和痹方联合西药对类风湿关节炎患者血清和滑膜液中IL-6、IL-8及IL-17水平的影响

目的探讨和痹方联合西药对类风湿关节炎(RA)患者血清和滑膜液中白介素-6(IL-6)、白介素-8(IL-8)及白介素-17(IL-17)水平的影响。方法选取2018年3月—2019年3月收治的RA患者289例,根据其治疗方式分成对照组141例、治疗组148例。对照组给予常规西药治疗,即甲氨蝶呤联合普威片治疗,治疗组采用和痹方联合西药治疗,两组均治疗3个月。比较两组临床疗效,并分析两组治疗前、治疗3个月后的中医证候积分,包括晨僵、关节疼痛、关节压痛、屈伸不利。分别采集血液、滑膜液测定IL-6、IL-8、IL-17水平,观察两组不良反应情况。结果治疗组总有效率87.16%高于对照组总有效率78.01%,差异有统计学意义(P<0.05)。两组治疗后晨僵、关节疼痛、关节压痛、屈伸不利积分及总积分均低于治疗前,且治疗组显著低于对照组,差异有统计学意义(P<0.05)。两组治疗后血清和滑膜液内IL-6、IL-8、IL-17水平均低于治疗前,且治疗组显著低于对照组,差异有统计学意义(P<0.05)。两组食欲下降、腹痛、腹泻、白细胞减少发生率比较,差异无统计学意义(P>0.05)。结论与单用西药治疗相比,RA患者采用和痹方与西药联合治疗,能进一步下调血清和滑膜液内IL-6、IL-8、IL-17水平,从而提高临床疗效,改善中医症状,安全性较高。

Effect of Hebi Formula with western medicine on the levels of interleukin-6,interleukin-8 and interleukin-17 in serum and synovial fluid of patients with rheumatoid arthritis

Objective To explore the effect of Hebi Formula combined with western medicine on the levels of interleukin-6(IL-6),interleukin-8(IL-8)and interleukin-17(IL-17)in serum and synovial fluid of patients with rheumatoid arthritis(RA).Methods A total of 289 RA patients admitted to our hospital from March,2018 to March,2019 were divided into a control group(141)and an observation group(148)according to their treatment approaches.The control group was treated with conventional western medicine(Methotrexate combined with Nimesulide Tablets),while the observation group was treated with Hebi Formula combined with western medicine.Both groups were treated for 3 months.The clinical effect of the two groups was compared,and the TCM syndrome scores(morning stiffness,joint pain,joint tenderness,limitation of flexion and extension)in both groups were compared before and after treatment.The levels of IL-6,IL-8 and IL-17 in blood and synovial fluid were measured and the adverse events were observed in both groups.ResultsThe total effective rate of the observation group(87.16%)was higher than that of the control group(78.01%),and the difference was statistically significant(P<0.05).After treatment,the scores of morning stiffness,joint pain,joint tenderness,limitation of flexion and extension and the total score in the two groups decreased compared with those before treatment;and the scores in the observation group was lower than in the control group,with statistical significance(P<0.05).After treatment,the levels of IL-6,IL-8 and IL-17 in serum and synovial fluid in both groups decreased,and the levels in the observation group were significantly lower than in the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of anorexia,abdominal pain,diarrhea and leukopenia between the two groups(P>0.05).Conclusion Compared with simple western medicine,the combined treatment of Hebi Formula and western medicine can further reduce the levels of IL-6,IL-8 and IL-17 in serum and synovial fluid,and thus improving the clinical efficacy and TCM syndrome with higher safety.