[1]张永红,王笑青,张万义,等.顽痹清丸与白芍总苷胶囊治疗湿毒瘀热型 类风湿关节炎的对比研究[J].中医正骨,2014,26(12):10-15.
　ZHANG Yonghong*,WANG Xiaoqing,ZHANG Wanyi,et al.A clinical comparison of Wanbiqing Wan(顽痹清丸)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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顽痹清丸与白芍总苷胶囊治疗湿毒瘀热型 类风湿关节炎的对比研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期数:
2014年12期
页码:
10-15
栏目:
临床研究
出版日期:
2014-12-30

文章信息/Info

Title:
A clinical comparison of Wanbiqing Wan(顽痹清丸)and total glucosides of paeony capsules for treatment of type DAMP TOXIN STAGNATED HEAT rheumatoid arthritis
作者:
张永红; 王笑青; 张万义; 沙莎; 许素琴; 王玉丽; 侯宏理; 曹焱; 张丽丽
河南省洛阳正骨医院,河南省骨科医院,河南 洛阳 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
关键词:
关节炎; 类风湿 顽痹清丸 白芍 消炎药; 非甾类 抗风湿药 治疗; 临床研究性
Keywords:
Arthritis; rheumatoid;  Wanbiqing Wan;  Radix paeoniae alba;  Anti-inflammatory agents; non-steroidal;  Antirheumatic agents;  Therapies; investigational
摘要:
目的:比较顽痹清丸与白芍总苷胶囊治疗湿毒瘀热型类风湿关节炎的临床疗效。方法:将60例湿毒瘀热型类风湿关节炎患 者随机分为2组,治疗组患者(40例)采用口服顽痹清丸联合右旋布洛芬胶囊、甲氨蝶呤片和来氟米特片治疗,对照组患者(20例)采 用白芍总苷胶囊联合右旋布洛芬胶囊、甲氨蝶呤片和来氟米特片治疗。治疗2个疗程后比较2组患者血沉,C反应蛋白、类风湿因 子、肿瘤坏死因子α、白介素-1的血清含量,关节疼痛评分变化情况及总体疗效。结果:①急性期反应物、炎性细胞因子及关节 疼痛评分。治疗2个疗程后,治疗组血沉、C反应蛋白、类风湿因子、肿瘤坏死因子α、白介素-1及关节疼痛视觉模拟评分均较治 疗前降低[(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],对照组血 沉、C反应蛋白、类风湿因子、肿瘤坏死因子α、白介素-1及关节疼痛视觉模拟评分均较治疗前降低[(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组C反应蛋白、类风湿因 子、肿瘤坏死因子α比较,差异均无统计学意义[(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 疗组血沉、白介素-1及关节疼痛视觉模拟评分下降幅度均大于对照组[(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临床疗效。治疗2个 疗程后,按照西医疗效标准,治疗组达到ACR70标准8例、达到ACR50标准16例、达到ACR20标准11例、未达到ACR20标准5例,对照组 达到ACR70标准3例、达到ACR50标准5例、达到ACR20标准5例、未达到ACR20标准7例; 治疗组疗效优于对照组(Z=- 5.455,P=0.000)。按照中医疗效标准,治疗组临床控制6例、显效15例、有效12例、无效7例,对照组临床控制3例、显效6例、有 效5例、无效6例; 治疗组疗效优于对照组(Z=-5.864,P=0.000)。结论:分别采用顽痹清丸与白芍总苷胶囊,联合非甾体抗炎药及 改善病情的抗风湿药治疗湿毒瘀热型类风湿关节炎,均可以有效降低急性期反应物水平及炎性细胞因子水平,缓解关节疼痛; 但 是,顽痹清丸联合非甾体抗炎药及改善病情的抗风湿药在降低血沉、白介素-1水平,缓解关节疼痛及临床疗效方面,优于白芍总苷 胶囊联合非甾体抗炎药及改善病情的抗风湿药,值得临床推广应用。
Abstract:
Objective:To compare the clinical curative effect of Wanbiqing Wan(顽痹清丸)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