类风关合剂治疗类风湿性关节炎的临床及实验研究

作者	单位
许得盛	上海医科大学附属华山医院脏象研究室
沈自尹	上海医科大学附属华山医院脏象研究室
卢苇	上海医科大学附属华山医院脏象研究室
王文健	上海医科大学附属华山医院脏象研究室
蔡定芳	上海医科大学附属华山医院脏象研究室
陈伟华	上海医科大学附属华山医院脏象研究室

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中文摘要:

雷公藤与补肾益气、祛风活血药组成类风关合剂，治疗类风湿性关节炎，治疗后患者的人类白细胞Ⅱ类抗原（ＨＬＡ－ＤＲ＋）细胞及ＣＤ４／ＣＤ８比值下降（Ｐ＜０．０５），自身混合淋巴细胞反应（ＡＭＬＲ）水平提高（Ｐ＜０．０５）。实验研究显示，类风关合剂和单味雷公藤均可减轻类风关模型鼠病变关节的肿胀；合剂在减轻滑膜细胞炎症、软骨细胞纤维变性方面作用较雷公藤强；而在致免疫器官萎缩及抑制免疫细胞对有丝分裂原的增殖反应方面作用较雷公藤小。提示合剂可能通过改善Ｔ细胞亚群分布及细胞免疫功能缓解或减轻类风关病症。合剂中补肾益气和祛风活血药可提高雷公藤的药效作用，减轻其副作用。

英文摘要:

The RA mixture is composed of Tripterygium Wilfordii (TW) and other Chinese medicinal herbs with effect of expelling Wind, activiting blood circulation, invigorating the Kidney and Qi. The authors treated rheumatoid arthritis (RA) patients with RA mixture and compared it with D-penicillamine as control. The two group’s therapeutical effect is similar (P ＞0 . 05) , but the side effect occuring ratio in treatment group was obviously lower than that of control group (p＜0 . 01) .After treatment with RA mixture, the patient’s human lymphocytic antigen-degenerative reaction (HLA-DR+) cell, CD4/CD8 ratio reduced and auto-mixed lymphocytic reaction (AMLR) level enhanced(p＜0. 05). The results of animal experiment showed that swelling of RA model mouse’s joint could be reduced by both RA mixture and TW. Comparing with TW, RA mixture had stronger effect in controlling the inflammation of synovial cell and fibroid degeneration of fibrocytes.At the same time, RA mixture had stronger effect in protecting the immune organ from atrophy and protecting functions of cellular immunity. All above suggest that RA mixture reduce the syndroms of RA by improving distribution of T lymphocyte subsets and the functions of cellular immunity.The other Chinese medicinal herbs in the RA mixture could enhance TW’s therapeutical effect and reduce it’s side effect.

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