摘要
目的探讨芪龙风湿丸联合甲氨蝶呤治疗类风湿关节炎(RA)肝肾阴虚证的疗效及对外周血微RNA(miRNA)-146a、miR-155、miR-124a水平的影响。方法选取2016年10月至2018年10月苏州市中医医院收治的78例RA患者作为研究对象,按照治疗方法不同分为对照组和观察组,每组39例。两组患者均根据RA诊断及治疗指南给予非药物治疗。其中,对照组在常规治疗的基础上给予甲氨蝶呤片,每次10 mg,每周1次。观察组在对照组的基础上给予芪龙风湿丸。治疗12周后,比较两组患者的临床疗效,主要症状体征[RA活动度评分-28(DAS-28)、数字评分法(NRS)、双手平均握力、晨僵时间]评分、红细胞沉降率(ESR)、类风湿因子(RF)及外周血miR-146a、miR-155、miR-124a水平。结果观察组总有效率明显高于对照组[94.87%(37/39)比74.36%(29/39)](P<0.05)。治疗12周后,两组患者的DAS-28、NRS评分明显降低,双手平均握力显著增加,晨僵时间缩短(P<0.05);观察组的DAS-28、NRS评分低于对照组,双手平均握力大于对照组,晨僵时间短于对照组(P<0.05)。治疗12周后,两组患者的ESR和RF水平均明显下降(P<0.05);观察组的ESR、RF水平低于对照组(P<0.05)。治疗12周后,两组患者的外周血miR-146a、miR-155、miR-124a水平均显著降低(P<0.05),且观察组的外周血miR-146a、miR-155、miR-124a水平低于对照组(10.4±1.8比12.8±3.1,21.6±3.3比30.0±4.1,16.8±2.2比21.3±3.2)(P<0.05)。结论芪龙风湿丸联合甲氨蝶呤治疗RA疗效确切,其治疗效果可能与调节外周血miR-146a、miR-155、miR-124a水平有关。
Objective To explore the therapeutic effect of Qilong fengshi pill combined with methotrexate on rheumatoid arthritis(RA)with syndrome of liver-kidney Yin deficiency and its effect on peripheral blood levels of microRNA(miR)-146a,miR-155,and miR-124a.Methods A total of 78 RA patients admitted to Suzhou Traditional Chinese Medicine Hospital from Oct.2016 to Oct.2018 were included in the study.According to the treatment methods,they were divided into a control group and an observation group,39 cases in each group.Both groups were given non-drug treatment according to RA diagnosis and treatment guidelines.And,the control group was given methotrexate tablets on the basis of basic treatment,10 mg each time,once a week.The observation group was given Qilong fengshi pill on the basis of the control group.After 12 weeks of treatment,the clinical efficacy,main symptoms and signs of the two groups were compared,including disease activity score for rheumatoid arthritis-28(DAS-28),numerical rating scale(NRS),average grip strength of both hands,morning stiffness time,erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),and levels of miR-146a,miR-155 and miR-124a in peripheral blood.Results The total effective rate of the observation group was significantly higher than that of the control group[94.87%(37/39)vs 74.36%(29/39)](P<0.05).After 12 weeks of treatment,the DAS-28 and NRS scores of the two groups were significantly decreased,the average grip strength of both hands was significantly increased,and the morning stiffness time was shortened(P<0.05);and the DAS-28 and NRS scores of the observation group were lower than those of the control group,the average grip strength of both hands was greater than that of the control group,and the morning stiffness time was shorter than that of the control group(P<0.05).After 12 weeks of treatment,the levels of ESR and RF in the two groups decreased significantly(P<0.05),and the levels of ESR and RF in the observation group were lower than those in the control group(P<0.05).After 12 weeks of treatment,the levels of miR-146a,miR-155 and miR-124a in peripheral blood of the two groups were significantly decreased(P<0.05),and the levels of miR-146a,miR-155 and miR-124a in the observation group were lower than those in the control group(10.4±1.8 vs 12.8±3.1,21.6±3.3 vs 30.0±4.1,16.8±2.2 vs 21.3±3.2)(P<0.05).Conclusion Qilong fengshi pill combined with methotrexate is effective in the treatment of RA,and the therapeutic effect may be related to the regulation of the levels of miR-146a,miR-155 and miR-124a in peripheral blood.
作者
刘锐
刘秋红
李晶晶
赵琳
徐薇薇
LIU Rui;LIU Qiuhong;LI Jingjing;ZHAO Lin;XU Weiwei(Department of Rheumatism,Suzhou Traditional Chinese Medicine Hospital,Suzhou 215009,China)
出处
《医学综述》
2019年第23期4752-4756,共5页
Medical Recapitulate
基金
苏州市科技计划项目(SYS201655)
关键词
类风湿关节炎
芪龙风湿丸
甲氨蝶呤
Rheumatoid arthritis
Qilong fengshi pill
Methotrexate
