【摘要】 目的探讨阳和汤治疗类风湿性关节炎伴骨关节损伤的临床疗效及作用机制。方法研究对象为我院骨伤科符合纳入标准且确诊为类风湿性关节炎伴骨关节损伤患者74例,按随机数字表法分组,每组37例,对照组予以西医治疗,研究组在西医治疗基础上联合阳和汤加减治疗,测定关节液和血清学指标,同时对比临床疗效。结果相对于治疗前,2组治疗后关节液TNF-α、IL-6及IL-1β降低,关节液SOD升高,MDA、NO降低,血清ESR、OPG及RF降低,血清补体和免疫球蛋白含量降低(P<0.05);相对于对照组,研究组治疗后关节液TNF-α、IL-6及IL-1β较低,关节液SOD较高,MDA、NO较低,血清ESR、OPG及RF较低,血清补体和免疫球蛋白含量较低(P<0.05),且对照组有效率72.97%低于研究组有效率91.89%(P<0.05)。结论阳和汤加减治疗类风湿性关节炎伴骨关节损伤疗效确切,其作用机制与降低炎症指标及氧化应激指标,提高免疫功能关系密切。更多还原

【Abstract】 Objective To investigate the clinical effect and mechanism of Yanghe decoction in the treatment of rheumatoid arthritis with bone and joint injury. Methods 74 cases of rheumatoid arthritis with bone and joint injury from the orthopedics department of our hospital were selected and randomly divided into 2 groups, 37 cases each. Control group received western medicine treatment, and study group were treated on the based of western medicine combined with Yanghe decoction treatment, indexes in synovial fluid and serum markers were detected and clinical effect were compared after the treatment. Results Compared with before treatment, levels of TNF-α, IL-6 and IL-1β in synovial fluid decreased in 2 groups after treatment, levels of SOD increased, MDA and NO decreased, levels of serum ESR, OPG and RF decreased, levels of complement and immunoglobulin in serum decreased, all above differences were statistically significant(P <0.05); Compared with the control group, levels of TNF-α, IL-6 and IL-1β in synovial fluid in the study group were lower, levels of SOD were higher, MDA and NO were lower, levels of serum ESR, OPG and RF were lower, levels of complement and immunoglobulin in serum were lower, all above differences were statistically significant(P <0.05), the clinical effective rates in the control group(72.97%) was lower than the study group(91.89%)(P <0.05). Conclusion Yanghe decoction in the treatment of rheumatoid arthritis with bone and joint injury was curative effective, and its mechanism may reduce the indexes of oxidative stress and inflammation, improve the immune function of close relationship.更多还原