摘要
目的探讨银苓消肿丸联合碳酸氢钠在痛风性关节炎治疗中的效果及可能机制。方法选取2022年7月至2023年7月该院收治的98例痛风性关节炎患者为研究对象,按照随机数字表法分为对照组与研究组,每组49例,对照组采用碳酸氢钠治疗,研究组在碳酸氢钠基础上联合银苓消肿丸治疗,比较两组临床疗效、关节疼痛、肿胀及活动障碍评分[关节压痛疼痛视觉模拟评分(VAS)、肿胀、活动障碍];比较两组骨破坏因子[破骨细胞分化因子(RANKL)、抗酒石酸酸性磷酸酶-5b(TRACP-5b)、β-胶联降解产物(β-CTX)]、炎症因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]、核转录因子-κB(NF-κB)、Nod样受体蛋白3(NLRP3)水平,以及不良反应(消化不良、头晕、血压升高、肌肉疼痛)发生情况。结果研究组、对照组总有效率分别为95.92%、77.55%,研究组明显高于对照组,差异有统计学意义(χ^(2)=7.184,P=0.007)。治疗后,两组VAS、肿胀、活动障碍评分均降低,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组RANKL、TRACP-5b、β-CTX水平均降低,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组IL-1β、TNF-α、NF-κB、NLRP3水平均降低,且研究组低于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在痛风性关节炎的治疗中应用银苓消肿丸联合碳酸氢钠能够改善关节症状及功能,降低炎症因子水平,有效调节NLRP3、NF-κB信号通路,临床应用价值较高,值得推广。
Objective To investigate the effect and possible mechanism of Yinling Xiaozhong pill combined with sodium bicarbonate in the treatment of gouty arthritis.Methods A total of 98 patients with gouty arthritis admitted to Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from July 2022 to July 2023 were selected as the research objects,and were divided into control group and study group according to the random number table method,with 49 cases in each group.The control group was treated with sodium bicarbonate,and the study group was treated with Yinling Xiaozhong pill on the basis of sodium bicarbonate.The clinical efficacy,pain,swelling and mobility disability scores[visual analogue scale(VAS)score of joint tenderness and pain,swelling,mobility disorder],bone destruction factors[osteoclast differentiation factor(RANKL),tartrate-resistant acid phosphatase-5b(TRACP-5b),β-collagen degradation product(β-CTX)],inflammatory factors[interleukin-1β(Il-1β),tumor necrosis factor-α(TNF-α)]and nuclear transcription factor-κb(NF-κB),NOD-like receptor protein 3(NLRP3)expression level,occurrence of adverse reactions(dyspepsia,dizziness,increased blood pressure,muscle pain)were compared between the two groups.Results The total effective rate of the study group and the control group were 95.92%and 77.55%respectively,which in the study group was significantly higher than that in the control group,the difference was statistically significant(χ^(2)=7.184,P=0.007).After treatment,the VAS,swelling and mobility disorder scores of the two groups decreased(P<0.05),and those of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,the levels of RANKL,TRACP-5b andβ-CTX in the two groups decreased,and those in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of IL-1β,TNF-α,NF-κB and NLRP3 in the two groups decreased,and those in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference on the incidence rates of adverse reactions between the two groups(P>0.05).Conclusion Yinling Xiaozhong pill combined with sodium bicarbonate in the treatment of gouty arthritis can improve joint symptoms and function,reduce the level of inflammatory factors,effectively regulate NLRP3,NF-κB signaling pathway,and has high clinical application value,which is worthy of promotion.
作者
武晔
王晓磊
刘丹
郭圆圆
王金
侯艳辉
胡丽伟
刘文雅
WU Ye;WANG Xiaolei;LIU Dan;GUO Yuanyuan;WANG Jin;HOU Yanhui;HU Liwei;LIU Wenya(Department of Rheumatology,Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou,Hebei 061000,China;Hebei Key Laboratory of Integrated Traditional Chinese and Western Medicine Osteoarthropathy Research,Cangzhou,Hebei 06100,China)
出处
《检验医学与临床》
CAS
2024年第10期1387-1390,1395,共5页
Laboratory Medicine and Clinic
基金
河北省中医药类科学研究课题计划项目(2024465)。
关键词
痛风性关节炎
银苓消肿丸
碳酸氢钠
骨破坏因子
Nod样受体蛋白3
gouty arthritis
Yinling Xiaozhong pill
sodium bicarbonate
bone destruction factors
nod-like receptor protein 3
