二十八味风湿骨痛散联合治疗高原地区寒湿痹阻证类风湿性关节炎的效果及对IGFBP-6的影响  

Effect of 28-Flavor Fengshi Gutong Powder Combined in the Treatment of Rheumatoid Arthritis of Cold-Dampness Arthralgia Type in Plateau Area and Its Impact on IGFBP-6

作　　者：王森林[1] 张永刚[1] 张英 沈括[2] 郑桂萍 李男 宋晓霞 韩曼[3] WANG Senlin;ZHANG Yonggang;ZHANG Ying;SHEN Kuo;ZHENG Guiping;LI Nan;SONG Xiaoxia;HAN Man(Department of Traditional Chinese Medicine,Qinghai Provincial People's Hospital,Xining 810007,China;Department of Hematology and Rheumatism,Qinghai Provincial People's Hospital,Xining 810007,China;Department of Hematology and Rheumatism,Guang'anmen Hospital China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]青海省人民医院中医科,西宁810007 [2]青海省人民医院血液风湿科,西宁810007 [3]中国中医科学院广安门医院风湿免疫科,北京100053

出　　处：《临床误诊误治》2025年第8期91-95,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2020年青海省中藏医药科研创新项目(J2020020)。

摘　　要：目的观察二十八味风湿骨痛散联合治疗高原地区寒湿痹阻证类风湿性关节炎(RA)的效果及对血清胰岛素样生长因子结合蛋白-6(IGFBP-6)的影响。方法选取2021年1月至2023年1月收治的高原地区寒湿痹阻证RA患者60例,采用随机数字表法分为观察组和对照组各30例,对照组采用甲氨蝶呤治疗,观察组在对照组基础上联合二十八味风湿骨痛散外用,均治疗4周。比较2组临床疗效及不良反应,治疗前后中医证候总积分、晨僵时间、关节压痛数、关节肿胀数及C反应蛋白(CRP)、类风湿因子(RF)、红细胞沉降率(ESR)、IGFBP-6水平和28处关节疾病活动度评分(DAS28)。结果观察组治疗总有效率为93.33%(28/30)明显高于对照组的60.00%(18/30),差异有统计学意义(P<0.01)。治疗后,2组中医证候总积分、CRP、ESR、RF、DAS28评分均降低,且观察组低于对照组(P<0.05,P<0.01)。治疗后2组晨僵时间缩短,关节压痛数及关节肿胀数均减少,且观察组上述指标改善情况优于对照组(P<0.05)。治疗后2组IGFBP-6水平上升,且观察组高于对照组(P<0.05,P<0.01)。2组治疗期间总不良反应发生率比较差异无统计学意义(P>0.05)。结论二十八味风湿骨痛散外用联合治疗高原地区寒湿痹阻证RA的效果显著,可提升患者IGFBP-6水平,改善患者病症及免疫功能,且不良反应少。Objective To observe the effect of combined treatment with 28-flavor Fengshi Gutong Powder on rheumatoid arthritis(RA)of cold-dampness arthralgia type in plateau area and its effect on serum insulin-like growth factor binding protein-6(IGFBP-6).Methods From January 2021 to January 2023,60 patients with RA of cold-dampness arthralgia type in plateau areas were selected and divided into observation group and control group by random number table method,with 30 patients in each group.The control group was treated with Methotrexate,and the observation group was treated with 28-flavor Fengshi Gutong powder for 4 weeks.The clinical efficacy and adverse reactions of the two groups were compared,as well as the total traditional Chinese medicine(TCM)syndrome score,durtion of morning stiffness,number of joint tenderness,number of joint swelling,C reactive protein(CRP),rheumatoid factor(RF),erythrocyte settlement rate(ESR),IGFBP-6 level,and 28-joint disease activity score(DAS28)before and after treatment.Results The total effective rate of the observation group was 93.33%(28/30),which was significantly higher than that of the control group(60.00%,18/30),showing significant difference(P<0.01).After treatment,the total TCM syndrome score,CRP,ESR,RF and DAS28 scores of the two groups were decreased,which were lower in the observation group than in the control group(P<0.05,P<0.01).After treatment,the duration of morning stiffness of the two groups was shortened,the number of joint tenderness and joint swelling was reduced,and the improvement of the above indexes in the observation group was better than that in the control group(P<0.05).After treatment,the IGFBP-6 level of the two groups was increased,which was higher in the observation group than in the control group(P<0.05,P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Combined treatment with 28-flavor Fengshi Gutong powder can significantly improve IGFBP-6 level,and ameliorate the disease and immune f

关 键 词：类风湿关节炎 高原地区 二十八味风湿骨痛散 胰岛素样生长因子结合蛋白-6 C反应蛋白 类风湿因子 药物毒性 

分 类 号：R593.22[医药卫生—内科学]