三七总皂苷调整类风湿关节炎免疫相关内环境失衡状态的临床研究

作者	单位
张佳红	甘肃省人民医院风湿免疫科 (兰州730000)
王晋平	甘肃省人民医院风湿免疫科 (兰州730000)
王慧娟	甘肃省人民医院风湿免疫科 (兰州730000)

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中文摘要:

目的探讨三七总皂苷(PNS)治疗类风湿关节炎(RA)的疗效及可能的作用机理,并观察其对RA免疫内环境的影响和安全性。方法84例患者随机分为两组,对照组(41例)予双氯芬酸钠、来氟米特及糖皮质激素的常规治疗;治疗组(43例)在常规治疗基础上加用PNS,疗程均为4周。观察两组临床症状疗效及血小板(PLT)计数、免疫球蛋白(IgG、IgA、IgM)、补体(C)3、类风湿因子(RF)、C-反应蛋白(CRP)、铜蓝蛋白(CER)、结合珠蛋白(HPT)、α1-酸性糖蛋白(AAG)的变化。结果治疗后两组患者关节肿胀指数、关节压痛指数、关节疼痛指数、晨僵时间、患者疼痛评估(VAS)均较治疗前明显改善(P<0.01),且治疗组优于对照组(P<0.05或P<0.01);PLT、CER、AAG、HPT、CRP、IgG、IgA、IgM、C3、RF均较治疗前下降(P<0.01),且治疗组PLT、CER、AAG、CRP下降幅度优于对照组(P<0.05或P<0.01)。结论PNS可调节免疫相关内环境失衡状态,增强抗炎镇痛改善病情,提高疗效。

英文摘要:

Objective To study the therapeutic effect and possible mechanism of total panax notoginseng saponins(PNS)for treatment of rheumatoid arthritis(RA),and to observe its safety and influence on RA immune related inner environment.Methods Eighty-four patients were randomly assigned to two groups.All were treated with the routine therapy with diclofenac sodium,Leflunomide and prednisone,but for the 43 patients in the treatment group PNS was given additionally.The therapeutic course was 28 days for both groups.Clinical efficacy and change of indexes including platelet counts,immnuoglobulins(IgG,IgA,IgM),complement(C)3,rheumatoid factor(RF),C-reactive protein(CRP),ceruloplasmin(CER),haptoglobin(HPT),and α1-acid glycoprotein(AAG)were observed.Results Significant improvement of clincical symptoms,including the joint swelling index,joint tenderness index,joint pain index,time of morning stiffness and VAS revealed in both groups after treatment,and the effect in the treatment group was better(P<0.05 or P<0.01).PLT,CER,AAG,HPT,CRP,IgG,IgA,IgM,C3 and RF were lowered in both groups(P<0.01),but the lowering in PLT,CER,AAG and CRP in the treatment group was more significant than that in the control group respectively(P<0.05 or P<0.01).Conclusion PNS can significantly improve the condition of patients,enhance the therapeutic effect in treating RA,through regulating the disordered immunity and improving the effect of anti-inflammatory and analgesia.

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