乌梅透骨汤联合甲氨蝶呤治疗类风湿性关节炎的疗效  

Treatment of Rheumatoid Arthritis with Wumei Tonggu Decoction(乌梅透骨汤)Combined with Methotrexate

作　　者：王海华[1] 杨献忠[1] 薛宏彬[1] 王金华[1] WANG Haihua;YANG Xianzhong;XUE Hongbin;WANG Jinhua(Department of Traditional Chinese Medicine,The Second Hospital of Handan,Handan 056001,Hebei,China)

机构地区：[1]邯郸市第二医院中医科,河北邯郸056001

出　　处：《辽宁中医杂志》2021年第3期108-111,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：河北省医学科学研究课题计划(20191789)。

摘　　要：目的观察乌梅透骨汤联合甲氨蝶呤对肝肾亏虚夹瘀型类风湿性关节炎(RA)的治疗效果,及对骨保护素(OPG)、NF-κB受体活化子配体(RANKL)的影响。方法选取2016年3月—2018年8月在该院接受治疗的肝肾亏虚夹瘀型RA患者为研究对象,并随机分为对照组和观察组,两组患者均给予甲氨蝶呤治疗,观察组在此基础上给予乌梅透骨汤治疗。观察两组患者的治疗效果,比较两组患者治疗前后炎症因子、OPG,RANKL水平的差异。结果两组患者治疗前证候评分无差异,治疗后,观察组关节疼痛、关节肿胀、屈伸不利和晨僵评分低于对照组,差异有统计学意义(P<0.05);两组患者治疗前炎症因子水平无差异,治疗后,观察组患者的TNF-α、IL-1和IL-6水平低于对照组(t=17.133、3.997、10.839,P<0.001);两组患者治疗前OPG,RANKL水平无差异,治疗后,观察组患者的OPG水平高于对照组,RANKL水平低于对照组,差异有统计学意义;两组患者治疗前SF-36评分无差异,治疗后,观察组患者的SF-36评分高于对照组(t=-17.552、-13.250,P<0.001)。结果乌梅透骨汤联合甲氨蝶呤对肝肾亏虚夹瘀型类风湿性关节炎(RA)的治疗效果较好,可改善患者的OPG,RANKL水平,具有良好的临床应用价值。Objective To observe the therapeutic effect of Wumei Tongu Decoction(乌梅透骨汤)combined with methotrexate on rheumatoid arthritis(RA)of liver and kidney deficiency and blood stasis type and the influence on OPG,NF-κB and RANKL.Methods From March 2016 to August 2018,RA patients with liver and kidney deficiency and blood stasis type who were treated in our hospital were selected as research objects and randomly divided into control group and observation group.Both groups were treated with methotrexate.On the basis of this,the observation group was treated with Wumei Tonggu Decoction.We observed the treatment effect of the two groups,and compared the differences of inflammatory factors,OPG and RANKL before and after treatment in the two groups.Results There was no difference in the symptom scores before treatment between the two groups.After treatment,the joint pain,joint swelling,poor flexion and extension,and morning stiffness scores in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no difference in factor levels.After treatment,the levels of TNF-α,IL-1 and IL-6 in the observation group were lower than those in the control group(t=17.133,3.997,10.839,P<0.001).OPG and RANKL before treatment in the two groups had no difference.After treatment,the OPG level in the observation group was higher than that in the control group,and the RANKL level was lower than that of the control group.The difference was statistically significant.There was no difference in the SF-36 scores between the two groups after treatment.The SF-36 score was higher than that of the control group(t=-17.552,-13.250,P<0.001).Conclusion The combination of Wumei Tongu Decoction and methotrexate has a good therapeutic effect on RA of liver and kidney deficiency and blood stasis type.It can improve the levels of OPG and RANKL and has good clinical application value.

关 键 词：甲氨蝶呤 中西药结合 类风湿性关节炎 炎症因子 

分 类 号：R593.21[医药卫生—内科学]