四妙勇安汤合白虎汤加味辨治类风湿关节炎湿热痹阻证疗效及对血清sTREM-1、IL-32、GPI水平的影响  

Curative Effect of Modified Simiao Yongan Tang Combined with Baihu Tang for Rheumatoid Arthritis with Damp-Heat Obstruction Syndrome and Its Effect on Levels of STREM-1,IL-32 and GPI in Serum

作　　者：陈如平 吴华杰 CHEN Ruping;WU Huajie

机构地区：[1]杭州市西溪医院中医科,浙江杭州310023 [2]淳安县中医院骨伤科,浙江淳安311700

出　　处：《新中医》2021年第11期36-40,共5页New Chinese Medicine

摘　　要：目的:观察四妙勇安汤合白虎汤加味辨治类风湿关节炎湿热痹阻证的临床效果及其对血清中可溶性髓样细胞触发受体-1 (sTREM-1)、白细胞介素-32 (IL-32)、葡萄糖-6-磷酸异构酶(GPI)水平的影响。方法:选取120例类风湿关节炎患者,按照随机数字表法分为对照组和观察组各60例。对照组给予常规西药口服,观察组在对照组的基础上加用四妙勇安汤合白虎汤加味口服。通过中医证候积分变化比较2组治疗后的临床效果,进行疾病活动度(DAS28)、视觉模拟评分法(VAS)评分,并监测血清中相关因子水平。结果:治疗后,观察组的中医有效率为94.64%,高于对照组的78.57%(P<0.05)。与同组治疗前比较,2组治疗8周、12周后中医证候积分均降低(P<0.05),2组治疗后DAS28评分、VAS评分及血清类风湿因子(RF)、红细胞沉降率(ESR)、sTREM-1、IL-32、GPI水平均降低(P<0.05)。与对照组治疗8周、12周后比较,观察组治疗8周、12周后中医证候积分均较低(P<0.05)。与对照组治疗后比较,观察组治疗后DAS28评分、VAS评分及血清RF、ESR、sTREM-1、IL-32、GPI水平均较低(P<0.05)。结论:四妙勇安汤合白虎汤加味在减轻类风湿关节炎患者临床症状、控制病情进展方面有更好的效果,初步推断这可能与其能调控血清中sTREM-1、IL-32、GPI水平以减轻软骨炎症损伤有关。Objective: To observe the clinical effect of modified Simiao Yongan tang combined with Baihu tang for rheumatoid arthritis with damp-heat obstruction syndrome,and to observe its effect on levels of soluble triggering receptor expressed on myeloid cells-1(sTREM-1), interleukin-32(IL-32) and glucose-6 phosphate isomerase(GPI) in serum.Methods:A total of 120 cases of patients with rheumatoid arthritis were divided into the control group and the observation group according to the random number table method,60 cases in each group. The control group was given oral administration of routine western medicine, and the observation group was additionally given the oral administration of modified Simiao Yongan tang combined with Baihu tang based on the treatment of the control group. The clinical effect after treatment in the two groups was compared by the changes in Chinese medicine syndrome scores;the scores of Disease Activity Score-28(DAS28) and Visual Analogue Scale(VAS) were graded,and the levels of related factors in serum were monitored. Results:After treatment,the effective rate of Chinese medicine was 94.64% in the observation group,higher than that of 78.57% in the control group(P<0.05). Compared with those in the same group before treatment, the Chinese medicine syndrome scores after eight-week and twelve-week treatments in the two groups were decreased(P<0.05),and the scores of DAS28 and VAS as well as the levels of Theumatoid factors(RF),erythrocyte sedimentation rate(ESR),sTREM-1,IL-32 and GPI in serum in the two groups were decreased(P<0.05). Compared with those in the control group after eight-week and twelveweek treatments, the Chinese medicine syndrome scores in the observation group were lower(P<0.05). Compared with those in the control group after treatment,the scores of DAS28 and VAS as well as the levels of RF,ESR,sTREM-1,IL-32 and GPI in serum in the observation group were lower(P<0.05). Conclusion:Modified Simiao Yongan tang combined with Baihu tang has better effect in relieving the clinical symptom

关 键 词：类风湿关节炎 湿热痹阻证 四妙勇安汤 白虎汤 可溶性髓样细胞触发受体-1 白细胞介素-32 葡萄糖-6-磷酸异构酶 

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