独活寄生汤对类风湿关节炎患骨修复的影响  

Effects of Duhuo Jisheng Decoction on Bone Repair of Patients with Rheumatoid Arthritis Patients

作　　者：陈媛清[1] 崔森[1] 马红梅[1] 秦雅婧[1] 李晓凤[1] CHEN Yuanqing;CUI Sen;MA Hongmei;QIN Yajing;LI Xiaofeng(Department of Rheumatology and Immunology,Qinghai University Affiliated Hospital,Xining 810001,China)

机构地区：[1]青海大学附属医院风湿免疫科,西宁810000

出　　处：《世界中医药》2020年第23期3671-3674,共4页World Chinese Medicine

基　　金：国家自然科学基金项目(81260300)。

摘　　要：目的:探究独活寄生汤对类风湿关节炎患者骨修复的影响。方法:选取2017年11月至2019年10月青海大学附属医院收治的类风湿关节炎患者60例作为研究对象,按照随机数字表法分为对照组和观察组,每组30例。2组均口服甲氨蝶呤片+艾拉莫德片,观察组加用独活寄生汤,治疗3个月。观察2组的疗效、血清细胞因子、活动能力评分、临床症状各指标改善情况及不良反应。结果:治疗3个月后,观察组总有效率为93.33%,高于对照组的70.00%(P<0.05)。治疗3个月后,2组血清OPG、RANKL、IL-6、TNF-α水平升高,观察组高于对照组(P<0.05)。治疗3个月后,2组DAS28、HAQ评分、肿胀指数、压痛指数、双手握力均降低,观察组低于对照组;晨僵时间缩短,且观察组短于对照组(P<0.05)。观察组不良反应发生率为20.00%,与对照组的26.67%比较差异无统计学意义(P>0.542)。结论:独活寄生汤联合艾拉莫德可提高机体免疫力,有效改善类风湿关节炎患者血清OPG、RANKL水平,促进骨修复,并改善其活动能力和临床症状,安全性高,值得推广。Objective:To explore the effect of Duhuo Jisheng Decoction on bone repair in patients with rheumatoid arthritis.Methods:From November 2017 to October 2019,a total of 60 patients with rheumatoid arthritis treated in Qinghai University Affiliated Hospital were selected as the research objects and were randomly divided into an observation group(n=30)and a control group(n=30).Both groups took methotrexate tablets and Iramod tablets orally.The observation group was treated with Duhuo Jisheng Decoction for 3 months.The curative effect,serum cytokines,activity score,improvement of clinical symptoms and adverse reactions of the 2 groups were observed.Results:After 3 months of treatment,the total effective rate of the observation group was 93.33%,which was higher than 70.00%of the control group(P<0.05).After 3 months of treatment,the levels of serum OPG,RANKL,IL-6 and TNF-αin the 2 groups increased,and the observation group was higher than that in the control group(P<0.05).After 3 months of treatment,DAS28,HAQ score,swelling index,tenderness index and grip strength of both hands in the 2 groups decreased,while the observation group were lower than those in the control group.The morning stiffness time was shortened,and the observation group was shorter than the control group(P<0.05).The incidence of adverse reactions in the observation group was 20.00%,and there was no statistical difference between the observation group and the control group(26.67%)(P>0.05).Conclusion:Duhuo Jisheng Decoction combined with iguratimod can improve immunity,effectively improve serum OPG and RANKL levels of patients with rheumatoid arthritis,promote bone repair,and improve their mobility and clinical symptoms.It is safe and worthy of promotion.

关 键 词：类风湿关节炎 独活寄生汤 艾拉莫德 骨保护素 核因子-ΚB受体活化因子配体 免疫 骨修复 

分 类 号：R259[医药卫生—中西医结合] R593.22[医药卫生—中医内科学]