化瘀通痹方对活动期类风湿关节炎疗效及血清内TNF-α、IL-1β、CRP变化的研究

目的分析化瘀通痹方对活动期类风湿关节炎患者的疗效及患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、C反应蛋白(CRP)的变化情况。方法选取2016年8月-2018年8月收治的活动期类风湿关节炎患者104例,根据治疗方法不同分为对照组(西医常规治疗)和观察组(西医常规治疗基础上联合化瘀通痹方治疗),分析两组患者治疗后的临床疗效。结果观察组总有效率为92.31%(48/52),对照组为76.92%(40/52),观察组患者总有效率高于对照组(P<0.05)。两组治疗前症状、体征情况组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后晨僵持续时间短于对照组,关节压痛和关节肿胀积分低于对照组(P<0.05)。两组治疗前TNF-α、IL-1β、CRP、葡萄糖6磷酸异构酶(GPI)、类风湿因子(RF)、血肿瘤坏死因子样配体1A(TL1A)水平组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后TNF-α、IL-1β、CRP、GPI、RF、TL1A水平低于对照组(P<0.05)。两组治疗前28处关节疾病活动度(DAS28)积分组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后DAS28积分低于对照组(P<0.05)。结论化瘀通痹方治疗活动期类风湿关节炎可改善患者临床症状,降低患者TNF-α、IL-1β、CRP、GPI的表达水平,提高疗效。

Study on Effect of Huayu Tongbi Recipe on Patients with Active Rheumatoid Arthritis and Changes of Serum TNF-α, IL-1β and CRP

Objective To analyze the effect of Huayu Tongbi Recipe on active rheumatoid arthritis patients and the changes of serum tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) and C reactive protein(CRP). Methods A total of 104 patients with active rheumatoid arthritis admitted to our hospital from August 2016 to August 2018 were selected. According to the treatment methods, the patients were divided into two groups: control group(routine treatment of western medicine) and observation group(combined with Huayu Tongbi Recipe). Results The total effective rate of observation group was 92.31%(48/52) and that of control group was 76.92%(40/52). The total effective rate of the observation group was higher than that of the control group(P<0.05). The duration of morning stiffness after treatment in the observation group was shorter than that in the control group, and the joint tenderness and joint swelling score were lower than those in the control group(P<0.05). Before treatment, TNF-α, IL-1β, CRP, glucose 6 phosphoisomerase(GPI) and rheumatoid factor(RF) in the two groups were lower than those in the control group. Serum tumor necrosis factors between the two groups. The difference were not statistically significant(P>0.05). After treatment, the levels of TNF-α, IL-1β,CRP,GPI,RF and TL1 A in the observation group were lower than those in the control group(P<0.05), but there was no significant difference between the two groups before treatment(P>0.05). The DAS28 score in the observation group was lower than that in the control group(P<0.05). Conclusion Huayu Tongbi Recipe can improve the clinical symptoms, decrease the expressions of TNF-α, IL-1 β,CRP and GPI in patients with active rheumatoid arthritis, and improve the curative effect.