[1]帅波 沈霖△ 马陈 杨艳萍 卢芙蓉 廖奕 陈升浩 易剑华 赵莹 蔡珣.尪痹片联合甲氨蝶呤片对类风湿性关节炎患者血清DKK-1及关节滑膜侵蚀的影响[J].中国中医骨伤科杂志,2020,28(06):16-20.
　SHUAI Bo SHEN Lin MA Chen YANG Yanping LU Furong LIAO YiCHEN Shenghao YI Jianhua ZHAO Ying CAI Xun.Effect of Wangbi Pill Combined with Methotrexate on Serum DKK-1Expression and Synovial Erosion in Patients with Rheumatoid Arthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(06):16-20.
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尪痹片联合甲氨蝶呤片对类风湿性关节炎患者血清DKK-1及关节滑膜侵蚀的影响()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年06期
页码:
16-20
栏目:
临床研究
出版日期:
2020-06-10

文章信息/Info

Title:
Effect of Wangbi Pill Combined with Methotrexate on Serum DKK-1Expression and Synovial Erosion in Patients with Rheumatoid Arthritis
文章编号:
1005-0205(2020)06-0016-05
作者:
帅波1 沈霖1△ 马陈1 杨艳萍1 卢芙蓉1 廖奕1 陈升浩2 易剑华2 赵莹3 蔡珣3
1华中科技大学同济医学院附属协和医院中西医结合科(武汉,430022)2随州市中心医院骨科3武汉市江夏区第一人民医院(协和江南医院)
Author(s):
SHUAI Bo1 SHEN Lin1△ MA Chen1 YANG Yanping1 LU Furong1 LIAO Yi1CHEN Shenghao2 YI Jianhua2 ZHAO Ying3 CAI Xun3
1Department of Integrated Traditional Chinese Medicine and Western Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China; 2Department of Orthopaedics,Suizhou Central Hospital,Suizhou 441300,Hubei China; 3First People’s Hospital of Wuhan Jiangxia District(Union Hospital of Jiangnan),Wuhan 430200,China.
关键词:
类风湿性关节炎;  Dickkopf-1蛋白;  骨侵蚀
Keywords:
rheumatoid arthritis;  dickkopf-1 protein;  bone invasion
分类号:
R684.3
文献标志码:
A
摘要:
目的:探讨中药尪痹片联合甲氨蝶呤片对类风湿性关节炎(RA)患者Dickkopf-1蛋白(DKK-1)表达水平及关节滑膜侵蚀的影响。方法:纳入48例符合标准的RA患者,随机编码表法分为研究组和对照组:研究组给予甲氨蝶呤片10 mg/次,1次/周,结合尪痹片(0.5 g/片),4片/次,3次/日; 对照组给予同等剂量的甲氨蝶呤片及尪痹片模拟剂。两组均治疗24周。根据病情使用临时止痛药:对乙酰氨基酚,一次1片(0.5 g/片),1 d用量不超过4片,每周使用不超过2 d。治疗24周后,检测比较患者治疗前后循环血血沉(ESR),类风湿因子(RF),C反应蛋白(CRP),抗环化瓜氨酸多肽(CCP)抗体,DDK-1表达水平及DAS28-ESR评分、Sharp评分、MRI骨侵蚀比例评分、水肿容量评分、关节滑膜炎评分。结果:治疗前两组患者的ESR,CRP,CCP,RF,DKK-1,DSA28-ESR,Sharp评分,MRI骨侵蚀评分、骨髓水肿评分及滑膜炎评分差异无统计学意义(P>0.05)。治疗后治疗组ESR,CRP,CCP,RF,DKK-1,DSA28-ESR,MRI滑膜炎评分均较治疗前明显下降(P<0.05)。对照组治疗后ESR,CRP,CCP,DSA28-ESR,MRI滑膜炎评分均较治疗前明显下降(P<0.05)。两组治疗后Sharp评分、MRI骨侵蚀评分及骨髓水肿评分较治疗前差异无统计学意义(P>0.05),治疗后组间比较差异也无统计学意义(P>0.05)。对照组治疗后RF及DKK-1较治疗前差异无统计学意义(P>0.05)。治疗后治疗组CCP,RF,DKK-1及DSA28-ESR与对照组比较差异有统计学意义(P<0.05),且治疗后治疗组ΔDAS-ESR疗效明显优于对照组(P<0.05)。结论:中药尪痹片联合甲氨蝶呤片可明显降低RA患者DDK-1表达水平,从而缓解关节滑膜侵蚀破坏作用,比单独使用甲氨蝶呤片更具优势,值得临床推广应用。
Abstract:
Objective:To investigate the effect of Wangbi pill combined with methotrexate on the expression of Dickkopf-1 protein(DKK-1)and synovial erosion in patients with rheumatoid arthritis(RA).Methods:All 48 RA patients were randomly divided into study group and control group:the study group was given methotrexate 10 mg/time,1 time/week,combined with Wangbi pill(0.5 g/tablet),4 tablets/time,3 times/d; the control group was given the same dose of methotrexate and Wangbi pill simulant.Both groups were treated for 24 weeks.Use temporary painkillers according to the condition:acetaminophen,1 tablet(0.5 g/tablet)at a time,the daily dosage was not more than 4 tablets,and the weekly dosage was not more than 2 d.After 24 weeks of treatment,the changes of ESR,RF,CRP,anti CCP antibody and DDK-1 expression in the circulating blood,the DAS28-ESR score,Sharp score,MRI bone erosion ratio score,edema volume score and synovitis score were compared before and after treatment.Results:There was no significant difference in ESR,CRP,CCP,RF,DKK-1,DAS28-ESR,Sharp score,MRI bone erosion score,bone marrow edema score and synovitis score between the two groups(P>0.05).The scores of ESR,CRP,CCP,RF,DKK-1,DAS28-ESR and MRI synovitis score in the treatment group were significantly lower than those before treatment(P<0.05).The level of ESR,CRP,CCP,DAS28-ESR and MRI synovitis score in the control group were significantly lower than those before treatment(P<0.05).There was no significant difference in sharp score,MRI bone erosion score and bone marrow edema score between the two groups after treatment(P>0.05),and there was no significant difference between the two groups after treatment(P>0.05).There was no significant difference in level of RF and DKK-1 between the two groups(P>0.05).After treatment,there were significant differences in CCP,RF,DKK-1 and DAS28-ESR between the treatment group and the control group(P<0.05),and the effect of DAS28-ESR in the treatment group was significantly better than that in the control group(P<0.05).Conclusion:The combination of traditional Chinese medicine and methotrexate can significantly reduce the expression level of DDK-1 in RA patients,so as to alleviate the damage of synovium erosion.It has more advantages than methotrexate alone,so it is worthy of clinical application.

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备注/Memo

备注/Memo:
(收稿日期:2020-01-09)基金项目:重大新药创制项目(2014ZX09201021-010); 国家自然科学基金(81473492,81974546); 华中科技大学自主创新-人才培养基金(2019kfyRCPY093)△通信作者 E-mail:shenlinhb@sina.cn
更新日期/Last Update: 2020-06-10