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[1]張永紅,王笑青,張萬(wàn)義,等.頑痹清丸與白芍總苷膠囊治療濕毒瘀熱型 類風(fēng)濕關(guān)節(jié)炎的對(duì)比研究[J].中醫(yī)正骨,2014,26(12):10-15.
　ZHANG Yonghong*,WANG Xiaoqing,ZHANG Wanyi,et al.A clinical comparison of Wanbiqing Wan(頑痹清丸)and total glucosides of paeony capsules for treatment of type DAMP TOXIN STAGNATED HEAT rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(12):10-15.
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頑痹清丸與白芍總苷膠囊治療濕毒瘀熱型 類風(fēng)濕關(guān)節(jié)炎的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年12期
頁(yè)碼:
10-15
欄目:
臨床研究
出版日期:
2014-12-30

文章信息/Info

Title:
A clinical comparison of Wanbiqing Wan(頑痹清丸)and total glucosides of paeony capsules for treatment of type DAMP TOXIN STAGNATED HEAT rheumatoid arthritis
作者:
張永紅; 王笑青; 張萬(wàn)義; 沙莎; 許素琴; 王玉麗; 侯宏理; 曹焱; 張麗麗
河南省洛陽(yáng)正骨醫(yī)院,河南省骨科醫(yī)院,河南 洛陽(yáng) 471002
Author(s):
ZHANG Yonghong*; WANG Xiaoqing; ZHANG Wanyi; SHA Sha; XU Suqin; WANG Yuli; HOU Hongli; CAO Yan; ZHANG Lili.*
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關(guān)鍵詞:
關(guān)節(jié)炎; 類風(fēng)濕 頑痹清丸 白芍 消炎藥; 非甾類 抗風(fēng)濕藥 治療; 臨床研究性
Keywords:
Arthritis; rheumatoid;  Wanbiqing Wan;  Radix paeoniae alba;  Anti-inflammatory agents; non-steroidal;  Antirheumatic agents;  Therapies; investigational
摘要:
目的:比較頑痹清丸與白芍總苷膠囊治療濕毒瘀熱型類風(fēng)濕關(guān)節(jié)炎的臨床療效。方法:將60例濕毒瘀熱型類風(fēng)濕關(guān)節(jié)炎患 者隨機(jī)分為2組,治療組患者(40例)采用口服頑痹清丸聯(lián)合右旋布洛芬膠囊、甲氨蝶呤片和來(lái)氟米特片治療,對(duì)照組患者(20例)采 用白芍總苷膠囊聯(lián)合右旋布洛芬膠囊、甲氨蝶呤片和來(lái)氟米特片治療。治療2個(gè)療程后比較2組患者血沉,C反應(yīng)蛋白、類風(fēng)濕因 子、腫瘤壞死因子α、白介素-1的血清含量,關(guān)節(jié)疼痛評(píng)分變化情況及總體療效。結(jié)果:①急性期反應(yīng)物、炎性細(xì)胞因子及關(guān)節(jié) 疼痛評(píng)分。治療2個(gè)療程后,治療組血沉、C反應(yīng)蛋白、類風(fēng)濕因子、腫瘤壞死因子α、白介素-1及關(guān)節(jié)疼痛視覺(jué)模擬評(píng)分均較治 療前降低[(69.30±35.20)mm·h-1,(42.40±29.20)mm·h-1,t=3.305,P=0.001;(42.40 ±33.00)mg·L-1,(12.00±14.80)mg·L-1,t=5.846,P=0.000;(131.10±93.90) IU·mL-1,(91.70±71.50)IU·mL-1,t=2.161,P=0.034;(124.80±31.20)pg·mL- 1,(110.00 ±28.70)pg·mL-1,t=3.198,P=0.002;(33.10±7.39)ug·g-1,(29.50 ±8.59)ug·g-1,t=4.561,P=0.000;(6.12 ±0.89)分,(3.46±1.44)分,t=4.482,P=0.005],對(duì)照組血 沉、C反應(yīng)蛋白、類風(fēng)濕因子、腫瘤壞死因子α、白介素-1及關(guān)節(jié)疼痛視覺(jué)模擬評(píng)分均較治療前降低[(58.50 ±33.70)mm· h-1,(41.70±27.80)mm·h-1,t=2.206,P=0.034;(31.70 ±28.00)mg·L-1, (13.80±16.70)mg·L-1,t=2.449,P=0.019;(159.30±83.80)IU·mL-1, (105.00±53.70)IU·mL-1,t=2.569,P=0.014;(114.20±32.70)pg·mL-1, (117.60±31.80)pg·mL-1,t=2.038,P=0.049;(35.80±8.26)ug·g-1,(34.90±8.03)ug ·g-1,t=2.509,P=0.016;(5.85±1.12)分,(3.75±1.18)分,t=2.850,P=0.007]; 2組C反應(yīng)蛋白、類風(fēng)濕因 子、腫瘤壞死因子α比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義[(33.20±32.80)mg·L-1,(17.80±33.70)mg·L- 1,t=1.687,P=0.097;(39.30±55.20)IU·mL-1,(53.40±69.90)IU·mL-1,t=- 0.848,P=0.400;(12.80±39.10)pg·mL-1,(-3.40±41.50)pg·mL-1,t=1.485,P=0.143]; 治 療組血沉、白介素-1及關(guān)節(jié)疼痛視覺(jué)模擬評(píng)分下降幅度均大于對(duì)照組[(26.80±31.50)mm·h-1, (7.70±35.60)mm·h-1,t=2.121,P=0.038;(2.25±1.30)ug·g-1,(0.80±0.81) ug·g-1,t=2.117,P=0.039;(3.11±1.94)分,(2.10±1.58)分,t=2.014,P=0.049]。②臨床療效。治療2個(gè) 療程后,按照西醫(yī)療效標(biāo)準(zhǔn),治療組達(dá)到ACR70標(biāo)準(zhǔn)8例、達(dá)到ACR50標(biāo)準(zhǔn)16例、達(dá)到ACR20標(biāo)準(zhǔn)11例、未達(dá)到ACR20標(biāo)準(zhǔn)5例,對(duì)照組 達(dá)到ACR70標(biāo)準(zhǔn)3例、達(dá)到ACR50標(biāo)準(zhǔn)5例、達(dá)到ACR20標(biāo)準(zhǔn)5例、未達(dá)到ACR20標(biāo)準(zhǔn)7例; 治療組療效優(yōu)于對(duì)照組(Z=- 5.455,P=0.000)。按照中醫(yī)療效標(biāo)準(zhǔn),治療組臨床控制6例、顯效15例、有效12例、無(wú)效7例,對(duì)照組臨床控制3例、顯效6例、有 效5例、無(wú)效6例; 治療組療效優(yōu)于對(duì)照組(Z=-5.864,P=0.000)。結(jié)論:分別采用頑痹清丸與白芍總苷膠囊,聯(lián)合非甾體抗炎藥及 改善病情的抗風(fēng)濕藥治療濕毒瘀熱型類風(fēng)濕關(guān)節(jié)炎,均可以有效降低急性期反應(yīng)物水平及炎性細(xì)胞因子水平,緩解關(guān)節(jié)疼痛; 但 是,頑痹清丸聯(lián)合非甾體抗炎藥及改善病情的抗風(fēng)濕藥在降低血沉、白介素-1水平,緩解關(guān)節(jié)疼痛及臨床療效方面,優(yōu)于白芍總苷 膠囊聯(lián)合非甾體抗炎藥及改善病情的抗風(fēng)濕藥,值得臨床推廣應(yīng)用。
Abstract:
Objective:To compare the clinical curative effect of Wanbiqing Wan(頑痹清丸)versus total glucosides of paeony capsules for treatment of type DAMP TOXIN STAGNATED HEAT rheumatoid arthritis(RA).Methods:Sixty patients with type DAMP TOXIN STAGNATED HEAT RA were randomly divided into two groups.The patients in treatment group(40 cases)were treated with oral application of Wanbiqing Wan,dexibuprofen capsules,methotrexate tablets and leflunomide tablets; while the others in the control group(20 cases)were treated with oral application of total glucosides of paeony capsules,dexibuprofen capsules,methotrexate tablets and leflunomide tablets.After two- course treatment,the two groups were compared with each other in joint pain visual analogue scores(VAS),total curative effects and serum contents of erythrocyte sedimentation rate(ESR),c-reactive protein(CRP),rheumatoid factor(RF),tumor necrosis factor-alpha(TNF-α)and interleukin-1(IL-1).Results:ESR,CRP,RF,TNF-α,IL-1 and VAS decreased in treatment group after two-course treatment(69.30+/-35.20 vs 42.40+/-29.20 mm/h,t=3.305,P=0.001; 42.40+/-33.00 vs 12.00+/-14.80 mg/L,t=5.846,P=0.000; 131.10+/-93.90 vs 91.70+/-71.50 IU/mL,t=2.161,P=0.034; 124.80+/-31.20 vs 110.00+/-28.70 pg/mL,t=3.198,P=0.002; 33.10+/-7.39 vs 29.50+/-8.59 ug/g,t=4.561,P=0.000; 6.12+/-0.89 vs 3.46+/-1.44 points,t=4.482,P=0.005).ESR,CRP,RF,TNF-α,IL-1 and VAS decreased in control group after two-course treatment(58.50+/-33.70 vs 41.70+/-27.80 mm/h,t=2.206,P=0.034; 31.70+/-28.00 vs 13.80+/-16.70 mg/L,t=2.449,P=0.019; 159.30+/-83.80 vs 105.00+/-53.70 IU/mL,t=2.569,P=0.014; 114.20+/-32.70 vs 117.60+/-31.80 pg/mL,t=2.038,P=0.049; 35.80+/-8.26 vs 34.90+/-8.03 ug/g,t=2.509,P=0.016; 5.85+/-1.12 vs 3.75+/-1.18 points,t=2.850,P=0.007).There were no statistical differences in CRP,RF and TNF-α between the 2 groups (33.20+/-32.80 vs 17.80+/-33.70 mg/L,t=1.687,P=0.097; 39.30+/-55.20 vs 53.40+/-69.90 IU/mL,t=-0.848,P=0.400; 12.80+/-39.10 vs -3.40+/-41.50 pg/mL,t=1.485,P=0.143).The decreased value of ESR,IL-1 and VAS of treatment group were greater than those of control group(26.80+/-31.50 vs 7.70+/-35.60 mm/h,t=2.121,P=0.038; 2.25+/-1.30 vs 0.80+/-0.81 ug/g,t=2.117,P=0.039; 3.11+/-1.94 vs 2.10+/-1.58 point,t=2.014,P=0.049).According to western medical curative effect standard,most patients reached to ACR70 standard(8),ACR50 standard(16)and ACR20 standard(11)and 5 patinets did not reach ACR20 standard in treatment group; while most patients reached to ACR70 standard(3),ACR50 standard(5),ACR20 standard(5)and 7 patinets did not reached ACR20 standard in control group after two-course treatment.The clinical curative effect was better in the treatment group compared with the control group(Z=-5.455,P=0.000).According to TCM curative effect standard,the pathogenetic condition of 6 patients were controlled,15 good,12 fair and 7 poor in the treatment group; while the pathogenetic condition of 3 patients were controlled,6 good,5 fair and 6 poor in the control group.The clinical curative effect was better in the treatment group compared with the control group(Z=-5.864,P=0.000).Conclusion:Combined with nonsteroidal antiinflammatory drugs(NSAIDs)and disease modifying antirheumatic drugs(DMARDs),both Wanbiqing Wan and total glucosides of paeony capsules can effectively lower acute phase reactants level and inflammatory cytokines level and relieve the joint pain in the treatment of type DAMP TOXIN STAGNATED HEAT RA.However,Wanbiqing Wan combined with NSAIDs and DMARDs surpassed total glucosides of paeony capsules combined with NSAIDs and DMARDs in lowering the level of ESR and IL-1 and relieving the joint pain,and it has better clinical effect,so it is worthy of popularizing in clinic.

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更新日期/Last Update: 2014-12-30