尪痹胶囊联合甲氨蝶呤治疗类风湿关节炎临床研究
|
摘要
目的探讨尪痹胶囊联合甲氨蝶呤治疗类风湿关节炎(RA)的临床疗效及对炎性细胞因子、骨代谢指标的影响。方法选取医院2016年10月至2017年10月收治的RA患者260例,根据随机数字表法分为对照组和研究组,各130例。对照组患者口服甲氨蝶呤片治疗,研究组患者在对照组治疗基础上联合尪痹胶囊治疗。结果研究组治疗总有效率为85. 38%,显著高于对照组的67. 69%(P<0. 05);治疗后,两组患者骨钙素N端中分子片段(N-MID)、总Ⅰ型胶原氨基端延长肽(TPINP)、25羟维生素D[25(OH)D]均较治疗前升高,且研究组高于对照组(P<0.05);β-胶原降解产物(β-CTX)较治疗前降低,且研究组显著低于对照组(P<0.05);两组患者白细胞介素8(IL-8)、肿瘤坏死因子-α(TNF-α)、血细胞沉降率(ESR)、C反应蛋白(CRP)、环氧合酶-2(COX-2)、巨噬细胞集落刺激因子(M-CSF)均较治疗前降低,且研究组显著低于对照组(P<0.05);两组不良反应发生率比较无明显差异(P>0.05)。结论尫痹胶囊联合甲氨蝶呤治疗RA,疗效确切,可显著改善炎性反应,拮抗骨吸收,安全性较好。
Objective To investigate the clinical effect of Wangbi Capsules combined with methotrexate in the treatment of rheumatoidarthritis( RA) and its effect on inflammatory cytokines and bone metabolism markers. Methods Totally 260 patients with RA admitted toour hospital from October 2016 to October 2017 were selected and divided into the control group and the study group according to therandom number table method,130 cases in each group. The patients in the control group were treated with Methotrexate Tablets,on thisbasis, the patients in the study group were treated with Wangbi Capsules. Results The total effective rate of the study group was85. 38%,which was significantly higher than 67. 69% of the control group( P < 0. 05). After treatment,the levels of N-mid osteocalcin( N-MID),total procollagen typeⅠ Intact N-terminal propeptide( TPINP) and 25-hydroxyvitamin D [ 25( OH) D ] in the two groups werehigher than those before treatment,and those in the study group were higher than those in the control group( P < 0. 05). The levels ofβ-collagen degradation products(β-CTX) in the two groups were lower than those before treatment,and that in the study group waslower than that in the control group( P < 0. 05). The levels of interleukin-8( IL-8), tumor necrosis factor-α( TNF-α), erythrocytesedimentation rate( ESR), C-reactive protein( CRP), cyclooxygenase-2( COX-2), macrophage colony stimulating factor( M-CSF) in thetwo groups were lower than those before treatment,and those in the study group were lower than those in the control group( P < 0. 05).There was no significant difference in the total incidence rate of adverse reactions between the two groups( P > 0. 05). Conclusion WangbiCapsules combined with methotrexate in the treatment of RA have a definite curative effect and better safety, which can significantlyimprove the inflammatory response of patients and antagonize bone resorption.
Objective To investigate the clinical effect of Wangbi Capsules combined with methotrexate in the treatment of rheumatoidarthritis( RA) and its effect on inflammatory cytokines and bone metabolism markers. Methods Totally 260 patients with RA admitted toour hospital from October 2016 to October 2017 were selected and divided into the control group and the study group according to therandom number table method,130 cases in each group. The patients in the control group were treated with Methotrexate Tablets,on thisbasis, the patients in the study group were treated with Wangbi Capsules. Results The total effective rate of the study group was85. 38%,which was significantly higher than 67. 69% of the control group( P < 0. 05). After treatment,the levels of N-mid osteocalcin( N-MID),total procollagen typeⅠ Intact N-terminal propeptide( TPINP) and 25-hydroxyvitamin D [ 25( OH) D ] in the two groups werehigher than those before treatment,and those in the study group were higher than those in the control group( P < 0. 05). The levels ofβ-collagen degradation products(β-CTX) in the two groups were lower than those before treatment,and that in the study group waslower than that in the control group( P < 0. 05). The levels of interleukin-8( IL-8), tumor necrosis factor-α( TNF-α), erythrocytesedimentation rate( ESR), C-reactive protein( CRP), cyclooxygenase-2( COX-2), macrophage colony stimulating factor( M-CSF) in thetwo groups were lower than those before treatment,and those in the study group were lower than those in the control group( P < 0. 05).There was no significant difference in the total incidence rate of adverse reactions between the two groups( P > 0. 05). Conclusion WangbiCapsules combined with methotrexate in the treatment of RA have a definite curative effect and better safety, which can significantlyimprove the inflammatory response of patients and antagonize bone resorption.
引文
[1]刘贺,陈伟,王轶楠,等.类风湿性关节炎的间充质干细胞治疗研究进展[J].中国妇幼保健,2013,28(21):3534-3536.
[2] OONO M,FUJITA Y,UCHIDA N,et al. Rheumatoid meningitisdeveloped in patient with stable rheumatoid arthritis and myasthe-nia gravis-detailed analysis of intracranial inflammation usingflow cytometry[J]. J Neuroinflammation,2018,15(1):151.
[3] BORDBAR M,SHAKIBAZAD N,FATTAHI M,et al. Effect of ur-sodeoxycholic acid and vitamin E in the prevention of liver injuryfrom methotrexate in pediatric leukemia[J]. Turk J Gastroenterol,2018,29(2):203-209.
[4]端淑杰,刘健,王孝飞,等.类风湿关节炎中医外治法研究进展[J].中国临床保健杂志,2016,19(1):96-100.
[5]中华医学会风湿病学分会.类风湿关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(4):265-270.
[6]姜一真,唐若余,潘娇娇,等.泼尼松联合甲氨蝶呤或来氟米特治疗老年类风湿关节炎的疗效比较[J].中国老年学杂志,2015,35(21):6199-6201.
[7] TANAKA Y. Diagnosis and treatment of rheumatoid arthritis:to-ward the best practice. Anti-bone resorbing treatment forrheumatoid arthritis[J]. Clin Calcium,2018,28(5):630-636.
[8] KARDOS Z,OLH C,SEPSI M,et al. Increased frequency of tem-poral acoustic window failure in rheumatoid arthritis:a manifesta-tion of altered bone metabolism?[J]. Clin Rheumatol,2018,37(5):1183-1188.
[9]田军伟,陶鹏飞.艾拉莫德联合甲氨蝶呤对类风湿性关节炎患者血清M-CSF、IL-6、IL-8及骨代谢的影响[J].海南医学,2017,28(3):391-393.
[10]刘洋,王腾腾,施杞,等.淋巴回流功能与类风湿性关节炎相关性及中医药调控机制的研究进展[J].世界科学技术-中医药现代化,2016,18(11):1855-1861.
[11] BORDBAR M,SHAKIBAZAD N,FATTAHI M,et al. Effect ofursodeoxycholic acid and vitamin E in the prevention of liver in-jury from methotrexate in pediatric leukemia[J]. Turk J Gas-troenterol,2018,29(2):203-209.
[12]李荣良,沈贤发,薛鸾,等.甲氨蝶呤联合硫酸羟氯喹治疗类风湿性关节炎中医不同证型疗效分析[J].河南中医,2017,37(11):1975-1977.
[13]端淑杰,刘健,王孝飞,等.类风湿关节炎中医外治法研究进展[J].中国临床保健杂志,2016,19(1):96-100.
[14]高海燕,李小峰,张宝牛,等.活动期类风湿关节炎患者单光子发射计算机断层关节显像与骨代谢标志物的相关性研究[J].中华内科杂志,2016,55(11):845-848.
[15]武晔,王晓磊,姜淑华,等.银苓消肿丸治疗湿热痹阻型类风湿关节炎临床疗效及安全性观察[J].陕西中医,2017,38(2):191-193.
[2] OONO M,FUJITA Y,UCHIDA N,et al. Rheumatoid meningitisdeveloped in patient with stable rheumatoid arthritis and myasthe-nia gravis-detailed analysis of intracranial inflammation usingflow cytometry[J]. J Neuroinflammation,2018,15(1):151.
[3] BORDBAR M,SHAKIBAZAD N,FATTAHI M,et al. Effect of ur-sodeoxycholic acid and vitamin E in the prevention of liver injuryfrom methotrexate in pediatric leukemia[J]. Turk J Gastroenterol,2018,29(2):203-209.
[4]端淑杰,刘健,王孝飞,等.类风湿关节炎中医外治法研究进展[J].中国临床保健杂志,2016,19(1):96-100.
[5]中华医学会风湿病学分会.类风湿关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(4):265-270.
[6]姜一真,唐若余,潘娇娇,等.泼尼松联合甲氨蝶呤或来氟米特治疗老年类风湿关节炎的疗效比较[J].中国老年学杂志,2015,35(21):6199-6201.
[7] TANAKA Y. Diagnosis and treatment of rheumatoid arthritis:to-ward the best practice. Anti-bone resorbing treatment forrheumatoid arthritis[J]. Clin Calcium,2018,28(5):630-636.
[8] KARDOS Z,OLH C,SEPSI M,et al. Increased frequency of tem-poral acoustic window failure in rheumatoid arthritis:a manifesta-tion of altered bone metabolism?[J]. Clin Rheumatol,2018,37(5):1183-1188.
[9]田军伟,陶鹏飞.艾拉莫德联合甲氨蝶呤对类风湿性关节炎患者血清M-CSF、IL-6、IL-8及骨代谢的影响[J].海南医学,2017,28(3):391-393.
[10]刘洋,王腾腾,施杞,等.淋巴回流功能与类风湿性关节炎相关性及中医药调控机制的研究进展[J].世界科学技术-中医药现代化,2016,18(11):1855-1861.
[11] BORDBAR M,SHAKIBAZAD N,FATTAHI M,et al. Effect ofursodeoxycholic acid and vitamin E in the prevention of liver in-jury from methotrexate in pediatric leukemia[J]. Turk J Gas-troenterol,2018,29(2):203-209.
[12]李荣良,沈贤发,薛鸾,等.甲氨蝶呤联合硫酸羟氯喹治疗类风湿性关节炎中医不同证型疗效分析[J].河南中医,2017,37(11):1975-1977.
[13]端淑杰,刘健,王孝飞,等.类风湿关节炎中医外治法研究进展[J].中国临床保健杂志,2016,19(1):96-100.
[14]高海燕,李小峰,张宝牛,等.活动期类风湿关节炎患者单光子发射计算机断层关节显像与骨代谢标志物的相关性研究[J].中华内科杂志,2016,55(11):845-848.
[15]武晔,王晓磊,姜淑华,等.银苓消肿丸治疗湿热痹阻型类风湿关节炎临床疗效及安全性观察[J].陕西中医,2017,38(2):191-193.