补肝强腰方对活动期强直性脊柱炎肝肾亏虚证患者TNF-α、IL-37、COX-2及骨代谢的影响  

Effects of Bugan Qiangyao Recipe on TNF-α,IL-37,COX-2 and Bone Metabolism in Patients with Active Ankylosing Spondylitis with Liver and Kidney Deficiency Syndrome

作　　者：吕水英 鲁超 殷继超 张俊莉 徐鹏刚 牛晓庆 刘德玉 LYU Shuiying;LU Chao;YIN Jichao;ZHANG Junli;XU Penggang;NIU Xiaoqing;LIU Deyu(Shaanxi Provincial Hospital of Integrative Medicine,Xi′an Shaanxi China 710003;Xi′an Red Cross Hospital,Xi′an Shaanxi China 710054;The Affiliated Hospital to Shaanxi University of Traditional Chinese Medicine,Xianyang Shaanxi China 712000)

机构地区：[1]陕西省中西医结合医院,陕西西安710003 [2]西安市红会医院,陕西西安710054 [3]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《中医学报》2022年第9期1982-1987,共6页Acta Chinese Medicine

基　　金：陕西省中医药管理局中西医结合临床协作创新项目(2020-ZXY-006);西安市第五医院院内科研项目(20201c01)。

摘　　要：目的:观察补肝强腰方治疗活动期强直性脊柱炎肝肾亏虚证患者的临床疗效,并观察其对患者肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、血清白细胞介素-37(interleukin-37,IL-37)、环氧合酶2(cyclooxygenase 2,COX-2)及骨代谢的影响。方法:114例活动期强直性脊柱炎肝肾亏虚证患者随机分为对照组和治疗组各57例。对照组给予西医常规治疗,观察组在对照组治疗基础上给予补肝强腰方。两组均治疗8周,治疗后比较两组患者临床疗效、不良反应发生率,治疗前后两组患者IL-37、COX-2、血沉(erythrocyte sedimentation rate,ESR)、TNF-α、血清骨形态发生蛋白-2(Bone morphogenetic protein-2,BMP-2)、骨钙素(bone gla protein,BGP)水平,巴氏强直性脊柱炎活动指数(bath ankylosing spondylitis disease activity index,BASDAI)评分及中医证候积分。结果:治疗后,两组患者ESR、IL-37、TNF-α水平均显著降低,观察组以上指标均低于同期对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清COX-2水平显著降低,BMP-2、BGP水平显著升高;观察组COX-2水平低于同期对照组,BMP-2、BGP水平高于同期对照组(P<0.05)。治疗后,两组患者BASDAI评分、中医证候积分均显著降低,观察组上述评分均低于同期对照组(P<0.05)。观察组有效率96.49%(55/57),高于对照组的78.95%(45/57),差异有统计学意义(P<0.05)。观察组不良反应发生率为10.54%(6/57),低于对照组的26.32%(15/57),差异有统计学意义(P<0.05)。结论:补肝强腰方治疗活动期强直性脊柱炎肝肾亏虚证患者疗效显著,可减轻患者脊柱炎症反应,促进骨代谢恢复,降低BASDAI评分、中医证候积分,提高腰椎活动功能。Objective:To observe the clinical efficacy of Bugan Qiangyao Decoction in the treatment of patients with active ankylosing spondylitis with Liver and Kidney deficiency syndrome,and to observe its effect on tumor necrosis factor-α(TNF-α),serum interleukin-37(IL-37),cyclooxygenase 2(COX-2)and bone metabolism.Methods:114 patients with active ankylosing spondylitis with liver and kidney deficiency syndrome were randomly divided into control group and treatment group,57 cases in each group.The control group was given conventional western medicine treatment,and the observation group was given Bugan Qiangyao Recipe on the basis of the treatment of the control group.Both groups were treated for 8 weeks,and the clinical efficacy,bone morphogenetic protein protein-2(BMP-2),bone gla protein(BGP)levels,bath ankylosing spondylitis disease activity index(BASDAI)score and TCM syndrome score were compared between the two groups after treatment.Results:After treatment,the levels of ESR,IL-37 and TNF-αin the two groups were significantly decreased,and the above indexes in the observation group were lower than those in the control group at the same period,and the differences were statistically significant(P<0.05).After treatment,the levels of serum COX-2 in the two groups were significantly decreased,while the levels of BMP-2 and BGP were significantly increased;the levels of COX-2 in the observation group were lower than those in the control group,and the levels of BMP-2 and BGP were higher than those in the control group(P<0.05).After treatment,the BASDAI scores and TCM syndrome scores in the two groups were significantly decreased,and the above scores in the observation group were lower than those in the control group at the same period(P<0.05).The effective rate in the observation group was 96.49%(55/57),which was higher than that in the control group,which was 78.95%(45/57),and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 10.54%(6/57),which was lower th

关 键 词：活动期强直性脊柱炎 肝肾亏虚证 补肝强腰方 骨代谢 炎症因子 腰椎活动功能 

分 类 号：R259.932.2[医药卫生—中西医结合]