消瘀接骨散外敷配合电磁波谱治疗仪照射辅助治疗类风湿关节炎的效果及其对炎性指标的影响

摘要

目的 探讨消瘀接骨散外敷配合电磁波谱治疗仪(TDP)照射辅助治疗类风湿关节炎(RA)的效果及其对肿瘤坏死因子(TNF-α)、白细胞介素10(IL-10)、白细胞介素17(IL-17)的影响.方法 选取RA患者60例,按随机数字表分为研究组和对照组,每组30例.对照组给予常规治疗,研究组在常规治疗基础上加用消瘀接骨散外敷配合电磁波谱治疗仪照射辅助治疗.结果 治疗后两组比较,两组RA患者的DAS 28-3评分均降低,对照组差值为(-1.38 ±0.56)分,研究组差值为(-2.20 ±0.74)分,两组治疗后比较,研究组DAS 28-3缓解程度优于对照组(P<0.01);两组患者主要症状(关节疼痛、关节压痛、关节肿胀、晨僵)分值均明显降低(P<0.01);在改善关节压痛、关节肿胀、晨僵症状积分方面,研究组优于对照组(P<0.05);研究组红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽(CCP)、葡萄糖-6-磷酸异构酶(GPI)、免疫球蛋白均降低,补体C3、C4升高(P<0.01或P<0.05);对照组GPI无显著变化,补体C3升高,其余指标均降低(P<0.01或P<0.05);研究组在降低ESR、CRP、抗CCP方面,优于对照组(P<0.05),在升高C3方面,研究组优于对照组(P<0.01),两组TNF-α、IL-17降低,IL-10值升高(P<0.05).两组治疗后相比较,研究组在降低IL-17、升高IL-10方面,研究组优于对照组(P<0.05).结论 消瘀接骨散外敷配合TDP照射可改善RA患者炎性指标,上调体内抑炎因子水平,提高临床缓解率.%Objective To explore the effect of XiaoYuJieGu powder combined with irradiation therapy(TDP)on rheumatoid arthritis(RA)and its effect on tumor necrosis factor(TNF-α),interleukin 10(IL-10),interleukin 17 (IL-17).Methods A total of 60 patients with RA were selected and randomly divided into study group and control group,30 cases in each group.The control group was given conventional treatment,and the study group was treated with XiaoYuJieGu powder and TDP radiation based on the conventional treatment.Result After treatment,DAS28-3 score of RA patients were decreased in both groups,the DAS28-3 score of study group was lower than control group(P<0.01). The main symptoms scores of the two groups(joint pain,joint tenderness joint swelling and stiffness)were significantly de-creased(P<0.01);the improvement of joint tenderness,joint swelling and stiffness symptoms in the study group were better than the control group(P<0.05).CRP,RF,ESR,GPI,anti CCP immunoglobulin were reduced and complement C3,C4 were increased(P<0.05)in the study group.In the control group,there was no significant change in GPI,the complement C3 was increased,and the rest of the indexes were decreased(P<0.05).The study group was better than the control group(P<0.05)in decreasing ESR,CRP,anti CCP and increasing C3;TNF-αand IL-17 decreased and IL-10 in-creased in the two groups(P<0.05).After treatment,the study group was superior to the control group in reducing IL-17 and increasing IL-10(P<0.05).Conclusions XiaoYuJieGu powder combined with TDP can decrease the inflammatory indexes,while increase anti inflammatory cytokines in patients with RA and improve the clinical remission rate.