木防己汤联合甲氨蝶呤对类风湿关节炎急性发作期患者氧自由代谢、骨代谢及血瘀状态的影响  

Effect of Mufangji Decoction combined with Methotrexate on oxygen free metabolism,bone metabolism and blood stasis in patients with acute rheumatoid arthritis

作　　者：丁文聪 陈陶甫 缪辉宇 DING Wencong;CHEN Taofu;MIAO Huiyu(The First Clinical School of Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou510405,China;Department of Traditional Chinese Medicine,Heyuan Hospital of Traditional Chinese Medicine,Guangdong Province,Heyuan517000,China;Department of Acupuncture and Massage,the Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou510407,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广东省河源市中医院中医内科,广东河源517000 [3]广州中医药大学第三附属医院针灸推拿科,广东广州510407

出　　处：《中国医药导报》2020年第18期131-134,142,共5页China Medical Herald

基　　金：广东省中医药局科研项目(20182060)。

摘　　要：目的探讨类风湿关节炎(RA)急性发作期应用木防己汤联合甲氨蝶呤(MTX)治疗的临床效果。方法选取2014年1月~2018年5月广州中医药大学第三附属医院收治的122例急性发作期RA患者,运用随机数字表法将其分成观察组(61例)与对照组(61例)。对照组口服MTX+叶酸片治疗,观察组在此基础上加用木防己汤治疗。所有患者均治疗8周。比较两组临床效果,治疗前后氧自由代谢指标[总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)、活性氧(ROS)]、骨代谢指标[骨钙素(BGP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、Ⅰ型胶原氨基端延长肽(PINP)]、血瘀状态指标[红细胞沉降率(ESR)、D-二聚体(D-D)、纤维蛋白原(Fbg)]水平变化,不良反应发生情况。结果治疗后,观察组总有效率明显高于对照组(P <0.05)。与治疗前比较,治疗后两组血清T-AOC、SOD、BGP、PINP水平升高,且观察组高于对照组(P <0.05);两组血清ROS、β-CTX浓度、ESR值、血浆D-D及Fbg水平降低,且观察组低于对照组(P <0.05);两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 RA急性发作期应用木防己汤联合MTX治疗能明显缓解患者症状,纠正体内氧自由基代谢失衡,维持骨代谢平衡,改善血瘀状态,疗效切实,安全性高。Objective To explore clinical effect of Mufangji Decoction combined with Methotrexate(MTX)in the treatment of acute attack of rheumatoid arthritis(RA).Methods A total of 122 patients with acute episode RA admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2014 to May 2018 were selected and they were divided into the observation group(61 cases)and the control group(61 cases).The control group was orally treated with MTX+Folic Acid Tablets,and the observation group was treated with Mufangjitang on the basis of the control group.All patients were treated for 8 weeks.The clinical effects,indicators of free oxygen metabolism[total antioxidant capacity(T-AOC),superoxide dismutase(SOD),reactive oxygen species(ROS)],bone metabolism indicators[osteocalcin(BGP),typeⅠcollagen carboxy terminal peptideβspecial sequence(β-CTX),propeptide of typeⅠprocollagen(PINP)],blood stasis sta tus indicators[erythrocyte sedimentation rate(ESR),D-dimer(D-D),Fibrinogen(Fbg)]level changes,and adverse reactions of the two groups were compared before and after treatment.Results After treatment,the total effective rate in the observation group was significantly higher than that in the control group(P<0.05).After treatment,serum T-AOC,SOD,BGP,and PINP levels in the two groups were higher than those before treatment,and those of the observation group were higher than the control group(P<0.05).The concentrations of serum ROS,β-CTX,the ESR value and plasma D-D,Fbg levels in the two groups were lower than those before treatment,and those of the observation group were lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Mufangji Decoction combined with Methotrexate helps patients with acute rheumatoid arthritis relieve symptoms,corrects the imbalance of oxygen free radical metabolism in body,maintains the balance of bone metabolism and improves blood stasis state with practical curative effect and h

关 键 词：类风湿关节炎 木防己汤 氧自由代谢 骨代谢 血瘀状态 

分 类 号：R593.22[医药卫生—内科学]