中药膏方联合ACR达标控制方案对类风湿关节炎患者血清中IL-1及TNF-α的影响

摘要

目的 观察中药膏方联合ACR达标控制方案治疗类风湿关节炎(RA)的临床疗效及对患者外周血清中白细胞介素-1(IL-1)和肿瘤坏死因子-α(TNF-α)的影响.方法 120例活动期RA患者随机分为两组,对照组60例采用ACR达标控制方案(甲氨蝶呤+柳氮磺吡啶+美洛昔康)治疗,观察组60例在对照组基础上加用中药膏方治疗,观察2组治疗前后各项临床和实验室指标的变化.结果 观察组各项临床和实验室指标[包括关节肿胀数、关节压痛数、红细胞沉降率(ESR)、C-反应蛋白(CRP)]及IL-1和TNF-α的改善程度明显优于对照组(P<0.05).结论 在ACR达标控制方案治疗的基础上加用中药膏方治疗RA具有较好的临床疗效,对改善关节功能及降低活动期炎症指标具有较好的作用,且能明显降低外周血清中IL-1和TNF-α的表达水平.%Objective To assess the clinical efficacy of the herb paste joint the standard control program of ACR and its effections on the content of IL-1 and TNF-α in peripheral serum in the treatment of patients with rheumatoid arthritis( RA). Methods 120 cases of active RA patients were randomly divided into two groups, the control group ( 60 cases) were treated with the standard control program of ACR ( Methotrexate and Sulfasalazine and Meloxicam ),the observation group( 60 cases ) were treated with the herb paste on the basis of the control group. The changes of various clinical and laboratory indicators were observed before and after the treatment. Results The improvements of the clinical and laboratory parameters( including the swollen joint count, tender joint count, erythrocyte sedimentation rate ( ESR ), C-reactive protein( CRP),IL-1 and TNF-α) of the observation group were significantly better than the control group( P<0. 05 ). Conclusion Added with the herb paste on the basis of the standard control program of ACR has better clinical efficacy on the treatment of RA,and has a good effect to improve joint function and reduce the activity of inflammatory indicators, and could significantly reduce the expression of IL-1 and TNF-a in peripheral serum.