神经药理学报 ›› 2023, Vol. 13 ›› Issue (2): 30-.DOI: 10.3969/j.issn.2095-1396.2023.02.005

• 研究论文 • 上一篇    下一篇

肌骨超声评估白芍总苷治疗类风湿关节炎的临床研究

刘红杰,皮天龙,王钢,荣铁成,穆桂瑶,田杰祥   

  1. 1.张家口市第二医院,张家口,075000,中国

    2.甘肃中医药大学附属医院,兰州,730000,中国

  • 出版日期:2023-04-26 发布日期:2023-11-30
  • 通讯作者: 王钢,主任医师,博士研究生导师;研究方向:主要从事中西医结合防治风湿骨病研究
  • 作者简介:刘红杰,硕士研究生,研究方向:中西医结合防治风湿骨病研究;E-mail:505173170@qq.com
  • 基金资助:
    国家自然科学基金项目(No.81960832),河北省中医药管理局项目(No.2022530)

Musculoskeletal Ultrasound Evaluation of A Clinical Study of TGP in the Treatment of Rheumatoid Arthritis

LIU Hong-jie, PI Tian-long, WANG Gang, RONG Tie-cheng, MU Gui-yao, TIAN Jie-xiang   

  1. 1. Zhangjiakou NO.2 hospital, Zhangjiakou, 075000, China  2. The Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, 730000, China
  • Online:2023-04-26 Published:2023-11-30

摘要:

目的:通过应用肌骨超声探讨白芍总苷(total glucosides of paeony, TGP)对类风湿关节炎(rheumatoid arthritis, RA)患者骨破坏的临床疗效。方法:选取2021年7月至2023年7月张家口市第二医院住院及门诊符合诊断标准的类风湿关节炎患者56例,按随机数字表法随机分为治疗组和对照组各28例,对照组给予口服甲氨蝶呤,治疗组在此基础上加用白芍总苷,疗程12周,观察治疗前后两组患者红细胞沉降率(erythrocyte sedimentation rate, ESR)、C-反应蛋白(C-reaction protein, CRP)等炎症指标,通过ACR20/50/70评价两组患者治疗后的疗效,肌骨超声检测患者关节滑膜增生、滑膜内血流信号、骨侵蚀及关节积液等。比较两组患者治疗前后及组间上述指标的变化。结果:① 治疗组ACR20/50/70达标率高于对照组,两组患者的炎性指标ESR、CRP均较治疗前降低,但治疗组明显高于对照组;② 与治疗前相比,两组患者滑膜增生、关节腔积液、滑膜血流均降低,治疗组降低较为明显,差异有统计学意义,治疗前后骨破坏差异无统计学意义。结论:白芍总苷可提高达标率,减轻类风湿关节炎患者急性期症状,抑制炎症反应,保护关节,防治RA骨破坏,延缓类风湿关节炎病程进展。

关键词: 类风湿关节炎, 肌骨超声, 白芍总苷, 7关节超声评分法

Abstract:

Objective: To investigate the clinical effect of TGP on bone destruction in patients with Rheumatoid Arthritis (RA) by musculoskeletal ultrasound. Methods: A total of 56 patients with rheumatoid arthritis who were admitted to our hospital from 2021-07 to 2023-07 and were randomly divided into the treatment group and the control group with 28 patients in each group according to the random number table method. The control group was treated with methotrexate, and the treatment group was treated with methotrexate and TGP for 12 weeks. Inflammatory indicators such as ESR and CRP were observed before and after treatment. The Clinical effect of the two groups was evaluated by ACR20/50/70. Musculoskeletal ultrasound was used to detect synovial, the synovium blood flow signal, bone erosion and joint effusion. The above indexes were compared between the two groups before and after treatment. Results: ① The control rate of ACR20/50/70 in the treatment group was higher than that in the control group, and the inflammatory indexes ESR and CRP in both groups were lower than before treatment, but the treatment group was significantly higher than the control group. ② Compared with before treatment, synovial, articular effusion and synovial blood flow were all decreased in 2 groups, and the decrease was more obvious in the treatment group, the difference was statistically significant, while there was no statistically significant difference in bone destruction before and after treatment. Conclusion:TGP can improve the standard reaching rate, reduce the symptoms of patients with rheumatoid arthritis in the acute phase, inhibit inflammatory response, protect joints, prevent RA bone damage, and delay the progression of rheumatoid arthritis.

Key words: rheumatoid arthritis, musculoskeletal ultrasound, TGP, 7-joint  , ultrasound score