摘要
目的 :观察健脾化湿通络中药新风胶囊 (XFC)治疗活动期类风湿性关节炎 (RA)的临床疗效 ,并探讨其作用机制。方法 :4 0例活动期RA患者随机分为 2组 ,治疗组 2 0例采用XFC ,对照组 2 0例采用雷公藤多苷片 ,两组均以 3个月为 1个疗程 ,均治疗 1个疗程 ,观察临床疗效及C反应蛋白、类风湿因子、CD4 + 、CD8+ 、CD4 + /CD8+ 、细胞因子 (IL 1、TNFα、IL 4、IL 10 )及血管内皮生长因子 (VEGF)等指标的变化。结果 :XFC在总有效率、改善活动期RA关节症状及部分实验室指标方面与雷公藤多苷片作用相似 ,但在改善全身症状及治疗脾虚湿盛、血瘀证候 ,调节CD4 + /CD8+ ,调整细胞因子平衡及降低VEGF方面显著优于雷公藤多苷片 ;而且XFC药物不良反应 (如食欲减退、腹胀、腹泻 )的积分值显著低于对照组。结论 :XFC可综合改善活动期RA的关节及全身病变 ,无不良反应 ,其作用机制是调节T细胞免疫功能 ,下调致炎因子 ,上调抑炎因子 ,降低血管通透性 ,抑制血管增生 。
Objective:To observe the clinical effects of Xinfeng capsule (XFC), a traditional Chinese prescription for invigorating the spleen Qi, removing dampness and obstruction in the channels, in treating rheumatoid arthritis (RA) in active stage, and explore the mechanism. Method: 40 cases of RA were randomly divided into two groups. The treatment group (n=20) was treated with XFC for three months as a therapeutic course, and the control group (n=20) with tripterygium wilfordii polycoside tablet (TPT) for three months as a therapeutic course. Two groups were all treated for one course. The targets including clinical effects, C reactive protein, rheumatoid factor, CD4 +, CD8 +, CD4 +/CD8 + ratio, cytokin(CK), vascular endothelial growth factor (VEGF) were observed. Result: The effects of XFC were similar to that of TPT in the total effective rate, improving the joint symptoms, et al. But the XFC was superior to TPT in improving general symptoms of the patients with RA, regulating CD4 +/ CD8 + ratio and CK and reducing VEGF. The integrals of side effects such as poor appetite, abdominal distention and diarrhea in XFC group were lower than those in TPT group. Conclusion: XFC is able to improve the joint and general symptoms in the patients with RA in active stage, and has no side effects. The mechanism may relate to regulating the function of T lymphocyte, down regulating interleukin 1, tumor necrosis factor α and up regulating interleukin 4, interleukin 10, restraining the hyperplasia of blood vessel, reducing the permeability of blood vessel, improving the microcirculation and protecting the gastric mucosa.
出处
《安徽中医学院学报》
CAS
2003年第3期12-16,共5页
Journal of Anhui Traditional Chinese Medical College
基金
国家卫生部优秀青年科技基金资助项目 (992 6 )
关键词
活动期类风湿性关节炎
新风胶囊
治疗
中医药疗法
Rheumatoid arthritis
Xinfeng capsule
Tripterygium wilfordii polycoside tablet
Immune function
Cytokin
Vascular endothelial growth factor
