摘要 目的:观察清热蠲痹汤联合甲氨蝶呤治疗湿热痹阻型类风湿关节炎的临床疗效。方法:选取湿热痹阻型类风湿关节炎患者134例,按随机数字表法分为观察组和对照组各67例。对照组给予常规西药治疗,观察组在对照组基础上给予清热蠲痹汤治疗。比较2组临床疗效,统计中医证候积分,检测治疗前后血清α1酸性糖蛋白(α1-AGP)、肿瘤坏死因子配体相关分子-1A(TL1A)、C-反应蛋白(CRP)、白细胞介素-17 (IL-17)、白细胞介素-1 (IL-1)水平。结果:观察组总有效率为91.04%,对照组为76.12%,观察组总有效率高于对照组(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05)。治疗后,2组关节肿痛、屈伸不利、晨僵及口渴汗出积分低于治疗前(P<0.05),且观察组关节肿痛、屈伸不利、晨僵及口渴汗出积分低于对照组(P<0.05)。治疗前,2组α1-AGP、TL1A、CRP、IL-17、IL-1水平比较,差异均无统计学意义(P>0.05)。治疗后,2组α1-AGP、TL1A、CRP、IL-17、IL-1水平较治疗前降低(P<0.05),且观察组α1-AGP、TL1A、CRP、IL-17、IL-1水平低于对照组(P<0.05)。观察组不良反应发生率为4.48%,对照组为7.46%,2组比较,差异无统计学意义(P>0.05)。结论:清热蠲痹汤联合甲氨蝶呤治疗湿热痹阻型类风湿关节炎疗效显著,可改善患者临床症状,降低血清α1-AGP、TL1A的表达,减轻炎症反应,且不增加不良反应。 Objective:To observe the clinical effect of Qingre Juanbi tang combined with methotrexate for rheumatoid arthritis of damp-heat obstruction type. Methods:A total of 134 cases of patients with rheumatoid arthritis of damp-heat obstruction type were selected and divided into the observation group and the control group according to the random number table method,67 cases in each group. The control group was treated with routine western medicine,and the observation group was additionally treated with Qingre Juanbi tang based on the treatment of the control group. The clinical effect in the two groups was compared;Chinese medicine syndrome scores were counted;the levels of α1-acid glycoprotein(α1-AGP),tumor necrosis factor ligand-related molecule 1 A(TL1 A),C-reactive protein(CRP),interleukin-17(IL-17) and interleukin-1(IL-1) in serum before and after treatment were detected. Results:The total effective rate was 91.04% in the observation group,higher than that of 76.12% in the control group(P<0.05). Before treatment,there was no significant difference being found in the comparison of Chinese medicine syndrome scores(P>0.05). After treatment,the scores of joint swelling and pain,difficulty in extension and flexion,morning stiffness,and thirst and sweating in the two groups were lower than those before treatment(P<0.05), and the above scores in the observation group were lower than those in the control group(P<0.05). Before treatment,there was no significant difference being found in the comparison of levels of α1-AGP,TL1 A,CRP,IL-17 and IL-1 between the two groups(P>0.05). After treatment,the levels of α1-AGP,TL1 A,CRP,IL-17 and IL-1 in the two groups were decreased when compared with those before treatment(P<0.05),and the above levels in the observation group were lower than those in the control group(P<0.05). The incidence of adverse reactions was 4.48% in the observation group and 7.46% in the control group,there being no significance in the difference(P>0.05). Conclusion:Qingre Juanbi tang combined with methotr
机构地区 驻马店市中心医院康复医学科
出处 《新中医》 CAS 2021年第6期62-66,共5页 Journal of New Chinese Medicine
关键词 类风湿关节炎 湿热痹阻型 清热蠲痹汤 甲氨蝶呤 Α1酸性糖蛋白 血清肿瘤坏死因子配体相关分子-1A 中医证候积分 炎症因子 Rheumatoid arthritis Damp-heat obstruction type Qingre Juanbi tang Methotrexate α1-acid glycoprotein Tumor necrosis factor ligand-related molecule 1 A Chinese medicine syndrome scores Inflammatory factors
