活血通络汤治疗类风湿关节炎致肺间质纤维化的疗效观察  

Effect of Huoxue Tongluo Decoction(活血通络汤)on Pulmonary Interstitial Fibrosis Caused by Rheumatoid Arthritis

作　　者：秦晓娟[1] 奚娜[1] QIN Xiaojuan;XI Na(Hanzhong People's Hospital,Hanzhong 723000,Shaanxi,China)

机构地区：[1]汉中市人民医院,陕西汉中723000

出　　处：《辽宁中医杂志》2024年第5期115-118,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的 探讨活血通络汤治疗类风湿关节炎(rheumatoid arthritis, RA)致肺间质纤维化的疗效及对患者肺功能和疾病相关指标的影响。方法 采用随机数字表法将于2019年12月—2022年3月在汉中市人民医院接受治疗的126例RA致肺间质纤维化患者分为A组和B组,各63例。A组给予强的松,B组在A组基础上给予活血通络汤。两组疗程均为3个月。比较两组治疗3个月后的临床疗效,治疗前、治疗3个月后的临床症状和体征改善情况、肺功能及血清细胞因子,治疗期间的安全性。结果 B组和A组治疗3个月后的总有效率分别为87.30%(55/63)、69.84%(44/63),与A组相比,B组较高,差异有统计学意义(P<0.05)。两组治疗3个月后的关节肿胀指数、关节压痛指数、关节功能障碍指数、血清C反应蛋白(C-reactive protein, CRP)、白细胞介素-1β(interleukin-1β,IL-1β)、类风湿因子(rheumatoid factor, RF)、转化生长因子-β(transforming growth factor-β,TGF-β)水平均比治疗前低,且与A组相比,B组较低;两组晨僵时间均比治疗前短,且与A组相比,B组较短;两组第1秒用力呼气容积(forced expiratory volume in one second, FEV1)、用力肺活量(forced vital capacity, FVC)、肺总量及弥散量均比治疗前高,且与A组相比,B组较高,差异有统计学意义(P<0.05)。B组和A组治疗期间的不良反应发生率比较,差异无统计学意义[7.94%(5/63) vs 12.70%(8/63),P>0.05]。结论 活血通络汤可有效缓解RA致肺间质纤维化临床症状,减轻患者炎症反应,抑制肺成纤维细胞增殖,进一步改善患者肺功能,进而提高治疗效果,且安全性良好。Objective To investigate the effect of Huoxue Tongluo Decoction(活血通络汤)on pulmonary interstitial fibrosis caused by rheumatoid arthritis(RA)and its influence on lung function and disease-related indexes.Methods A total of 126 patients with pulmonary interstitial fibrosis caused by RA admitted to Hanzhong People's Hospital from December 2019 to March 2022 were divided into the group A and the group B by random number table method,with 63 cases in each group.The group A was given prednisone,and the group B was given Huoxue Tongluo Decoction on the basis of the group A.The course of treatment was 3 months in both groups.The clinical efficacy after 3 months of treatment,the improvement of clinical symptoms and signs,lung function and serum cytokine before and after 3 months of treatment,the safety during treatment between the two groups were compared.Results After 3 months of treatment,the total effective rates in the group B and the group A were 87.30%(55/63)and 69.84%(44/63),and compared with that of the group A,the rate of the group B was higher(P<0.05).After 3 months of treatment,the joint swelling index,joint tenderness index,joint dysfunction index,the levels of serum C-reactive protein(CRP),interleukin-1β(IL-1β),rheumatoid factor(RF)and transforming growth factor-β(TGF-β)in the two groups were lower than those before treatment,and compared with those of the group A,these indexes of the group B were lower.The time of morning stiffness in the two groups was shorter than that before treatment,and compared with that of the group A,the time of the group B was shorter.The values of forced expiratory volume(FEV1),forced vital capacity(FVC),total lung volume and diffusive capacity in the first second of the two groups were higher than those before treatment,and compared with those of the group A,the values of the group B were higher(P<0.05).There was no significant difference in the incidence of adverse reactions between the group B and the group A during treatment[7.94%(5/63)vs 12.70%(8/63),P>0.05].Concl

关 键 词：类风湿关节炎 肺间质纤维化 强的松 活血通络汤 肺功能 

分 类 号：R255.6[医药卫生—中医内科学]