[1]杨庆万,安 阳△,项飞燕,等.引火汤对类风湿关节炎患者骨代谢的影响*[J].陕西中医杂志,2020,(1):73-75.
 YANG Qingwan,AN Yang,XIANG Feiyan,et al.Effect of Yinhuo decoction on bone metabolism in patients with rheumatoid arthritis[J].,2020,(1):73-75.
点击复制

引火汤对类风湿关节炎患者骨代谢的影响*
分享到:

《陕西中医》杂志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年1期
页码:
73-75
栏目:
临床研究
出版日期:
2020-01-05

文章信息/Info

Title:
Effect of Yinhuo decoction on bone metabolism in patients with rheumatoid arthritis
文章编号:
DOI:10.3969/j.issn.10007369.2020.01.020
作者:
杨庆万1安 阳2△项飞燕1雷玉梅1
1.贵州中医药大学(贵阳 550025); 2.贵州中医药大学第二附属医院(贵阳 550002)
Author(s):
YANG QingwanAN YangXIANG Feiyanet al.
Guizhou University of Traditional Chinese Medicine(Guiyang 550025)
关键词:
类风湿关节炎骨质疏松骨代谢引火汤糖皮质激素甲状旁腺激素25羟基维生素D3
Keywords:
Key words 〖WT5BZ〗〖HT5”SS〗Rheumatoid arthritisOsteoporosisBone metabolismYinhuo decoctionGlucocorticoidParathyroid hormone25hydroxyvitamin D3
分类号:
R593.22
文献标志码:
A
摘要:
摘 要 目的:观察引火汤对长期运用糖皮质激素治疗的类风湿性关节炎类风湿关节炎(RA)患者骨代谢的影响。方法:将长期接受激素疗法RA患者随机分为两组,对照组49 例口服甲泼尼龙片、甲氨蝶呤片、碳酸钙D3片;治疗组50 例在对照组基础上联合中药汤剂引火汤口服。两组疗程均为6 个月,比较两组治疗后骨代谢标志物(甲状旁腺激素、25羟基维生素D3)、L24骨密度平均值(BMD)、血清钙磷水平、炎症指标(血沉、C反应蛋白)及关节VAS评分的变化。结果:两组治疗方案均可有效降低PTH水平(P<0.05),治疗组在降低甲状旁腺激素(PTH)及改善25羟基维生素D3、BMD方面优于对照组(P<0.05);在改善关节炎症与疼痛方面,治疗组优于对照组(P<0.05)。结论:引火汤可以改善RA患者长期口服抗风湿药物后的骨代谢及钙磷代谢平衡,与抗风湿药联用后可以增强抗炎作用,但目前研究尚不能证实其确切的机制。
Abstract:
Abstract 〖WT5BZ〗〖HT5”SS〗Objective:To observe the effect of Yinhuo decoction on bone metabolism in patients with longterm glucocorticoid RA.Methods:Patients with longterm steroid therapy were randomly divided into two groups.The control group consisted of 49 patients taking oral methylprednisolone tablets,methotrexate tablets and calcium carbonate D3 tablets.The treatment group consisted of 50 patients was combined with Yinhuo decoction on the basis of the control group.Soup was taken orally.Both groups were treated for 6 months.The bone metabolism markers (parathyroid hormone,25hydroxyvitamin D3),L24 bone mineral density (BMD),serum calcium and phosphorus levels,and inflammation index were compared between the two groups.ESR,Creactive protein) and changes in joint VAS scores.Results:Both groups were effective in reducing PTH (P<0.05).The treatment group was superior to the control group in reducing PTH and improving 25hydroxyvitamin D3 and BMD (P<0.05).In improving joint inflammation and pain.The treatment group was superior to the control group (P<0.05).Conclusion:Yinhuo decoction can improve the bone metabolism and calcium and phosphorus metabolism balance after longterm oral antirheumatic drugs in patients with RA.It can enhance the antiinflammatory effect when combined with antirheumatic drugs,but the current research has not confirmed its exact mechanism.

参考文献/References:

[1] 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.
[2] 刘 娜,王晓元,王秀茹,等.全国多中心类风湿关节炎糖皮质激素应用的现况调查[J].中国医药,2016,11(8):12161221.
[3] Aletaha D,Neogi T,Silman AJ,et al.2010 rheumatoid arthritis classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J].Arthritis Rheum,2010,62(9):25692581.2017,4(18):3511.
[4] 叶伟胜,张铁良.类风湿关节炎流行病学进展[J].国际骨科学杂志,2009,30(3):146147.
[5] 王宇强,苏学涛,赵永军,等.血清铁过载与老年女性骨质疏松性骨折的关系研究[J].陕西医学杂志,2016,45(12):15961597.
[6] Weinstein RS.Clinical practice:glucocorticoidinduced bone disease[J].N Engl J Med,2011,365(1):6270.
[7] 刘晓雄,郝海军.绝经后女性骨质疏松患者血清25羟维生素D水平变化及其意义[J].陕西医学杂志,2016,45(5):585586,603.
[8] 马 伟,牟慧琴,马占洋.绝经后骨质疏松症中医病因病机研究概况[J].中医杂志,2012,53(13):11521154.
[9] 王 瑛,刘 元,李 娜,等.坤泰胶囊治疗雷公藤引起类风湿关节炎卵巢早衰的临床观察[J].陕西中医,2015,36(7):773774.
[10] 卢朝霞,王 欣,周少怀.补肾健脾汤对绝经后骨质疏松症患者细胞因子及骨密度水平的影响[J].陕西中医,2017,38(4):438439.
[11] 王 玲,杨碧芳,宁文君.补充维生素D对高血压患者血压控制及甲状旁腺素和甲状腺激素水平的影响[J].陕西医学杂志,2017,46(8):11341135.
[12] 陈小香,谭 新,邓伟民.骨质疏松症患者骨密度与血清25羟维生素D的相关性研究[J].中国骨质疏松杂志,2017,23(7):851855.
[13] 陈 洁,陈兴强,符薇薇.慢性肾脏病患者血清骨保护素、甲状旁腺激素与骨密度的关系[J].陕西医学杂志,2017,46(3):318319,322.
[14] 夏 涛.甲状旁腺激素(134)联合鲑鱼降钙素对绝经后骨质疏松压缩性骨折患者骨密度、骨代谢的影响[J].陕西医学杂志,2018,47(11):14801482,1486.
[15] Boonen S,BischoffFerrari HA,Cooper C,et al.Addressing the musculoskeletal components of fracture risk with calcium and vitamin D:a review of the evidence[J].Calcif Tissue Int,2006,78(1):257270.

相似文献/References:

[1]贾 辉.利塞膦酸钠联合中药对老年女性髋骨骨折的影响研究*[J].陕西中医杂志,2019,(2):226.
[2]刘志队,史丽璞.加味桂枝芍药知母汤对活动期寒热错杂型类风湿关节炎患者ESR、CRP和RF调控作用分析*[J].陕西中医杂志,2019,(1):82.
[3]倪丹红,刘 丹,吕琴琴,等.秦息痛片联合传统抗风湿药治疗早期活动性 类风湿关节炎临床研究*[J].陕西中医杂志,2019,(4):484.
[4]刘志队,史丽璞,张铁峰.加味桂枝芍药知母汤治疗寒热错杂型类风湿关节炎临床研究*[J].陕西中医杂志,2019,(7):906.
 LIU Zhidui,SHI Lipu,ZHANG Tiefeng..Clinical analysis of modified Guizhi Fuyao Zhimu decoction in treating cold and hot miscellaneous rheumatoid arthritis[J].,2019,(1):906.
[5]李 锐,叶冰玉△,刘佳钰,等.活血通络汤辨治类风湿关节炎合并肺间质纤维化临床研究*[J].陕西中医杂志,2019,(8):1041.
 LI Rui,YE Bingyu,LIU Jiayu,et al.Brief analysis of Huoxue Tongluo decoction on differentiation and treatment of rheumatoid arthritis with pulmonary interstitial fibrosis[J].,2019,(1):1041.
[6]李 良,孙银娣,李亚峰,等.四妙二藤汤联合双氯芬酸钠对类风湿关节炎患者关节情况、炎症指标和复发率的影响[J].陕西中医杂志,2019,(10):1397.
 LI Liang,SUN Yindi,LI Yafeng,et al.Effect of Simiao Erteng decoction combined with diclofenac sodium on joint condition,inflammation index and recurrence rate in patients with rheumatoid arthritis[J].,2019,(1):1397.
[7]尚 磊,刘 茜△.断藤益母汤甲氨喋呤联合对类风湿性关节炎患者DAS28评分和炎症指标的影响*[J].陕西中医杂志,2019,(10):1400.
 SHANG Lei,LIU Qian..Effect of Duanteng Yimu decoction and methotrexate on DAS28 Score and inflammatory indicators in rheumatoid arthritis patients[J].,2019,(1):1400.
[8]刘 茜,樊亚红△,陈爱林,等.秦息痛药液外敷治疗类风湿关节炎疗效评价*[J].陕西中医杂志,2019,(10):1403.
 LIU Qian,FAN Yahong,CHEN Ailin,et al.Evaluation of the therapeutic effect of external application of Qinxitong liquid onrheumatoid arthritis[J].,2019,(1):1403.
[9]李鸿,徐无忌△.加味身痛逐瘀汤治疗骨质疏松椎体压缩性骨折经皮穿刺椎体成形术后残余痛临床研究*[J].陕西中医杂志,2019,(11):1545.
 LI Hong,XU Wuji..Clinical observation on residual pain after PVP in the treatment of osteoporotic vertebral compression fracture with Jiawei Shentong Zhuyu decoction[J].,2019,(1):1545.
[10]尚磊,李映雪△.补肾通痹汤联合雷公藤多苷治疗老年类风湿关节炎疗效研究*[J].陕西中医杂志,2019,(11):1552.
 SHANG Lei,LI Yingxue..Effect of Bushen Tongbi decoction combined with tripterygium wilfordii polyglycosides in the treatment of eldery rheumatoid arthritis[J].,2019,(1):1552.

备注/Memo

备注/Memo:
*贵州省社会发展攻关项目(黔科合SY字\[2015\]3048) 贵州省高层次创新型人才培养计划—“百”层次人才项目(黔科 合平台人才\[2016\]5650) 贵州省中医药(民族医药)治疗风湿病医学平台建设(黔科合平 台人才\[2018\]5707)
更新日期/Last Update: 2020-02-17