摘要
目的:探讨枸橼酸托法替布片联合仙灵骨葆胶囊对类风湿性关节炎(RA)合并骨质疏松患者血清炎症细胞因子、骨强度及骨代谢水平影响。方法:纳入2021年8月至2022年8月期间徐州医科大学附属连云港医院诊治的80例RA合并骨质疏松患者。根据随机数字表法将患者分为对照组(雷公藤多苷片联合仙灵骨葆胶囊治疗)和实验组(枸橼酸托法替布片联合仙灵骨葆胶囊治疗),各为40例。对比两组疗效、炎症细胞因子、骨强度及骨代谢指标,观察两组不良反应发生率。结果:实验组的临床总有效率高于对照组(P<0.05)。实验组治疗后巨噬细胞集落刺激因子(M-CSF)、白细胞介素-1β(IL-1β)、环氧合酶-2(COX-2)低于对照组同期(P<0.05)。实验组治疗后横截面积(CSA)、横截面转动惯量(CSMI)、截面系数(Z)、皮质厚度(CT)高于对照组同期(P<0.05)。实验组治疗后骨钙素N端中分子(N-MID)、总Ⅰ型胶原氨基端延长肽(T-PINP)、骨钙素(BGP)、Ⅰ型胶原羧基端前肽(PICP)高于对照组同期,β-胶原降解产物(β-CTX)低于对照组同期(P<0.05)。两组治疗后腰椎骨密度和股骨颈骨密度较治疗前升高,且实验组高于对照组同期(P<0.05)。两组治疗后血沉(ESR)、C反应蛋白(CRP)、类风湿关节炎患者病情(DAS28)评分下降,且实验组低于对照组同期(P<0.05)。两组不良反应发生率组间对比无统计学差异(P>0.05)。结论:枸橼酸托法替布片联合仙灵骨葆胶囊应用于RA合并骨质疏松患者,可有效调节骨代谢水平,增强骨强度,降低血清炎症细胞因子水平。
Objective:To investigate the effects of Tofacitinib citrate tablets combined with Xianling Gubao capsule on serum inflammatory cytokines,bone strength and bone metabolism levels in patients with rheumatoid arthritis(RA)complicated with osteoporosis.Methods:80 patients with RA complicated with osteoporosis who were diagnosed and treated in Lianyungang Hospital Affiliated to Xuzhou Medical University from August 2021 to August 2022 were included.The patients were divided into the control group(Tripterygium wilfordii polyglycosides tablets combined with Xianling Gubao capsule)and the experimental group(Tofacitinib citrate tablets combined with Xianling Gubao capsule)according to the random number table method,with 40 cases each.The efficacy,inflammatory cytokines,bone strength and bone metabolism indexes were compared in the two groups,and the incidence of adverse reactions was observed in the two groups.Results:The total clinical effective rate in the experimental group was higher than that in the control group(P<0.05).Macrophage colony-stimulating factor(M-CSF),interleukin-1β(IL-1β)and cyclooxygenase-2(COX-2)in the experimental group after treatment were lower than those in the control group(P<0.05).The cross sectional area(CSA),cross sectional moment of inertia(CSMI),cross sectional coefficient(Z)and cortical thickness(CT)in the experimental group after treatment were higher than those in the control group(P<0.05).After treatment,the N-terminal intermediate molecule of osteocalcin(N-MID),the amino terminal extension peptide(T-PINP),osteocalcin(BGP)and carboxyterminal propeptide of type I procollagen(PICP)in the experimental group were higher than those in the control group at the same period,and theβ-collagen degradation products(β-CTX)was lower than that in the control group at the same period(P<0.05).Lumbar spine BMD and femoral neck BMD increased after treatment in both groups compared with before treatment,and were higher in the experimental group than in the control group during the same period(P<0.05).Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid arthritis patient condition(DAS28)scores decreased in both treatment groups,and were lower in the experimental group than in the control group during the same period(P<0.05).There was no significant difference in the incidence of adverse reactions in the two groups(P>0.05).Conclusion:Tofacitinib citrate tablets combined with Xianling Gubao capsule is applied to the patients with RA with osteoporosis,which can effectively regulate the bone metabolism level,enhance bone strength and reduce the serum inflammatory cytokines level.
作者
邵平
薛艳艳
相婷
孙占娟
邵海燕
SHAO Ping;XUE Yan-yan^;XIANG Ting;SUN Zhan-juan;SHAO Hai-yan(Department of Rheumatology and Immunology,Lianyungang Hospital Affiliated to Xuzhou Medical University,Lianyungang,Jiangsu,222002,China)
出处
《现代生物医学进展》
CAS
2023年第11期2183-2187,共5页
Progress in Modern Biomedicine
基金
江苏省卫生计生委科研项目(H20170658)。
关键词
枸橼酸托法替布片
仙灵骨葆胶囊
类风湿性关节炎
骨质疏松
炎症细胞因子
骨强度
骨代谢
Tofacitinib citrate tablets
Xianling Gubao capsule
Rheumatoid arthritis
Osteoporosis
Inflammatory cytokines
Bone strength
Bone metabolism
