强力风湿片治疗强直性脊柱炎临床及实验研究
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摘要
目的:评价强力风湿片治疗强直性脊柱炎(AS)的有效性和安全性及研究其可能的作用机制。方法:采用随机、对照方法将60例寒湿型AS患者随机分为两组,每组30例,治疗组给予强力风湿片治疗,对照组给予柳氮磺吡啶(SSZ)治疗,两组口服相同非甾体消炎镇痛药(NASIDs)美洛昔康。治疗12周,记录患者治疗4周、8周、12周症状、体征、BASDAI及BASFI积分、血沉、C反应蛋白、PLT等变化,观察不良反应及NASIDs服用时间,计算两组总有效率。实验研究方面,选择服用强力风湿片30例AS患者,并设立健康志愿者为对照组,常规分离外周血单个核细胞,RT-PCR半定量检测其治疗前后外周血单个核细胞中细胞因子肿瘤坏死因子-a(TNF-a)、γ-干扰素(IFN-γ)、白细胞介素-6(IL-6)mRNA片段的表达变化。
结果:治疗12周,两组AS患者全身疼痛,脊柱疼痛缓解,晨僵时间缩短,指距地改善、BASDAI和BASFI积分、红细胞沉降率、C反应蛋白显著下降(P＜0.05);治疗组较对照组改善明显,治疗组起效时间较快,NASIDs服用时间短,治疗组总有效率86.7%,对照组73.3%,两组比较,P＜0.05,差异有统计学意义,治疗组不良反应较对照组少。实验研究方面,AS患者外周血单个核细胞(PBMCs)中TNF-a、IL-6、IFN-γmRNA表达水平较正常对照组增高(P＜0.05),经强力风湿片治疗后AS患者PBMCs中IFN-γ、TNF-a、IL-6mRNA的表达下降。
结论:强力风湿片能显著减轻AS患者的症状,降低炎性指标,总有效率高,无明显不良反应。AS患者外周血单个核细胞中IL-6、TNF-a、IFN-γmRNA表达水平比正常组明显升高,经强力风湿片治疗后,AS患者外周血单个核细胞TNF-a、IFN-γ、IL-6mRNA表达下降,强力风湿片治疗AS的机理可能与减少TNF-a、IFN-γ、IL-6mRNA表达有关。
Objective:To evaluate the efficacy and safety in the treatment of ankylosing spondylitis by Qianglifengshi recipe and its possible mechanism.
Methods:Dividing the 60 AS patients of cold-dampness type randomly and evenly into two groups.Besides taking NASIDs(Meloxicam).Therapy group was treated by Qianglifengshi recipe and control group by sulfasalazine (SSZ) respectively for 12 weeks.The records included symptoms、signs、BASDAI、BASFI、erythrocyte sedimentation rate(ESR),C-reaction protein (CRP)、PLT、side effects after 4、8、12 weeks and the duration of NASIDs administration,followed by calculating the total effective percentages of the two groups.The experimental study was chose to be done on 30 AS patients with Qianglifengshi recipe by setting the comparison of healthy volunteers and separating the peripheral blood mononuclear cells(PBMCs) as a routine.RT-PCR semi-quantitative method was employed to detect the changes in mRNA expression of TNF-a、IFN-γ、IL-6 after the treatment.
Results:The systemic pain and spinal pain were relieved,and the duration of morning stiffness were shortened,and BASDAI、BASFI、ESR、CRP and PLT were significantly reduced after 12 weeks treatment(P＜0.05).More notable improvements in the therapy group were revealed:the therapy group has sooner taking of effect and shorter administration of NASIDs.The effective percentages of therapy group were 86.7%and control group were 73.3%. Comparing of the two group,p＜0.05,indicates the difference was stati stically significant.The incidence rates of gastrointestinal side effect of treatment group were lower than those of control group.In the experimental study,the expression level of PBMCs TNF-a、IL-6,IFN-γmRNA in AS patient group was higher prominently than that of control group (P＜0.05).Qianglifengshi recipe can decrease the expression of TNF-a、INF-γ.IL-6mRNA.
Conclusion:Qianglifengshi recipe can effectively relive the symptoms of AS,decrease the inflammation index without obvious side-effects.The initially high expression level of TNF-a、IL-6,IFN-γmRNA of AS patients can be reduced by Qianlifengshi recipe.Possibly,the mechanism of Qianglifengshi recipe for treating AS can be interprated by decreasing the expressing of TNF-a、INF-γ、IL-6mRNA.
结果:治疗12周,两组AS患者全身疼痛,脊柱疼痛缓解,晨僵时间缩短,指距地改善、BASDAI和BASFI积分、红细胞沉降率、C反应蛋白显著下降(P＜0.05);治疗组较对照组改善明显,治疗组起效时间较快,NASIDs服用时间短,治疗组总有效率86.7%,对照组73.3%,两组比较,P＜0.05,差异有统计学意义,治疗组不良反应较对照组少。实验研究方面,AS患者外周血单个核细胞(PBMCs)中TNF-a、IL-6、IFN-γmRNA表达水平较正常对照组增高(P＜0.05),经强力风湿片治疗后AS患者PBMCs中IFN-γ、TNF-a、IL-6mRNA的表达下降。
结论:强力风湿片能显著减轻AS患者的症状,降低炎性指标,总有效率高,无明显不良反应。AS患者外周血单个核细胞中IL-6、TNF-a、IFN-γmRNA表达水平比正常组明显升高,经强力风湿片治疗后,AS患者外周血单个核细胞TNF-a、IFN-γ、IL-6mRNA表达下降,强力风湿片治疗AS的机理可能与减少TNF-a、IFN-γ、IL-6mRNA表达有关。
Objective:To evaluate the efficacy and safety in the treatment of ankylosing spondylitis by Qianglifengshi recipe and its possible mechanism.
Methods:Dividing the 60 AS patients of cold-dampness type randomly and evenly into two groups.Besides taking NASIDs(Meloxicam).Therapy group was treated by Qianglifengshi recipe and control group by sulfasalazine (SSZ) respectively for 12 weeks.The records included symptoms、signs、BASDAI、BASFI、erythrocyte sedimentation rate(ESR),C-reaction protein (CRP)、PLT、side effects after 4、8、12 weeks and the duration of NASIDs administration,followed by calculating the total effective percentages of the two groups.The experimental study was chose to be done on 30 AS patients with Qianglifengshi recipe by setting the comparison of healthy volunteers and separating the peripheral blood mononuclear cells(PBMCs) as a routine.RT-PCR semi-quantitative method was employed to detect the changes in mRNA expression of TNF-a、IFN-γ、IL-6 after the treatment.
Results:The systemic pain and spinal pain were relieved,and the duration of morning stiffness were shortened,and BASDAI、BASFI、ESR、CRP and PLT were significantly reduced after 12 weeks treatment(P＜0.05).More notable improvements in the therapy group were revealed:the therapy group has sooner taking of effect and shorter administration of NASIDs.The effective percentages of therapy group were 86.7%and control group were 73.3%. Comparing of the two group,p＜0.05,indicates the difference was stati stically significant.The incidence rates of gastrointestinal side effect of treatment group were lower than those of control group.In the experimental study,the expression level of PBMCs TNF-a、IL-6,IFN-γmRNA in AS patient group was higher prominently than that of control group (P＜0.05).Qianglifengshi recipe can decrease the expression of TNF-a、INF-γ.IL-6mRNA.
Conclusion:Qianglifengshi recipe can effectively relive the symptoms of AS,decrease the inflammation index without obvious side-effects.The initially high expression level of TNF-a、IL-6,IFN-γmRNA of AS patients can be reduced by Qianlifengshi recipe.Possibly,the mechanism of Qianglifengshi recipe for treating AS can be interprated by decreasing the expressing of TNF-a、INF-γ、IL-6mRNA.
引文
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