| 张笑栩,王德秀.五积散加减方联合来氟米特对RA的疗效观察.[J].中南医学科学杂志.,2024,(6):918-921. |
| 五积散加减方联合来氟米特对RA的疗效观察 |
| Observation of therapeutic effects of Wujisan-modified formula combined with leflunomide on RA |
| 投稿时间：2024-03-21 修订日期：2024-10-11 |
| DOI：10.15972/j.cnki.43-1509/r.2024.06.010 |
| 中文关键词: 五积散加减方 来氟米特 免疫功能 临床疗效 骨代谢 类风湿关节炎 |
| 英文关键词:Wujisan-modified formula leflunomide immune function clinical effect bone metabolism RA |
| 基金项目:首都卫生发展科研专项项目(首发2020-2-7014) 作者简介:张笑栩,博士,主治医师,研究方向为风湿免疫系统疾病的中西医结合治疗,E-mail为zxxhaha@126.com。通信作者王德秀,博士,主治医师,研究方向为血液病的中西医结合诊治,E-mail为745753101@qq.com。 |
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| 中文摘要: |
| 目的观察五积散加减方联合来氟米特对类风湿关节炎(RA)的疗效。 方法将100例RA患者随机均分为对照组(来氟米特治疗)和观察组(对照组基础上联合五积散加减方治疗)。观察两组临床疗效和不良反应；比较两组治疗前后临床症状和疾病活动性评分28(DAS28)、免疫功能[免疫球蛋白(Ig)M、IgA、IgG]、血脂代谢[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)]、骨代谢[Ⅰ型原胶原氨基端延长肽(PINP)、骨钙蛋白(BGP)、骨特异性碱性磷酸酶(BAP)]、护骨因子(OPG)/核因子-κB受体激活蛋白配体(RANKL)信号通路情况。 结果观察组总有效率显著高于对照组(P＜0.05)。治疗后两组临床症状程度、DAS28评分以及血清IgM、IgA、IgG、TC、TG、LDLC、PINP、BAP、RANKL水平均降低,且观察组低于对照组(P＜0.05)；HDLC、BGP、OPG水平升高,且观察组高于对照组(P＜0.05)。两组不良反应发生率比较,差异无显著性(P＞0.05)。 结论五积散加减方联合来氟米特治疗RA可有效减轻患者临床症状和病情程度,改善血脂代谢、骨代谢,下调IgM、IgA、IgG水平,调节OPG/RANKL信号通路,且不会增加不良反应。 |
| 英文摘要: |
| AimTo observe the therapeutic effects of Wujisan-modified formula combined with leflunomide for the treatment of rheumatoid arthritis (RA). Methods100 RA patients were randomly divided into a control group (treated with leflunomide) and observation group (treated with a combination of Wujisan-modified formula on the basis of the control group). The clinical efficacy and adverse reactions of two groups were observed. The clinical symptoms and disease activity scores 28 (DAS28), immune function [immunoglobulin (Ig) M, IgA, IgG], lipid metabolism [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC)], bone metabolism [propeptide of type I procollagen (PINP), osteocalcin (BGP), bone-specific alkaline phosphatase (BAP)], osteoprotegerin (OPG)/receptor activator of nuclear factor-κB ligand (RANKL) signaling pathway before and after treatment between two groups were compared. ResultsThe total effective rate of the observation group was significantly higher than that of the control group (P＜0.05). The clinical symptoms severity, DAS28 scores, serum IgM, IgA, IgG, TC, TG, LDLC, PINP, BAP, and RANKL levels in both groups were decreased after treatment, and the observation group was lower than the control group (P＜0.05). The levels of HDLC, BGP, and OPG were increased, and the observation group was higher than the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). ConclusionThe combination of Wujisan-modified formula and leflunomide can effectively alleviate the clinical symptoms and severity of RA in patients, improve blood lipid metabolism and bone metabolism, downregulate IgM, IgA, and IgG levels, regulate the OPG/RANKL signaling pathway, but do not increase adverse reactions. |
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