中西医结合治疗类风湿关节炎疗效及其对糖皮质激素受体的影响

作者	单位
康信忠	南方医科大学中医药学院
吴启富	南方医科大学中医药学院
王康惠	南方医科大学中医药学院
丁朝霞	南方医科大学中医药学院
鲁莹	南方医科大学中医药学院
曾荣南	南方医科大学中医药学院

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中文摘要:

目的探讨风湿康治疗类风湿关节炎(RA)的疗效及作用机制。方法将38例中医辨证为湿热痹阻证类风湿关节炎患者随机分为两组,中药组20例,用风湿康联合甲泼尼龙治疗;西药组18例,用氨甲喋呤联合甲泼尼龙治疗,两组均治疗1个月。分别检测治疗前后类风湿因子(RF)、C反应蛋白(CRP)、血沉(ESR)及hGRαmRNA、hGRβmRNA的表达水平,并与20名健康对照组进行比较。结果 1个月后中药组及西药组RF、CRP均较治疗前显著降低(P<0.05),两组比较差异有统计学意义(P<0.05);而两组ESR治疗前后及组间比较,差异均无统计学意义(P>0.05);RA患者GRα和GRβ表达水平显著高于健康对照组(P<0.01),治疗后两治疗组hGRαmRNA均显著降低(P<0.01),中药组hGRβmRNA较治疗前显著降低(P<0.01),而西药组hGRβmRNA与治疗前比较,差异无统计学意义(P>0.05)。结论风湿康联合甲泼尼龙治疗可有效控制RA患者炎症反应,降低hGRα、hGRβ表达水平,提高RA的临床疗效。

英文摘要:

Objective To investigate the efficacy and mechanism of Fengshikang (FSK) in treating rheumatoid arthritis (RA). Methods Thirty-eight patients with RA of damp-heat block syndrome type in Chinese medicine (CM), were randomized into two groups. They all received glucocorticoid therapy for 1 month, but FSK was administered to the 20 patients in the CM group in addition, while to the 18 in the WM group, MTX was given. Besides, a normal control group with 20 healthy subjects was set up. Blood levels of RA related indices were measured and compared. Results After treatment, the levels of rheumatoid factor (RF) and C-reactive protein (CRP) were significantly reduced in both groups (P<0.05), but the reduction was more significant in the CM group (P<0.05). No significant change was found in the level of ESR after treatment and showed no significant difference between groups (P>0.05). Both hGRα mRNA and hGRβ mRNA expressions were significantly higher in the patients than in the normal controls (P<0.01), they were lowered after treatment in the CM group (P<0.01), but significant reduction could only be found in level of hGRβ mRNA in the control group (P<0.01). Conclusion FSK combined with glucocorticoid can effectively control the inflammatory reaction, decrease the level of hGRα and hGRβ expressions and enhance the clinical efficacy in treating RA.

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