宣痹汤合三妙散联合西药口服对类风湿关节炎湿热痹阻证患者疗效及血清sTREM-1、IL-32、GPI水平的影响  

Clinical Effects of Xuanbi Tang and Sanmiao San Combined with Oral Administration of Western medicine in Treating Rheumatoid Arthritis of Damp-heat Obstruction Pattern and Its Influence on the Levels of sTREM-1,IL-32 and GPI

作　　者：李婧 叶志勤[1] LI Jing;YE Zhiqin(Department of Rheumatology,Hubei Provincial Hospital of TCM,Wuhan 430000,China)

机构地区：[1]湖北省中医院风湿病科,湖北武汉430000

出　　处：《西部中医药》2022年第7期86-89,共4页Western Journal of Traditional Chinese Medicine

摘　　要：目的:研究宣痹汤合三妙散联合西药口服对类风湿关节炎(rheumatoid arthritis,RA)湿热痹阻证患者疗效及血清中可溶性髓系细胞触发受体1(soluble triggering receptor expresses on myeloid cells-1,sTREM-1)、白细胞介素32(interleukin-32,IL-32)、糖基磷脂酰肌醇(glycosyl phosphatidyl inositol,GPI)水平的影响。方法:将RA湿热痹阻证患者108例依据随机分组方法分为对照组和观察组各54例。对照组口服甲氨蝶呤片及柳氮磺吡啶肠溶片,观察组在对照组治疗的基础上联合宣痹汤合三妙散治疗。比较两组临床疗效、治疗前后血清sTREM-1、IL-32、GPI水平及中医症状和体征评分、骨性关节炎指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)、28个关节的疾病活动度评分(disease activity score of 28 joints,DAS28)与不良反应发生情况。结果:观察组临床疗效为96.29%,高于对照组的72.22%(P<0.05);治疗后两组sTREM-1、GPI、IL-32水平及中医症状和体征评分、WOMAC和DAS28评分均低于治疗前(P<0.05),观察组低于对照组(P<0.05);观察组治疗期间不良反应发生率低于对照组(P<0.05)。结论:宣痹汤合三妙散联合甲氨蝶呤片及柳氮磺吡啶肠溶片能有效改善RA湿热痹阻证患者关节肿胀、晨僵、关节压痛等症状,能调节sTREM-1、IL-32及GPI水平,效果优于甲氨蝶呤片及柳氮磺吡啶肠溶片,且不良反应少。Objective:To study clinical effects of Xuanbi Tang and Sanmiao San combined with oral administration of Western medicine in the treatment of RA of damp-heat obstruction pattern and its influence on the levels of sTREM-1,IL-32 and GPI.Methods:All 108 patients were divided into the control group and the observation group according to random grouping.The control group took methotrexate tablets and sulfasoazine enteric-coated tablets orally,and the observation group received Xuanbi Tang and Sanmiao San based on Western medicine.To compare clinical effects,the indexes of sTREM-1,IL-32 and GPI,the scores of TCM symptom and body signs,WOMAC,DAS28 and adverse reaction between both groups.Results:Clinical effective rate of the observation group was 96.29%,higher than 72.22% of the control group(P<0.05);after the treatment,the levels of sTREM-1,IL-32 and GPI,the scores of TCM symptom and body signs,WOMAC,DAS28 scores of both groups were lower than these before treating(P<0.05),the observation group was lower than the control group(P<0.05);total incidence of adverse reaction of the observation group was lower than the control group during therapeutic period(P<0.05).Conclusion:Xuanbi Tang and Sanmiao San combined with methotrexate tablets and sulfasoazine enteric-coated tablets in the treatment of RA of damp-heat obstruction pattern could effectively improve joint swelling,morning stiffness,joint tenderness,regulate the levels of sTREM-1,IL-32 and GPI,and its effects superior to these of methotrexate tablets and sulfasoazine enteric-coated tablets,with minor adverse reaction.

关 键 词：类风湿关节炎 湿热痹阻证 可溶性髓系细胞触发受体1 白细胞介素32 糖基磷脂酰肌醇 宣痹汤 三妙散 

分 类 号：R274.9[医药卫生—中西医结合]