[1]何娅娜,陈新宇,罗云涛,等.加味桂枝附子汤联合艾灸治疗类风湿关节炎疗效研究[J].陕西中医,2023,(11):1562-1565.[doi:DOI:10.3969/j.issn.1000-7369.2023.11.015]
 HE Yana,CHEN Xinyu,LUO Yuntao,et al.Curative effect study on modified Guizhi Fuzi decoction combined with moxibustion on rheumatoid arthritis[J].,2023,(11):1562-1565.[doi:DOI:10.3969/j.issn.1000-7369.2023.11.015]
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加味桂枝附子汤联合艾灸治疗类风湿关节炎疗效研究

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年11期
页码:
1562-1565
栏目:
临床研究
出版日期:
2023-11-05

文章信息/Info

Title:
Curative effect study on modified Guizhi Fuzi decoction combined with moxibustion on rheumatoid arthritis
作者:
何娅娜陈新宇罗云涛邓 旭蔡虎志沈宏荣
(湖南中医药大学第一附属医院,湖南 长沙 410007)
Author(s):
HE YanaCHEN XinyuLUO YuntaoDENG XuCAI HuzhiSHEN Hongrong
(The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)
关键词:
类风湿关节炎 加味桂枝附子汤 艾灸 白细胞介素-21 Wnt信号通路关键抑制因子Dickkopf-1 中医证候积分 不良反应
Keywords:
Rheumatoid arthritis Modified Guizhi Fuzi decoction Moxibustion Interleukin-21 Dickkopf-1 a key inhibitor of Wnt signaling pathway Traditional Chinese medicine syndrome score Adverse reaction
分类号:
R 593.22
DOI:
DOI:10.3969/j.issn.1000-7369.2023.11.015
文献标志码:
A
摘要:
目的:探讨加味桂枝附子汤联合艾灸治疗类风湿关节炎(RA)疗效及对血清白细胞介素-21(IL-21)、Wnt信号通路关键抑制因子Dickkopf-1(DKK-1)的影响。方法:选取80例RA患者随机分为对照组、联合组,各40例。对照组给予加味桂枝附子汤,联合组给予加味桂枝附子汤联合艾灸治疗。比较两组中医证候积分、临床疗效、晨僵时间、压痛关节数(TJC)、肿胀关节数(SJC)、关节功能评分、视觉模拟评分(VAS)、风湿性关节炎活动度评分(DAS28)、血清IL-21、血清DKK-1、不良反应。结果:与治疗前比较,两组治疗后晨僵、关节疼痛、关节肿胀评分、晨僵时间、TJC、SJC、WOMAC评分、VAS评分、DAS28评分、血清IL-21、DKK-1水平均下降,且治疗后联合组上述指标均低于对照组,差异有统计学意义(均P<0.05)。联合组总有效率92.50%高于对照组72.50%,差异有统计学意义(P<0.05)。两组患者便秘、失眠、皮肤瘙痒等不良反应发生率比较,差异无统计学意义(均P>0.05)。结论:加味桂枝附子汤联合艾灸治疗RA可有效改善患者临床症状,提高关节功能,减轻疼痛,降低血清IL-21、DKK-1水平,安全性较高。
Abstract:
Objective:To explore curative effect of modified Guizhi Fuzi decoction combined with moxibustion on rheumatoid arthritis(RA)and its influences on serum interleukin-21(IL-21)and Dickkopf-1 a key suppressor of Wnt signaling pathway(DKK-1).Methods:80 patients with RA were randomly divided into control group and combined group,40 cases in each group.The control group were treated with modified Guizhi Fuzi decoction,and the combined group treated with modified Guizhi Fuzi decoction combined with moxibustion.TCM syndrome score,clinical efficacy,time of morning stiffness,tenderness joint count(TJC),swelling joint count(SJC),joint function score,visual analog score(VAS),rheumatoid arthritis activity score(DAS28),and the levels of serum IL-21 and DKK-1,adverse reactions of the two groups were compared.Results:Compared with before treatment,the scores of morning stiffness,joint pain and joint swelling,time of morning stiffness,TJC,SJC,WOMAC score,VAS score,DAS28 score,the levels of serum IL-21 and DKK-1 in the two groups were obviously reduced after treatment,and the above indexes in the combination group were lower than those in the control group,difference statistically significant(all P<0.05).The total effective rate of the combined group 92.50% was obviously higher than that in the control group 72.50%,difference statistically significant(P<0.05).There were no obvious difference in the incidence of adverse reactions such as constipation,insomnia,skin itching between the two groups,difference not statistically significant(all P>0.05).Conclusion:Modified Guizhi Fuzi decoction combined with moxibustion can effectively improve clinical symptoms of RA patients enhance joint function relieve pain and reduce serum IL-21 and DKK-1 levels better security.

参考文献/References:

[1] Radu AF,Bungau SG.Management of rheumatoid arthritis:An overview[J].Cells,2021,10(11):2857-2859.
[2] 白 雪,付瑞嘉,乐世俊,等.雷公藤治疗类风湿性关节炎研究进展[J].中草药,2020,51(1):265-275.
[3] 张振明,董险峰,朱 峰,等.皮质类固醇激素和免疫抑制剂治疗硬膜炎的疗效与CT、MRI检查分析[J].陕西医学杂志,2013,42(4):471-472.
[4] Jekic B,Maksimovic N,Damnjanovic T.Methotrexate pharmacogenetics in the treatment of rheumatoid arthtis[J].Pharmacogenomics,2019,20(17):1235-1245.
[5] 巴燕艾克海提,古洁乃特汗?拜克里木.加味四妙勇安汤联合艾灸治疗类风湿关节炎疗效研究[J].陕西中医,2022,43(3):314-317.
[6] 尹谢添,赵诗超,向 楠,等.基于系统评价和GEO联合网络药理学对桂枝附子汤治疗类风湿关节炎作用机制的探讨[J].华南国防医学杂志,2022,36(5):364-375,392.
[7] 陈丽梅,王 慧,曾 鑫,等.艾灸对能量相关疾病影响的研究进展[J].中华中医药杂志,2022,37(2):912-923.
[8] 中华医学会风湿病学分会.类风湿关节炎诊治指南(草案)[J].中华风湿病学杂志,2003,17(4):250-254.
[9] 国家中医药管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:115-119.
[10] 马 文,苟斌虎,谢 川,等.艾灸联合雷公藤总甙治疗类风湿关节炎[J].世界中医药,2020,15(3):473-476.
[11] 杨 洋,薛建华,虞俊波,等.类风湿关节炎患者腕关节投掷运动不同位置的韧带长度变化[J].山东医药,2021,61(29):27-30.
[12] Melgonagle D,Watad A,Savic S.Mechanistic immunological based classification of rheumatoid arthritis[J].Autoimmun Rev,2018,17(11):1115-1123.
[13] 王 超,赵 岩,贺 鑫,等.HBV感染对类风湿关节炎和系统性红斑狼疮疾病活动度、免疫功能及炎症反应的影响[J].中华医院感染学杂志,2021,31(17):2599-2603.
[14] 邵 楠,曲 默,顿斯迪,等.加味桂枝附子汤联合西药治疗类风湿关节炎继发骨质疏松症的效果[J].当代医药论丛,2020,18(21):147-148.
[15] 谭炎金,杨小凤.通痹汤加减联合艾灸治疗类风湿关节炎临床疗效及对血清炎性因子的影响[J].世界中西医结合杂志,2020,15(5):884-888.
[16] 欧 凡,郭 健,刘 婷.加味桂枝附子汤联合依托考昔治疗寒湿痹阻型急性痛风性关节炎的疗效[J].中国老年学杂志,2020,40(1):122-125.
[17] 王英坤.桂枝附子汤联合盘龙灸治疗肾虚寒凝型类风湿关节炎临床观察[J].光明中医,2022,37(11):2013-2015.
[18] 肖 智,姜 如,胡筱薇.风湿骨痛胶囊联合来氟米特片治疗类风湿关节炎活动期患者疗效及对anti-CCP、DKK-1影响研究[J].医学理论与实践,2021,34(3):443-445.
[19] 帅 波,沈 霖,马 陈,等.尪痹片联合甲氨蝶呤片对类风湿关节炎患者血清DKK-1及关节滑膜侵蚀的影响[J].中国中医骨伤科杂志,2020,28(6):16-20.
[20] 刘 焕,孙 磊,刘 华,等.骨关节炎患者血清中DKK-1和MMP-13水平的相关研究[J].陕西医学杂志,2018,47(4):414-416.
[21] 杨 婧,何家锐,孙红兵,等.沙利度胺对类风湿关节炎滑膜细胞及外周血单个核细胞分泌肿瘤坏死因子-α和血管内皮生长因子的影响及机制研究[J].陕西医学杂志,2022,51(12):1501-1504,1510.
[22] 李小龙,葛郁龙.经皮钉棒内固定和Wiltse入路切开复位钉棒内固定治疗胸腰椎骨折疗效及对患者椎体形态、创伤因子的影响[J].陕西医学杂志,2022,51(8):986-989.
[23] 孙 建,刘风云,朱科达,等.附子汤加味联合甲氨蝶呤治疗类风湿关节炎寒湿痹阻证的疗效及对血清IL-21、CXCL13水平的影响[J].现代中西医结合杂志,2021,30(19):2098-2101.
[24] 王国芬.青风藤汤对类风湿关节炎患者Tfh、IL-21及抗CCP抗体的影响[J].现代实用医学,2019,31(8):1005-1007.

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备注/Memo

备注/Memo:
基金项目:湖南省科学技术厅重点领域研发计划项目(2019SK2321); 湖南省卫生健康委员会科研立项课题(202214055139 ); 湖南省发展和改革委员会创新引导专项(湘发改投资2019-412号); 全国名老中医药专家陈新宇传承工作室建设项目[国中医药人教函(2022)75号]; 湖南省研究生科研创新项目(QL20210176)
更新日期/Last Update: 2023-11-09