[1]刘 茜,张翊一,李映雪△,等.川羌除痹汤联合西药对类风湿性关节炎患者免疫功能及Th1/Th2型细胞因子的影响[J].陕西中医,2019,(12):1732-1735.
　LIU Qian,ZHANG Yiyi,LI Yingxue,et al.Effects of Chuanqiang Chubi decoction and western medicine on immune function and Th1/Th2 cytokines in patients with rheumatoid arthritis[J].,2019,(12):1732-1735.
点击复制

川羌除痹汤联合西药对类风湿性关节炎患者免疫功能及Th1/Th2型细胞因子的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年12期
页码:
1732-1735
栏目:
临床研究
出版日期:
2019-12-05

文章信息/Info

Title:
Effects of Chuanqiang Chubi decoction and western medicine on immune function and Th1/Th2 cytokines in patients with rheumatoid arthritis
文章编号:
DOI:10.3969/j.issn.10007369.2019.12.020
作者:
刘 茜; 张翊一; 李映雪△; 陈爱林
西安市第五医院（西安 710082）
Author(s):
LIU Qian; ZHANG Yiyi; LI Yingxue; et al.
Xi’an No.5 Hospital (Xi’an 710082)
关键词:
类风湿性关节炎; 川羌除痹汤; 免疫功能; Th1/Th2型细胞因子; 炎症反应
Keywords:
Key words Rheumatoid arthritis; Chuanqiang; Chubi decoction; Immune function; Th1/Th2 cytokines; Inflammatory reaction
分类号:
R593.22
文献标志码:
A
摘要:
摘 要 目的：观察川羌除痹汤联合西药对类风湿性关节炎患者免疫功能及Th1/Th2型细胞因子的影响。方法：将84例类风湿性关节炎(RA)患者随机分为观察组(42例)和对照组(42例)，对照组给予塞来昔布、来氟米特治疗，观察组在对照组的基础上给予川羌除痹汤治疗，疗程均为8周。记录两组中医症候积分、晨僵持续时间、关节压痛数与关节肿胀数、细胞免疫功能及Th1/Th2型细胞因子的变化，并对两组的临床疗效进行比较。结果：治疗组总有效率92.86%显著优于对照组总有效率73.81%，差异有统计学意义(P＜0.05)。治疗后，两组中医症候积分、关节压痛数、晨僵持续时间、关节肿胀数明显降低，观察组以上指标低于对照组(P＜0.05)。治疗后，两组CD3+、CD4+、CD4+/CD8+ 均明显增加，CD8+明显降低，观察组以上指标均优于对照组(P＜0.05)。治疗后，两组IL6、TNFα明显降低，IL4、IL10明显增加，观察组以上指标均优于对照组(P＜0.05)。结论：川羌除痹汤可显著改善RA患者临床症状，缓解疼痛，并改善细胞免疫功能，调节Th1/Th2型细胞因子表达，抑制炎症反应，其疗效优于单纯的西医疗法。
Abstract:
Abstract Objective:To observe the effect of Chuanqiang Chubi decoction combined with western medicine on immune function and Th1/Th2 cytokines in patients with rheumatoid arthritis.Methods:84 patients with RA were randomly divided into observation group and control group each 42 cases. The control group was treated with celecoxib and leflunomide. The observation group was treated with Chuanqiang Chubi decoction on the basis of the control group. The course of treatment was 8 weeks. The scores of TCM symptoms,the duration of morning stiffness,the number of tenderness and joint swelling,the changes of cellular immune function and Th1/Th2 cytokines in the two groups were recorded,and compare the clinical effects of the two groups. Results：The total clinical effective rate of the observation group 92.86%was significantly higher than that of the control group 73.81% (P＜0.05).After treatment,the scores of TCM symptoms,the duration of morning stiffness,the number of tenderness and swelling of joints in the two groups were significantly lower than those before treatment.The above indexes in the observation group were lower than those in the control group after treatment,and the difference was statistically significant (P＜0.05).After treatment,the levels of CD3+,CD4+,CD4+/CD8+ in the two groups were significantly higher than those before treatment,and the levels of CD8+ in the observation group were significantly lower than those before treatment.After treatment,the levels of CD3+,CD4+,CD4+/CD8+ in the observation group were higher than those in the control group,and the levels of CD8+ in the control group had statistical significance (P＜0.05).After treatment,the levels of interleukin6 (IL6),tumor necrosis factoralpha (TNFα) and interleukin4 (IL4) and interleukin10 (IL10) in the two groups were significantly lower than those before treatment.After treatment,the levels of IL6,TNFα in the observation group were lower than those in the control group,and the levels of IL4 and IL10 were higher than those in the control group,with statistical significance (P＜0.05).Conclusion:Chuanqiang Chubi decoction can significantly improve the clinical symptoms,relieve pain,improve cellular immune function,regulate the expression of Th1/Th2 cytokines and inhibit inflammatory reaction in RA patients.Its efficacy is better than that of western medicine alone.

参考文献/References:

[1] 胡晓敏,宗 英,余珊珊,等.类风湿关节炎治疗药物的研发进展及趋势[J].中国新药杂志,2017,31(1):3643.
[2] 徐 丹,高明利,于 静,等.中西医结合治疗类风湿性关节炎的疗效[J].世界中医药,2018,13(1):8387.
[3] 中华医学会风湿病学分会.2018中国类风湿关节炎诊疗指南[J].中华内科杂志,2018，57(4):242251.
[4] 国家中医药管理局.中医病证诊断疗效标准\[S\].南京：南京大学出版社,1994:118119.
[5] 国家食品药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:99104.
[6] 刘志琛,张文皓,张宏晨,等.门诊类风湿关节炎患者生活质量及其影响因素分析[J].西北国防医学杂志,2018,40(2):107110.
[7] 赵怡坤,朱田田,赵中亭,等.艾灸对类风湿关节炎免疫功能调节的机制研究进展[J].中国中医药信息杂志,2017,24(6):131133.
[8] 田新玮,刘丽丹,游碧荣,等.活血化瘀方联合来氟米特及甲氨蝶呤对类风湿关节炎患者凝血功能的影响[J].陕西中医,2018,39(10):14351437.
[9] 林 琳.补肾通督胶囊对类风湿性关节炎患者Th1/Th2细胞平衡的影响[J].辽宁中医杂志,2014,24(7):14511453.
[10] 向艳丽,石思蓉,覃晓莉,等.大豆多肽Lunasin对类风湿关节炎大鼠T细胞免疫指标的影响[J].中国应用生理学杂志,2018,34(1):1315.
[11] 李岩异.IL6、TNFα之后的类风湿关节炎治疗关键靶点[J].生物工程学报,2017,33(1):3643.
[12] 黄楚泉,蔡 奕,刘小翠,等.依那西普对类风湿关节炎患者血清TNFα、IL6及IL17的影响分析[J].河北医药,2017,39(1):111112.
[13] 马林霄,邵 平,刘惠杰,等.99锝亚甲基二磷酸盐联合甲氨蝶呤治疗对老年类风湿关节炎患者CRP、IL4、IL10水平的影响[J].中国老年学杂志,2018,38(5):11621164.
[14] 王秋燚,张小玲,宁乔怡,等.类风湿关节炎的中医证候分型研究进展[J].中华中医药杂志,2018,20(7):13211324.
[15] 姜 辉,刘晓闯,秦秀娟,等.五味温通除痹胶囊促进佐剂性关节炎大鼠滑膜组织细胞自噬活性及机制[J].细胞与分子免疫学杂志,2017,33(5):586590.
[16] 张国梁,周承扬,庞 坚, 等.柴胡细辛汤加减对颅脑损伤模型大鼠海马CA1区BDNF、SYN1表达与超微结构的影响[J].中医杂志,2017,58(8):682687. 
[17] 杨 柳,姜 海,苏晓琳, 等.HPLCDADELSD法同时测定牛膝中 β蜕皮甾酮、人参皂苷R0、竹节参皂苷Ⅳa的含量[J].中医药信息,2019,36(3):8791. 
[18] 申旭霁,张 彦,汪兴军, 等.基于中医传承辅助平台的含延胡索治疗痛经中成药组方规律分析[J].现代中药研究与实践,2018,32(3):6769,73. 
[19] 李 波,王明伟,强正泽, 等.基于低温与回潮条件的当归干燥Weibull函数模拟及其干燥特性研究[J].中草药,2019,50(13):30523057. 
[20] 梁梅荣.当归补血汤合桂枝汤治疗类风湿性关节炎疗效观察[J].中西医结合心血管病电子杂志,2017,5(20):147148.

相似文献/References:

[1]程红卫,秦 艳,胡筱娟.青白通痹胶囊的组方学研究*[J].陕西中医,2019,(4):537.
[2]全 健,丁文涛 Δ,武 辉.穴位注射配合桂枝芍药知母汤加减治疗类风湿性关节炎临床研究[J].陕西中医,2019,(5):671.
　QUAN Jian,DING Wentao,WU Hui..Rheumatoid arthritis treated by acupoint injection combined with Guizhi Shaoyao Zhimu decoction[J].,2019,(12):671.
[3]戴凤翔,邱联群△.当归四逆汤联合灸法治疗类风湿性关节炎临床研究[J].陕西中医,2019,(9):1235.
[4]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性关节炎疗效研究[J].陕西中医,2022,(3):314.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.010]
　Bayan·Ke'erhaiti,Gujienaitehan·Baikelimu.Study on curative effect of modified Simiao Yongan decoction combined with moxibustion on rheumatoid arthritis[J].,2022,(12):314.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.010]
[5]张 娜,唐华燕.生地苦参汤联合艾拉莫德对类风湿性关节炎患者血清抗CCP抗体及炎症因子的影响[J].陕西中医,2022,(3):318.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.011]
　ZHANG Na,TANG Huayan.Effect of Shengdi Kushen decoction combined with iguratimod on serum anti CCP antibody and inflammatory factors in rheumatoid arthritis[J].,2022,(12):318.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.011]
[6]吕建敏,刘广宇,赵海河,等.温针灸配合独活寄生汤治疗类风湿性关节炎临床研究[J].陕西中医,2022,(11):1613.[doi:DOI:10.3969/j.issn.1000-7369.2022.11.029]
　LYU Jianmin,LIU Guangyu,ZHAO Haihe,et al.Therapeutic effect of warm acupuncture combined with Duhuo Jisheng decoction on patients with rheumatoid arthritis[J].,2022,(12):1613.[doi:DOI:10.3969/j.issn.1000-7369.2022.11.029]
[7]邓文雯,肖 智,姜 如.透骨血竭散对类风湿性关节炎模型大鼠炎症因子的影响[J].陕西中医,2023,(7):868.[doi:DOI:10.3969/j.issn.1000-7369.2023.07.009]
　DENG Wenwen,XIAO Zhi,JIANG Ru.Effect of Tougu Xuejie powder on inflammatory factors in rats with rheumatoid arthritis[J].,2023,(12):868.[doi:DOI:10.3969/j.issn.1000-7369.2023.07.009]
[8]代雨晴,熊 浪,唐 芳,等.中医药调控中性粒细胞治疗类风湿性关节炎研究进展[J].陕西中医,2024,(11):1576.[doi:DOI:10.3969/j.issn.1000-7369.2024.11.030]
　DAI Yuqing,XIONG Lang,TANG Fang,et al.Research progress of Chinese medicine regulation of neutrophils in treatment of rheumatoid arthritis[J].,2024,(12):1576.[doi:DOI:10.3969/j.issn.1000-7369.2024.11.030]

更新日期/Last Update: 2019-12-19