塞来昔布联合尪痹舒汤剂治疗类风湿性关节炎疗效及对Th17/Tregs平衡的影响  

Effect of Celecoxib Combined with Wangbishu Decoction on Rheumatoid Arthritis and Its Effect on Th17/Tregs Balance

作　　者：万彬彬[1] 何浩[1] 金京娥 WAN Binbin;HE Hao;JIN Jing’e(Department of Rheumatology and Immunology,Wuhan First Hospital,Wuhan 430022,Hubei,China;Department of Traditional Chinese Medicine,Xinzhou District Chinese Medicine Hospital,Wuhan 100191,Hubei,China)

机构地区：[1]武汉市第一医院风湿免疫科,湖北武汉430022 [2]新洲区中医医院中医内科,湖北武汉100191

出　　处：《中华中医药学刊》2020年第10期194-197,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：湖北省自然科学基金(2014cfc1054);武汉市卫生计生委科研项目(WZ18D16)。

摘　　要：目的探讨塞来昔布联合尪痹舒汤剂治疗类风湿性关节炎(rheumatoid arthritis,RA)的效果观察及对Th17/Tregs平衡的影响。方法选取2017年6月—2019年1月医院收治的106例RA患者作为研究对象。随机将所有患者分为观察组和对照组,每组53例。对照组采用塞来昔布治疗,观察组采用塞来昔布联合尪痹舒汤剂治疗。比较两组间临床疗效、临床症状、VAS评分和DAS28评分、病情活动指标、Th17/Tregs及不良反应发生率。结果相比于对照组,观察组的总有效率更高(92.5%VS 77.4%)(P<0.05)。治疗后,相比于对照组,观察组关节肿胀数、关节压痛数、晨僵时间更少(P<0.05)。相比于对照组,观察组VAS评分和DAS28评分更低(P<0.05)。相比于对照组,观察组CRP、ESR、RF、抗CCP抗体更低(P<0.05)。相比于对照组,观察组Th17百分比、Th17/Tregs更低、Tregs百分比更高(P<0.05)。相比于对照组,观察组不良反应发生率更低(P<0.05)。结论塞来昔布联合尪痹舒汤剂用于治疗类风湿性关节炎,能有效缓解患者的临床症状,效果显著,其作用机制可能是通过改善Th17/Tregs平衡。Objective To study the effect of celecoxib combined with Wangbishu Decoction on the treatment of rheumatoid arthritis(RA)and its effect on the balance of Th17/Tregs.Methods From June 2017 to January 2019,106 patients with RA were selected as the subjects.All patients were randomly divided into observation group and control group with 53 cases in each.The control group was treated with celecoxib and the observation group was treated with celecoxib combined with Wangbishu Decoction.The clinical efficacy,clinical symptoms,VAS score and DAS28 score,disease activity index,Th17/Tregs and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher(92.5%VS 77.4%)than that in the control group(P<0.05).After treatment,compared with those of the control group,the number of joint swelling,the number of joint tenderness and the time of morning stiffness in the observation group were less(P<0.05).Compared with those of the control group,the VAS scores and DAS28 scores in the observation group were lower(P<0.05).Compared with those of the control group,the levels of CRP,ESR,RF and anti-CCP antibodies in the group were lower(P<0.05).Compared with those of the control group,the percentage of Th17 and Th17/Tregs in the observation group were lower and Tregs was higher(P<0.05).The incidence of adverse reactions was lower in the observation group than that in the control group(P<0.05).Conclusion Celecoxib combined with Wangbishu Decoction in the treatment of RA can effectively alleviate the clinical symptoms of patients.The effect is significant and the mechanism may be to improve Th17/Tregs balance.

关 键 词：塞来昔布 尪痹舒汤剂 类风湿性关节炎 辅助性T淋巴细胞 调节性T淋巴细胞 

分 类 号：R259.932.1[医药卫生—中西医结合]