3±47.2)和(160.7±58.3)pg/ml(P<0.05),低于对照组治疗12周后的(54.9±35.2)和(131.8±50.6)pg/ml(P<0.05)。而对照组治疗前后比较,差异无统计学意义(P>0.05)。观察组达ACR70、ACR50、ACR20标准及无效的比例分别为9.4%、28.1%、56.3%和6.3%,优于对照组的3.1%、18.8%、50.0%和28.1%,差异有统计学意义(P<0.05)。服药期间所有患者未发生严重不良反应,观察组、对照组不良反应发生率分别为3.1%和0.0%,两组比较,差异无统计学意义(P>0.05)。结论桂芍知母汤可降低RA患者血清TNF-α和CX3CL1水平,抑制关节的滑膜炎症反应,提高临床疗效,安全可靠。Objective To investigate the impact of Guishao Zhimu Decoction on serum TNF-αandchemokine CX3CL1in patients with rheumatoid arthritis(RA).Methods In the study64RA patients treatedin the Outpatient Department of our hospital from January2012to January2014were enrolled and randomlydivided into observation group and control group with32cases in each group.The patients in the controlgroup were given Meloxicam(15mg,once a day)and Methotrexate(15mg,once a week).Based on that,thecases in the observation group were given Guishao Zhimu Decoction(a daily dose,500ml water fordecoction).Serum TNF-αand CX3CL1levels before and after treatment were compared between the twogroups.Results After12weeks of treatment,serum TNF-αand CX3CL1levels of the observation group were(39.3±21.3)and(76.2±35.4)pg/ml respectively,which were significantly lower than those before treatment[(75.3±47.2)and(160.7±58.3)pg/ml,<0.05],and also significantly lower than those of the control group12weeks after treatment[(54.9±35.2)and(131.8±50.6)pg/ml,<0.05].In the control group,there was nosignificant difference in serum TNF-αor CX3CL1level before and after treatment(>0.05).The proportionsof achieving ACR70,ACR50and ACR20criteria and ineffectiveness in the observation group were9.4%,28.1%,56.3%and6.3%respectively,which were significantly better than3.1%,18.8%,50.0%and28.1%inthe control group(<0.05).The incidences of adverse reactions in the observation group and the control groupwere3.1%and0.0%respectively,there was no significant difference(>0.05).Conclusions Guishao ZhimuDecoction could significantly reduce serum TNF-αand CX3CL1levels of RA patients,then inhibit inflammationof articular synovium and improve the clinical efficacy.It is safe and reliable.

关 键 词：桂芍知母汤 类风湿关节炎 肿瘤坏死因子-Α CX3CL1 

分 类 号：R285.5[医药卫生—中药学] R259[医药卫生—中医学]