四妙散加减治疗湿热蕴结型急性痛风性关节炎疗效及对患者T细胞亚群、血液流变学及炎性标志物的影响  

Effect of Simiao powder on T cell subsets,hemorheology and inflammatory markers in acute gouty arthritis of damp-heat accumulation type

作　　者：郭良 谭昱[1] 马春涛[1] 陈立刚[1] 白曼莫 GUO Liang;TAN Yu;MA Chuntao;CHEN Ligang;BAI Manmo(Sanya Traditional Chinese Medicine Hospital,Sanya 572022,China)

机构地区：[1]三亚市中医院,海南三亚572022

出　　处：《陕西中医》2023年第2期199-204,共6页Shaanxi Journal of Traditional Chinese Medicine

基　　金：海南省卫生健康行业科研项目(21A200429)。

摘　　要：目的:探究四妙散加减治疗对湿热蕴结型急性痛风性关节炎(AGA)患者T细胞亚群、血液流变学及炎性标志物水平的影响。方法:选取湿热蕴结型AGA患者104例,分为塞来昔布组49例(口服塞来昔布胶囊治疗)和四妙散组(在塞来昔布组基础上给予四妙散加减治疗)55例,治疗3个月后,比较两组患者疗效、治疗前后中医症状积分、T细胞亚群、血尿酸(SUA)、全血黏度、血浆黏度、红细胞沉降率(ESR)、红细胞电泳(EEP)、纤维蛋白原(Fib)、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、白介素-6(IL-6)、白介素-8(IL-8)、白介素-17(IL-17)、8-羟基脱氧鸟苷(8-OHdG)、硝基络氨酸修饰蛋白(3-NT)、丙二醛(MDA)水平、疼痛评分(VAS)和不良反应发生率。结果:治疗后,四妙散组治疗总有效率、CD3^(+)、CD8^(+)水平明显高于塞来昔布组,临床症状积分、CD4^(+)、CD4/CD8、SUA、血流动力学指标(全血黏度、血浆黏度、ESR、EEP、Fib)、炎性标志物(hs-CRP、TNF-α、IL-1β、IL-6、IL-8、IL-17)、MDA、3-NT、8-OHdG水平、VAS评分、总不良反应发生率低于塞来昔布组(均P<0.05)。结论:四妙散加减能改善湿热蕴结型急性痛风性关节炎患者的临床症状、T细胞亚群和血液流变学指标,降低血尿酸,减轻疼痛,抑制炎症反应,降低氧化应激表达,减少不良反应发生。Objective:To explore the effect of modified Simiao powder on T cell subsets,hemorheology and inflammatory markers in patients with acute gouty arthritis(AGA)of damp-heat accumulation type.Methods:A total of 104 patients with damp-heat accumulation type AGA were retrospectively selected.According to different treatment methods,they were divided into celecoxib group(49 cases,treated with oral celecoxib capsules)and Simiao powder group(55 cases,treated with Simiao powder on the basis of celecoxib group).The curative effect,TCM symptom score,T cell subsets,blood uric acid(SUA),whole blood viscosity(ηb),plasma viscosity(ηp),erythrocyte sedimentation rate(ESR),erythrocyte electrophoresis(EEP),fibrinogen(Fib),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(IL-8),interleukin-17(IL-17),8-hydroxydeoxyguanosine(8-OHdG),nitrocytidine modified protein(3-NT),serum malondialdehyde(MDA)level,pain score(VAS)and incidence of adverse reactions were observed and compared between the two groups.Results:After treatment,the total effective rate,CD3^(+)and CD8^(+)levels in the Simiao powder group were significantly higher than those in the celecoxib group,and the clinical symptom scores,CD4^(+),CD4/CD8,SUA,hemorheology(ηb,ηp,ESR,EEP,Fib),inflammatory markers(hs-CRP,TNF-α,IL-1β,IL-6,IL-8,IL-17),MDA,3-NT,8-OH dG levels,VAS score and total adverse reaction rate were significantly lower than those in the celecoxib group(all P<0.05).Conclusion:Modified Simiao powder can improve the clinical symptoms,T cell subsets and hemorheological indexes of patients with acute gouty arthritis of damp-heat accumulation type,reduce blood uric acid,relieve pain,inhibit inflammatory reaction,reduce oxidative stress expression,and reduce adverse reactions.

关 键 词：急性痛风性关节炎 四妙散 湿热蕴结型 T细胞亚群 血液流变学 

分 类 号：R684.3[医药卫生—骨科学]