2018 年第 3 期 第 13 卷

清热解毒通络汤联合塞来昔布对骨关节炎患者血清相关炎性因子水平的影响

Effect of heat-clearing and detoxifying soup combined with celecoxib on serum inflammatory factors in patients with osteoarthritis

作者：梁治权顾文飞廖军

英文作者：

单位：830000乌鲁木齐，新疆医科大学附属中医医院骨二科（梁治权、廖军），脊柱一科（顾文飞）

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• 摘要：

• 目的    探讨清热解毒通络汤联合塞来昔布对骨关节炎患者血清相关炎性因子水平的影响。方法    将2014年3月至2017年3月入住新疆医科大学附属中医医院的90例骨关节炎患者按照随机数字表法分为对照组与观察组，各45例。对照组口服塞来昔布治疗，200 mg/次，1次/d，治疗4周；观察组在对照组基础上联合清热解毒通络汤治疗，1剂/d，400 ml分早、晚2次服用，治疗4周。比较2组治疗4周后临床疗效、治疗前后Lequesne指数及疼痛视觉模拟量表（VAS）评分、血清白细胞介素1β（IL-1β）及肿瘤坏死因子α（TNF-α）水平。结果    观察组治疗4周后总有效率明显高于对照组［88.9%（40/45）比73.3%（33/45）］，差异有统计学意义（P＜0.05）。治疗前，2组患者Lequesne指数及VAS评分比较，差异均无统计学意义（均P＞0.05）；治疗后，观察组与对照组患者Lequesne指数及VAS评分均明显低于治疗前［观察组：（4.4±1.1）分比（9.4±1.8）分，t=8.998,P=0.014；（2.2±0.5）分比（6.4±1.3）分，t=12.102,P=0.009；对照组：（6.6±1.2）分比（9.4±1.6）分，t=3.729,P=0.033；（3.9±0.8）分比（6.4±1.2）分，t=5.182,P=0.028］，且观察组患者Lequesne指数及VAS评分均明显低于对照组（t=3.335,P=0.040；t=4.397,P=0.031）。治疗前，2组患者血清IL-1β及TNF-α水平比较，差异均无统计学意义（均P＞0.05）；治疗后，观察组与对照组患者血清IL-1β及TNF-α水平均明显低于治疗前［观察组：（44±5）ng/L比（77±11）ng/L，t=6.738,P=0.021；（33±6）ng/L比（64±9）ng/L，t=11.398,P=0.010；对照组：（59±7）ng/L比（77±10）ng/L，t=3.656,P=0.034；（53±9）ng/L比（64±9）ng/L，t=3.023,P=0.045］，且观察组患者血清IL-1β 及TNF-α水平均明显低于对照组（t=3.550,P=0.038；t=3.378,P=0.037）。结论    清热解毒通络汤联合塞来昔布治疗骨关节炎的临床效果明显，可有效降低血清相关炎性因子水平。    

• Objective    To investigate the effect of heat-clearing and detoxifying soup combined with celecoxib on serum inflammatory factors in patients with osteoarthritis. Methods    Ninety patients with osteoarthritis admitted in Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University from March 2014 to March 2017 were randomly divided into control group and observation group, with 45 cases in each group. Patients in control group took celecoxib 200 mg/time, 1 time/d for 4 weeks; patients in observation group took Chinese medicine heat-clearing and detoxifying soup 1 dose/d (400 ml, twice daily in the morning and evening) for 4 weeks based on the same treatment in control group. Curative effect, Lequesne index, score of the Visual Analogue Scale(VAS) for pain, levels of serum interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) were analyzed. Results    The curative effect in observation group was significantly higher than that in control group［88.9%（40/45） vs 73.3%（33/45）］（P＜0.05）. There were no significant differences of Lequesne index and VAS score between groups before treatment(P＞0.05); Lequesne index and VAS score after treatment were significantly lower than those before treatment in both groups［observation group： （4.4±1.1）points vs （9.4±1.8）points, t=8.998, P=0.014； （2.2±0.5）points vs （6.4±1.3）points, t=12.102, P=0.009; control group： （6.6±1.2）points vs （9.4±1.6）points, t=3.729, P=0.033; （3.9±0.8）points vs （6.4±1.2）points, t=5.182, P=0.028］ and there were significant differences between groups（t=3.335, P=0.040; t=4.397, P=0.031）. There were no significant differences of serum levels of IL-1β and TNF-α between groups before treatment(P＞0.05); after treatment, levels of IL-1β and TNF-α in both groups were significantly lower than those before treatment［observation group： （44±5）ng/L vs （77±11）ng/L, t=6.738, P=0.021； （33±6）ng/L vs （64±9）ng/L, t=11.398, P=0.010； control group： （59±7）ng/L vs （77±10）ng/L, t=3.656, P=0.034； （53±9）ng/L vs （64±9）ng/L, t=3.023, P=0.045］; the levels in observation group were significantly lower than those in control group（t=3.550, P=0.038； t=3.378, P=0.037）. Conclusion    Heat-clearing and detoxifying soup combined with celecoxib can effectively reduce the level of serum inflammatory factors in patients with osteoarthritis.