Clinical Observation on Xiao Huoluodan Combined with Guizhi Shaoyao Zhimu Tang for Rheumatic Arthritis with Stagnancy of Cold-dampness

ZHANG Pan-ke; WANG Fang; ZHANG Guo-sheng

doi:10.13422/j.cnki.syfjx.2017030181

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Clinical Observation on Xiao Huoluodan Combined with Guizhi Shaoyao Zhimu Tang for Rheumatic Arthritis with Stagnancy of Cold-dampness

更新时间：2024-01-04

- Clinical Observation on Xiao Huoluodan Combined with Guizhi Shaoyao Zhimu Tang for Rheumatic Arthritis with Stagnancy of Cold-dampness
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 23, Issue 3, Pages: 181-186(2017)
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- DOI：10.13422/j.cnki.syfjx.2017030181
  CLC： R255.6
- Published：2017
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ZHANG Pan-ke, WANG Fang, ZHANG Guo-sheng. Clinical Observation on Xiao Huoluodan Combined with Guizhi Shaoyao Zhimu Tang for Rheumatic Arthritis with Stagnancy of Cold-dampness[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(3): 181-186.
DOI：

ZHANG Pan-ke, WANG Fang, ZHANG Guo-sheng. Clinical Observation on Xiao Huoluodan Combined with Guizhi Shaoyao Zhimu Tang for Rheumatic Arthritis with Stagnancy of Cold-dampness[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(3): 181-186. DOI： 10.13422/j.cnki.syfjx.2017030181.

摘要

目的：观察小活络丹合桂枝芍药知母汤加减治疗风湿性关节炎寒湿痹阻证的临床疗效及对血清肿瘤坏死因子-α（TNF-α），白细胞介素-17，IL-27和IL-32的影响。方法：将122例患者随机分为西医组和联合组各61例。另选择15例健康受试者作为健康对照组。西医组口服尼美舒利片，0.1 g/次，2次/d；和来氟米特胶囊，20 mg/次，1 次/d，口服。联合组在西医组治疗的基础上加服小活络丹合桂枝芍药知母汤加减，1剂/d。两组疗程均为3个月。记录治疗前后关节压痛数、疼痛、肿胀、屈伸不利、晨僵情况、健康评价问卷评分（HAQ）；进行治疗前后寒湿痹阻证评分；检测治疗前后血沉（ESR），C-反应蛋白（CRP），类风湿因子（RF）水平；检测治疗前后IL-17，IL-27，IL-32和TNF-α水平。结果：治疗后联合组类风湿疗效评估ACR20为90.16%，高于西医组的68.85%，比较差异有统计学意义（χ2=8.502，P<0.01），联合组ACR50和ACR70均高于西医组，但组间比较，差异无统计学意义；联合组中医证候疗效总有效率为88.52%，高于对照组的67.21%，比较差异有统计学意义（χ2=8.038，P<0.01）；治疗后联合组关节疼痛、关节压痛数，屈伸不利、晨僵时间、肿胀程度和HAQ评分均低于西医组（P<0.01）；治疗后联合组ESR，CRP和RF水平低于西医组，28个关节活动度DAS28评分也低于西医组（P<0.01）；与健康对照组比较，治疗前两组病例血清IL-17，IL-27，IL-32和TNF-α均显著升高（P<0.01）；治疗后联合组IL-17，IL-27，IL-32和TNF-α水平均低于西医组（P<0.01），但仍高于健康对照组（P<0.01）。结论：小活络丹合桂枝芍药知母汤治疗寒湿痹阻型RA患者，能进一步的改善症状，控制疾病活动，提高临床疗效，并能下调IL-17，IL-27，IL-32和TNF-α等促炎因子。

Abstract

Objective: To observe the clinical efficacy of Xiao Huoluodan combined with Guizhi Shaoyao Zhimu Tang in treating rheumatic arthritis with stagnancy of cold-dampness and investigate its effects on levels of tumor necrosis factor-α(TNF-α)

interleukin-17

32 (IL-17

32). Method: One hundred and twenty-two patients were randomly divided into western medicine group (61 cases) and combination group (61 cases) by random number table. Another 15 healthy subjects were selected as healthy group. Patients in western medicine group took nimesulide tablet

0.1 g/time

2 times/day; leflunomide capsule

20 mg/time

1 time/day. Based on the treatment in western medicine group

patients in combination group added Xiao Huoluodan combined with Guizhi Shaoyao Zhimu Tang

1 dose/day. The treatment course was 3 months for both groups. Before and after treatment

tender joint count

pain

swelling

inhibited bending and stretching

morning stiffness and health assessment questionnaire (HAQ) were recorded; scores of stagnancy of cold-dampness were graded; levels of erythrocyte sedimentation rate (ESR)

C reactive protein (CRP)

rheumatoid factors (RF)

IL-17

IL-27

IL-32 and TNF-α. Result: After treatment

evaluation criteria for rheumatoid ACR20 was 90.16% in combination group

higher than 68.85% in western medicine group (χ2=8.502

P<0.01). ACR50 and ACR70 in combination group were higher than those in western medicine group

but there were no statistically significant differences between two groups. The total effective rate for traditional Chinese modicine(TCM) symptom was 88.52% in combination group

higher than 67.21% in western medicine group (χ2=8.038

P<0.01). The scores of tender joint count

pain

swelling

inhibited bending and stretching

morning stiffness and health assessment questionnaire (HAQ)

disease activity score in 28 joints(DAS28) scores

and levels of ESR

CRP and RF in combination group were lower than those in western medicine group after treatment (P<0.01). As compared with the healthy group

levels of IL-17

IL-27

IL-32 and TNF-α were higher in case groups before treatment (P<0.01). And after treatment

those levels in combination group were lower than those in western medicine group(P<0.01)

but still higher than those in healthy group (P<0.01). Conclusion: Xiao Huoluodan combined with Guizhi Shaoyao Zhimu Tang can ameliorate symptoms

control disease activity

improve clinical efficacy

and down-regulate the levels of IL-17

IL-27

IL-32 and TNF-α in the treatment of rheumatic arthritis with stagnancy of cold-dampness.

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