盘龙七片辅助甲氨蝶呤和美洛昔康治疗类风湿关节炎的疗效及对TLR/MyD88信号通路的影响  

Efficacy of Panlongqi Tablets Combined with Methotrexate and Meloxicam in the Treatment of Rheumatoid Arthritis and Its Effects on TLR/MyD88 Signal Pathway

作　　者：陈辉[1] 刘伟杰 李伟[2] CHEN Hui;LIU Weijie;LI Wei(Dept.of Pharmacy,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China;Dept.of Rheumatism and Immunology,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院药学部,哈尔滨150086 [2]哈尔滨医科大学附属第二医院风湿免疫科,哈尔滨150086

出　　处：《中国医院用药评价与分析》2023年第3期290-294,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2019年黑龙江省自然科学基金项目(No.A20190269)。

摘　　要：目的:探讨盘龙七片辅助甲氨蝶呤和美洛昔康治疗类风湿关节炎(RA)的疗效及对Toll样受体(TLR)/髓样分化因子88(MyD88)信号通路的影响。方法:选取2018年12月至2021年9月于该院就诊的102例RA患者,按照随机数字表法分为对照组(n=51)和治疗组(n=51)。比较两组患者的总有效率,治疗前后的双手平均握力、晨僵时间、28个关节数疾病活动度评分(DAS28)和疼痛数字评价量表(NRS),比较实验室检测指标、TLR2 mRNA、MyD88 mRNA表达水平及不良反应发生情况。结果:治疗组患者的总有效率为94.12%(48/51),高于对照组的80.39%(41/51),差异有统计学意义(P<0.05)。与治疗前相比,两组患者治疗后的DAS-28评分、NRS评分显著降低,双手平均握力显著增加,晨僵时间显著缩短,全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白原(FIB)和红细胞沉降率(ESR)均显著降低,类风湿因子(RF)、抗链球菌溶血素O(ASO)、C反应蛋白(CRP)、抗环瓜氨酸肽抗体(ACCP)、TLR2 mRNA和MyD88 mRNA表达水平显著降低,差异均有统计学意义(P<0.05)。与对照组相比,治疗组患者治疗后的DAS-28评分、NRS评分降低,双手平均握力增加,FIB、ESR、RF、ASO、CRP、ACCP、TLR2 mRNA和MyD88 mRNA表达水平显著降低,差异均有统计学意义(P<0.05)。对照组、治疗组患者的不良反应发生率分别为21.57%(11/51)、23.53%(12/51),差异无统计学意义(P>0.05)。结论:盘龙七片辅助甲氨蝶呤和美洛昔康治疗RA患者可有效提高疗效,改善临床症状和体征,减轻疼痛,且安全性高,其可能是通过抑制TLR/MyD88信号通路介导的炎症反应来发挥作用。OBJECTIVE:To probe into the efficacy of Panlongqi tablets combined with methotrexate and meloxicam in the treatment of rheumatoid arthritis(RA)and its effects on Toll-like receptor(TLR)/myeloid differentiation factor 88(MyD88)signal pathway.METHODS:Totally 102 patients with RA admitted into the hospital from Dec.2018 to Sept.2021 were extracted to divided into the control group(n=51)and the treatment group(n=51)via the random number table method.The total effective rate,the average grip strength of both hands,morning stiffness time,28 joints disease activity score(DAS28)and pain numerical rating scale(NRS)were compared between two groups.The laboratory test indexes,TLR2 mRNA,MyD88 mRNA expression levels and adverse drug reactions were compared.RESULTS:The total effective rate of the treatment group was 94.12%(48/51),higher than 80.39%(41/51)of the control group,the difference was statistically significant(P<0.05).Compared with before treatment,the DAS-28 and NRS scores of two groups after treatment decreased significantly,the average grip strength of both hands increased significantly,and the morning stiffness time was shortened,the whole blood low shear viscosity,whole blood high shear viscosity,plasma viscosity,fibrinogen(FIB)and erythrocyte sedimentation rate(ESR)of two groups after treatment decreased,the levels of rheumatoid factor(RF),anti streptolysin O(ASO),C-reactive protein(CRP)and anti cyclic citrullinated peptide antibody(ACCP),TLR2 mRNA and MyD88 mRNA of two groups after treatment decreased significantly,with statistically significant difference(P<0.05).Compared with the control group,the DAS-28 and NRS scores decreased,the average grip strength of both hands increased,the levels of FIB,ESR,RF,ASO,CRP,ACCP,TLR2 mRNA and MyD88 mRNA in the treatment group decreased significantly after treatment,with statistically significant differences(P<0.05).The incidences of adverse drug reactions in the control group and treatment group was respectively 21.57%(11/51)and 23.53%(12/51),the difference was not statist

关 键 词：盘龙七片 类风湿关节炎 临床疗效 Toll样受体/髓样分化因子88 

分 类 号：R932[医药卫生—生药学]