摘要
目的：探讨中药蜡疗止痛技术治疗风寒湿痹型类风湿关节炎的临床疗效，并观察中药蜡疗对血清MMP-3、OPG及RANKL的影响及意义。方法：采用随机对照方法收集于2015年2月-2017年9月期间在本院风湿科治疗的类风湿关节炎患者132例，纳入符合观察标准的研究病例数100例，利用随机数字表法对所有患者进行编号，分为对照、观察组各50例；两组均采取中西医结合药物基础治疗，观察组在基础治疗基础上采用中药蜡疗止痛疗法。比较两组治疗前后的临床疗效改善情况、中医症状评分改善状况、基础血清生化学指标水平变化、特异性血清MMP-3、RANKL、OPG的水平变化来评价中药蜡疗止痛的临床治疗效果。结果：经治疗后，观察组治疗总有效率显著高于对照组总有效率，差异明显（P〈0．05）；治疗后，观察组中医症状评分降低明显优于对照组，差异明显（P〈0．05）；治疗后，两组患者基础血清生化学指标水平均较治疗前明显下降（P〈0．05），两组间比较，观察组下降更明显，差异明显（P〈0．05）；两组患者经治疗后血清MMP-3、RANKL水平较治疗前均明显降低（P〈0．05），血清OPG的含量较治疗前均明显升高（P〈0．05），观察组较对照组变化明显（P〈0．05）。结论：中药蜡疗能显著改善症状，提高类风湿关节炎治疗的临床疗效与预后；血清学指标MMP-3、RANKL、OPG可以用来预测类风湿关节炎患者疾病的严重程度及预后，可以根据检测结果对治疗效果进行评价，并作为评估类风湿关节炎病情严重程度的重要生化指标。
Objective ： To investigate the curative effect of traditional Chinese medicine paraffin on rheumatoid arthritis and observe the effect and significance on serum MMP -3, OPG and RANKL. Methods： A total of 132 patients with rheumatoid arthritis who were treated in our department of rheumatology between February 2015 and September 2017 were enrolled in the randomized controlled trial. A hundred cases were included in the study. All patients were divided into control group and observation group with 50 cases in each. Both groups were taken based on traditional Chinese and Western medicine treatment, the observation group based on the basic treatment of traditional Chinese medicine wax ther- apy analgesic therapy. The curative effect of traditional Chinese medicine wax therapy was compared between two groups before and after treatment to improve the clinical efficacy, improvement of symptom scores of Chinese medicine, basic se- rum biochemical indicators, serum specific levels of MMP - 3, RANKL and OPG. Results ： After treatment, the total ef- fective rate in the observation group was significantly higher than that in the control group （ P 〈 0. 05 ）. After treatment, the symptom score in the observation group was significantly lower than that in the control group（P 〈 0. 05 ）. After treat- ment, the baseline serum biochemical indexes in both groups were significantly lower than those before treatment （ P 〈 0. 05）, and the difference between the two groups was more obvious （ P 〈 0. 05 ）. The levels of serum MMP - 3 andRANKL were significantly lower than those before treatment（P 〈 0. 05 ）, and the content of OPG in serum was significant- ly higher than that before treatment （ P 〈 0. 05 ）. The changes in the observation group were more obvious than those in the control group （ P 〈 0. 05 ）. Conclusion ： Chinese medicine paraffin treatment can significantly improve the symptoms and the clinical curative effect and prognosis of rheumatoid arthritis. Serological markers MMP - 3, RANKL and OPG can be used to predict the severity and prognosis of rheumatoid arthritis patients. According to the test results ,we can evaluate the efficacy of the treatment and it serves as an important biochemical indicator for assessing the severity of rheumatoid arthritis.
作者
王晶
闻锐
WANG Jing;WEN Rui(Rheumatology and Rehabilitation Department,The Affiliated Hospital of Liaoning University of TCM,Shenyang 110032,Liaoning,China;The 4th People＇ s Hospital of Shenyang 110031,Liaoning,China)
出处
《中华中医药学刊》
CAS
北大核心
2018年第8期1868-1871,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家中医药管理局项目(201507006)
关键词
类风湿关节炎
中药蜡疗
风寒湿痹型
基质金属蛋白酶-3
炎症因子
rheumatoid arthritis
Chinese medicine paraffin
wind - cold - dampness type
matrix metalloproteinase -3 （ MMP - 3 ）
inflammatory factor
作者简介
王晶（1981-），女，辽宁沈阳人，主治医师，硕士，研究方向：风湿免疫疾病，擅长应用中医传统疗法治疗类风湿关节炎、干燥综合征、痛风性关节炎、骨关节炎等免疫科常见疾病。;通讯作者：闻锐（1968-），女，辽宁沈阳人，主任医师，学士，研究方向：风湿免疫疾病中西医结合诊治。
