Clinical Observation of Yiqi Yangyin Tongbi Prescription on Rheumatoid Arthritis and Pulmonary Interstitial Lesions

WANG Hui-lian; LI Song-wei; WANG Ji-hua; MENG Qing-liang

doi:10.13422/j.cnki.syfjx.2017070185

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Clinical Observation of Yiqi Yangyin Tongbi Prescription on Rheumatoid Arthritis and Pulmonary Interstitial Lesions

更新时间：2024-01-04

- Clinical Observation of Yiqi Yangyin Tongbi Prescription on Rheumatoid Arthritis and Pulmonary Interstitial Lesions
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 23, Issue 7, Pages: 185-190(2017)
- 作者机构：
- 作者简介：
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- DOI：10.13422/j.cnki.syfjx.2017070185
  CLC： R259
- Published：2017
- 稿件说明：
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WANG Hui-lian, LI Song-wei, WANG Ji-hua, et al. Clinical Observation of Yiqi Yangyin Tongbi Prescription on Rheumatoid Arthritis and Pulmonary Interstitial Lesions[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(7): 185-190.
DOI：

WANG Hui-lian, LI Song-wei, WANG Ji-hua, et al. Clinical Observation of Yiqi Yangyin Tongbi Prescription on Rheumatoid Arthritis and Pulmonary Interstitial Lesions[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(7): 185-190. DOI： 10.13422/j.cnki.syfjx.2017070185.

摘要

目的：探讨益气养阴通痹方治疗类风湿关节炎合并肺间质病变（RA-ILD）的疗效及对血清基质金属蛋白酶-9（MMP-9），MMP-1，转化生长因子-β1（TGF-β1）和Ⅱ型肺泡表细胞表面抗原（KL-6）水平的影响。方法： 120例患者采用区组随机按数字表法分为对照组和观察组各60例。对照组口服塞来昔布胶囊，0.2 g/次，2次/d；和口服环磷酰胺片，100 mg/次，1次/隔日；和泼尼松龙片，30 mg/次，1次/d，晨服，起效后按规律减量。观察组在对照组治疗的基础上采用益气养阴通痹方内服，1剂/d，两组疗程均为6个月。进行治疗前后高分辨率CT（HRCT）检查及评分，进行治疗前后症状、体征评分；检测治疗前后肺功能，包括肺总量（TLC），用力肺活量（FVC），1秒用力肺活量（FEV1），每分钟肺泡最大通气量（MVV）和一氧化碳弥散量（DLCP）等指标；检测治疗前后MMP-9，MMP-1，TGF-β1和KL-6水平。结果：治疗后观察组HRCT评分和症状、体征评分均低于对照组（P<0.01）；治疗后观察组TLC，FVC，FEV1%，MVV和DLCP均高于对照组（P<0.05，P<0.01）；治疗后观察组血清MMP-9，TGF-β1和KL-6水平均低于对照组，MMP-1水平高于对照组（P<0.01）。结论：在免疫抑制剂和激素治疗的基础上，益气养阴通痹方能下降HRCT评分，减小肺间质病变的面积和程度，并能改善肺功能，减轻临床症状，其作用机制可能是通过调节患者的MMP-9，TGF-β1，KL-6和MMP-1等纤维化调节因子水平来实现的。

Abstract

Objective: To discuss the efficacy of Yiqi Yangyin Tongbi prescription for rheumatoid arthritis and pulmonary interstitial lesions (RA-ILD) and investigate its effects on serum matrix metalloproteinases-9 (MMP-9)

MMP-1

transforming growth factor-β1 (TGF-β1) and surface antigen of Ⅱ type alveolar table cells (KL-6). Method: One hundred and twenty patients were randomly divided into control group (60 cases) and observation group (60 cases) by random number table and randomized block design. Patients in control group orally took celecoxib capsules

0.2 g/time

2 times/day.Cyclophosphamide tablets

100 mg/time

1 time/every 2 days.Prednisolone tablets

30 mg/time

1 time/day on every morning

and the dose was decreased after taking effect. Based on the treatment of control group

patients in observation group added Yiqi Yangyin Tongbi prescription

1 dose/day. The treatment course was 6 months for both groups. Before and after treatment

high resolution-CT (HRCT) was conducted and graded

and symptoms and signs were graded. Lung function

total lung capacity (TLC)

forced vital capacity (FVC)

forced vital capacity per minute (FEV1)

maximal voluntary ventilation per minute (MVV) and carbon monoxide diffusion capacity (DLCO) were detected before and after treatment. Levels of MMP-9

MMP-1

TGF-β1 and KL-6 were detected before and after treatment. Result: After treatment

scores of HRCT

symptoms and signs of patients in observation group were lower than those in control group (P<0.01). Levels of TLC

FVC

FEV1%

MVV and DLCO in observation group were higher than those in control group after treatment (P<0.05

P<0.01).The levels of MMP-9

TGF-β1 and KL-6 were lower than those in control group

and level of MMP-1 was higher than that in control group (P<0.01). Conclusion: Yiqi Yangyin Tongbi prescription based on the immunosuppressive agents and hormone therapy can reduce score of HRCT

reduce area and degree of interstitial lung disease

ameliorate patients lung function

and relieve clinical symptoms. The mechanism may be associated with regulating levels of MMP-9

TGF-β1

KL-6 and MMP-1.

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