黄芪五藤汤治疗气虚络阻证活动期类风湿关节炎患者效果及其对巨噬细胞极化的影响  

Effect of Huangqi Wuteng Decoction in the Treatment of Patients with Rheumatoid Arthritis in Active Stage of Qi-deficiency and Collateral Obstruction Syndrome and Its Effect on Macrophage Polarization

作　　者：傅慧 胡林飞 FU Hui;HU Linfei(Department of Pharmacy,Xinyu Hospital of Traditional Chinese Medicine,Xinyu 338025,China;不详)

机构地区：[1]新余市中医院药剂科,江西新余338025 [2]新余市中医院风湿免疫科,江西新余338025

出　　处：《中国医学创新》2024年第36期147-151,共5页Medical Innovation of China

基　　金：江西省中医药管理局科技计划项目(2023B1297)。

摘　　要：目的:分析黄芪五藤汤治疗气虚络阻证活动期类风湿关节炎(RA)患者的临床效果及其对巨噬细胞极化的影响。方法:选取2021年5月—2023年11月在新余市中医院就诊的80例气虚络阻证活动期RA患者为研究对象,按照随机数字表法分为观察组(40例)和对照组(40例)。对照组给予常规的西医治疗,观察组在对照组的基础上加用黄芪五藤汤,连续治疗12周。对比两组中医症候积分、RA相关指标水平[血清类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP抗体)、血浆红细胞沉降率(ESR)、血清C反应蛋白(CRP)]、巨噬细胞标志物的表达[CD80、CD86、CD163、CD206]及生活质量评分。结果:两组治疗后的生活质量各项评分均比治疗前高,中医症候积分、RF、抗CCP抗体、ESR、CRP和CD80、CD86、CD163、CD206表达水平均低于治疗前(P<0.05)。治疗后,观察组的生活质量各项评分均比对照组高,中医症候积分、RF、抗CCP抗体、ESR、CRP和CD80、CD86、CD163、CD206表达水平均低于对照组(P<0.05)。结论:针对活动期RA患者,结合西医治疗使用黄芪五藤汤治疗气虚络阻证明显可以缓解相关症状,可显著减低RA相关指标水平,提高生活质量,抑制相关巨噬细胞标志物的表达水平。Objective:To analyze the clinical effect of Huangqi Wuteng Decoction on patients with rheumatoid arthritis(RA)in active stage of Qi-deficiency and collateral obstruction syndrome and its influence on macrophage polarization.Method:A total of 80 patients with RA in active stage of Qi-deficiency and collateral obstruction syndrome who were treated in Xinyu Hospital of Traditional Chinese Medicine from May 2021 to November 2023 were selected as the research objects.They were divided into observation group(40 cases)and control group(40 cases)according to random number table method.The control group was treated with routine western medicine,while the observation group was treated with Huangqi Wuteng Decoction on the basis of the control group.The treatment was continued for 12 weeks.The TCM symptoms score,RA related indicators[serum rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP), plasma erythrocyte sedimentation rate (ESR), serum C reactive protein (CRP)], expression of macrophage markers (CD80, CD86, CD163, CD206) and quality of life scores were compared between the two groups. Result: The quality of life scores in both groups after treatment were higher than those before treatment, and the TCM syndrome scores, RF, anti-CCP, ESR, CRP and the expression levels of CD80, CD86, CD163 and CD206 were lower than those before treatment (P<0.05). After treatment, the quality of life scores of the observation group were higher than those of the control group, and the TCM syndrome score, RF, anti-CCP, ESR, CRP and the expression levels of CD80, CD86, CD163 and CD206 were lower than those of the control group (P<0.05). Conclusion: For patients with RA in active stage, combined with western medicine, the use of Huangqi Wuteng Decoction in the treatment of Qi-deficiency and collateral obstruction syndrome can obviously alleviate the relevant symptoms, significantly reduce the levels of RA related indicators, improve the quality of life, and inhibit the expression levels of related macrophage markers.

关 键 词：黄芪五藤汤 气虚络阻证 活动期类风湿关节炎 巨噬细胞极化 

分 类 号：R259[医药卫生—中西医结合]