摘要
目的 探讨腰痛活血胶囊对强直性脊柱炎(AS)患者疗效及M1、M2型炎症因子的影响.方法 选取2020年1月至2023年11月安徽中医药大学第一附属医院风湿科收治的60例AS患者,采用随机数字表法分为研究组、对照组各30例.研究组予腰痛活血胶囊(1.2 g,3次/d)联合沙利度胺口服(50 mg,每晚1次),对照组予沙利度胺口服(50 mg,每晚1次),2组均治疗4周.观察治疗前后疼痛视觉模拟评分法(VAS)评分、强直性脊柱炎疾病活动指数(BASDAI)评分、Bath强直性脊柱炎功能指数(BASFI)评分、Bath强直性脊柱炎计量学指数(BASMI)、Bath强直性脊柱炎总体指数(BAS-G)、中医临床证候积分及血清红细胞沉降率(ESR)、C反应蛋白(CRP)、M1型炎症细胞因子[肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6]、M2型炎症细胞因子(IL-4、IL-10)的表达.结果 2组治疗后,研究组和对照组的总有效率分别为90％及70％,研究组总有效率高于对照组,差异有统计学意义(P＜0.05).与治疗前相比较,研究组治疗后VAS、BASDAI、BASFI、BAS-G、BASMI、ESR、CRP、TNF-α、IL-6降低,腰骶脊背僵痛积分、腰脊活动受限积分、晨僵积分、夜间疼痛积分、关节肿痛积分及中医证候总积分降低,IL-4、IL-10表达升高(P＜0.01).与对照组治疗后相比较,研究组治疗后VAS、BASDAI、BAS-FI、CRP、IL-6、腰骶脊背僵痛、腰脊活动受限、夜间疼痛、中医证候总积分降低,IL-10表达升高(P＜0.01).结论 腰痛活血胶囊联合沙利度胺可显著改善AS患者临床症状,通过上调M2型炎症因子表达,降低AS患者免疫炎症水平,改善患者临床症状且临床疗效安全.
Abstract
Objective To explore the efficacy of the Yaotong Huoxue Capsule on patients with ankylosing spondylitis(AS)and its impact on M1 and M2 type inflammatory factors,and to explore its mechanism of action.Meth-ods Sixty patients with AS admitted to the Rheumatology Department of the First Affiliated Hospital of Anhui Universi-ty of Traditional Chinese Medicine from January 2020 to November 2023 were selected as the research subjects.Using a random number table method,the study group and the control group were divided into 30 cases each.The study group received Yaotong Huoxue Capsule(1.2 g,tid)with oral thalidomide tablets(50 mg,qn),while the control group re-ceived only oral thalidomide tablets(50 mg,qn).Treatment duration for both groups was 4 weeks.VAS,BASDAI,BAS-FI,BASMI,BAS-G,traditional Chinese medicine clinical syndrome scores and ESR,CRP,M1 type inflammatory cyto-kines(TNF-α,IL-6)and M2 type inflammatory cytokines(IL-4,IL-10)were assessed before and after treatment.Re-sults After-treatment,effective rates of study group and control group were 90％and 70％,The study group's effective rate was significantly higher than that of control group(P＜0.05).Compared with pre-treatment,VAS,BASDAI,BASFI,BAS-G,BASMI,ESR,hs-CRP,TNF-α,IL-6 decreased,and scores for various symptoms and traditional Chinese medicine syndromes decreased,with increase in IL-4 and IL-10 expression(P＜0.01).Compared with the control group post-treatment,the study group exhibited decreases in VAS,BASDAI,BASFI,CRP,IL-6,symptoms,and total traditional Chi-nese medicine syndrome scores,with increase in IL-10 expression(P＜0.01).Conclusions The combination of Yao-tong Huoxue Capsule and saliduride significantly improves clinical symptoms in AS patients.This improvement occurs through the upregulation of M2 type inflammatory factor expression,thereby reducing the immune inflammatory levels in AS patients,which not only improves clinical symptoms but also demonstrates clinical efficacy with safety.
基金项目
国家自然科学基金面上项目(82274501)
安徽省高等学校自然科学研究项目(KJ2021A0561)
安徽中医药大学第一附属医院优秀医学人才基金(院发[2019]118号)
维普
万方数据