补肾通督胶囊对类风湿性关节炎患者骨代谢及炎性细胞因子的影响

目的:研究补肾通督胶囊对类风湿性关节炎患者骨代谢及炎性细胞因子的影响,探讨补肾通督胶囊的药效机制,评价补肾通督胶囊治疗类风湿性关节炎的临床疗效。方法:将类风湿性关节炎患者134例按照入院顺序抽签后随机分为试验组和对照组各67例,对照组口服雷公藤多甙片治疗,试验组口服补肾通督胶囊治疗。观察患者Ⅰ型胶原氨基端前肽(PINP)、骨特异性碱性磷酸酶(BAP)、血清骨钙素(BGP)、干扰素γ(IFN-γ)、白细胞介素4(IL-4)、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)等指标及临床疗效和不良反应发生情况。结果:2组治疗后PINP、BAP水平低于治疗前,BGP水平高于治疗前,差异有统计学意义(P0.05);试验组治疗后PINP、BAP水平低于对照组,BGP水平高于对照组,差异有统计学意义(P0.05);2组治疗后IFN-γ、TNF-α、IL-1β水平低于治疗前,IL-4水平高于治疗前,差异有统计学意义(P0.05);试验组治疗后IFN-γ、TNF-α、IL-1β水平低于对照组,IL-4水平高于对照组,差异有统计学意义(P0.05);总有效率试验组为92.54%,对照组为73.13%,2组比较差异有统计学意义(P0.05);试验组无明显不良反应,对照组有1例患者治疗4周后外周静脉血白细胞(WBC)下降,停药后恢复正常。结论:补肾通督胶囊能降低类风湿性关节炎患者PINP、BAP、IFN-γ、TNF-α、IL-1β水平,升高BGP、IL-4水平,能在一定程度上减少炎性细胞因子介导的免疫性损伤,缓解类风湿性关节炎患者受累关节红肿热痛的症状,效果优于雷公藤多甙片治疗,且安全性高、无不良反应。

The Influence of BuShen TongDu Capsules on the Levels of Inflammatory Cytokines and Bone Metabolism of the Patients with Rheumatoid Arthritis

Objective: To study the influence of BuShen TongDu capsules on the levels of inflammatory cytokines and bone metabolism of the patients with rheumatoid arthritis (RA), discuss pharmacodynamic mechanism of BuShen TongDu capsules and assess clinical effects of BuShen TongDu capsules in treating RA. Methods: All 134 RA patients were randomized into the experiment group and the control group by drawing lots according to the admission order, 67 cases each group, the control group took Glucosidorum Tripterygll Totorum (GTT) tablets while the experiment group BuShen TongDu capsules. The indexes of PINP, BAP, BGP, IFN-γ, IL-4, TNF-α, IL-1β and others, clinical effects as well as the incidence of adverse reaction of the patients were observed. Results: The levels of PINP and BAP in both groups after treating were lower than these before treating, the level of BGP higher than that before treating, and the difference had statistical meaning (P＜0.05); the experiment group was lower than the control group after treating in the levels of PINP and BAP, BGP higher than that of the control group, and the difference presented statistical meaning (P＜0.05); the levels of IFN-γ, TNF-α and IL-1β in both groups after treating were lower than these before treating, the level of IL-4 higher than that before treating, and the difference showed statistical meaning (P＜0.05); the levels of IFN-γ, TNF-α and IL-1β in the experiment group were lower than these of the control group, the level of IL-4 higher than that of the control group, and the difference showed statistical meaning (P＜0.05); total effective rate of the experiment group was 92.54%, higher than 73.13% of the control group, and the difference showed statistical meaning (P＜0.05); there was no obvious adverse reaction in the experiment group, in the control group, there was one patient manifesting WBC decreasing in peripheral venous blood after treating for four weeks and returning to normal after stopping the medicine. Conclusion:BuShen TongDu capsules could lower the levels of PINP, BAP, IFN-γ, TNF-α and IL-1β of the patients with RA, raise the levels of BGP and IL-4 of the patients, reduce inflammatory cytokines-mediated immunological injury to a certain degree, rapidly relieve reddness, swelling, hot and pain of the affected joints of RA patients, which shows high safety and no adverse reaction.