黑地雷方联合艾瑞昔布治疗风湿热痹型骨关节炎的疗效OACSTPCD
Clinical effect of Heidilei Decoction combined with imrecoxib on osteoarthritis with wind dampness heat Bi syndrome
目的 观察黑地雷方联合艾瑞昔布治疗风湿热痹型骨关节炎的临床疗效,评价其对基质金属蛋白酶 9(MMP-9)及组织金属蛋白酶抑制因子 1(TIMP-1)的影响.方法 选取 2021-04 至 2023-04 在武警北京总队医院外二科就诊的风湿热痹型骨关节炎患者 63 例,随机分为对照组(艾瑞昔布片,n=31)和联合治疗组(黑地雷方+艾瑞昔布片,n=32),疗程 4 周,进行疼痛视觉模拟量表(VAS)、加拿大西安大略—麦克马斯特大学骨关节炎评分(WOMAC)、奎森膝关节功能演算指数(Lequesne)等判定,计算临床疗效及总有效率,取患者血清测定MMP-9、TIMP-1含量及MMP-9/TIMP-1比值,并监测两组患者治疗期间的不良反应及随访 6 个月内的疾病复发率.结果 联合治疗组患者总有效率为 90.6％,与对照组的 80.6％比较差异有统计学意义(P<0.05);两组治疗后膝关节 VAS评分、WOMAC评分、Lequesne指数及血清 MMP-9 含量、TIMP-1 含量、MMP-9/TIMP-1比值均较治疗前显著降低(P<0.05 或 P<0.01);治疗后,联合治疗组膝关节 VAS 评分、WOMAC 评分、Lequesne指数及血清MMP-9含量、TIMP-1 含量、MMP-9/TIMP-1 比值均低于治疗后对照组,组间差异均有统计学意义(P<0.01);联合治疗组不良反应发生率 12.4％,与对照组的 9.6％比较,差异无统计学意义(P>0.05);随访 6 个月内,联合治疗组复发率为10.3％,显著低于对照组的32.0％(P<0.05).结论 黑地雷方联合艾瑞昔布可有效缓解风湿热痹型骨关节炎症状,降低疾病复发率,可能与其调控MMPs及其抑制物TIMPs的动态平衡有关.
Objective To evaluate the clinical efficacy of of Heidilei Decoction combined with imrecoxib(CHDI)on osteoar-thritis with wind dampness heat Bi syndrome(OA-WDHB)and its effect on matrix metalloproteinases(MMPs)and tissue inhibitor of matrix metalloproteinases(TIMPs)expression.Methods A total of 63 OA-WDHB patients who attended the Beijing Municipal Corps Hospital of Chinese People's Armed Police Force from April 2021 to April 2023 were selected,and randomly divided into control group(treated with imrecoxib,n=31)and combined drugs group(treated with CHDI,n=32).After 4 weeks of treatment,the pain visual analogue scale(VAS),Western Ontario and McMaster Universities osteoarthritis index(WOMAC)and Lequesne algofunctional index(LAI)in knee joints of patients were evaluated,the improvement rate of clinical efficacy was calculated,and the MMP-9 and TIMP-1 expression and MMP-9/TIMP-1 in serum were detected.The adverse reactions of the two groups during the treatment and dis-ease recurrence within 6 months of follow-up were monitored.Results The clinical efficacy rate in CHDI group(90.6％)were notably elevated as compared to the control group(80.6％)(P<0.05).The VAS,WOMAC,LAI,serum MMP-9 and TIMP-1 expression and MMP-9/TIMP-1 in post-treatment of both groups were evidently improved as compared to those in pre-treatment(P<0.05 or P<0.01).In comparison with the control group,the VAS,WOMAC,LAI,serum MMP-9 and TIMP-1 expression and MMP-9/TIMP-1 were significantly improved in CHDI group after the treatment(P<0.01).The incidence of adverse reactions in CHDI group was 12.4％,which was not statistically significant when compared with 9.6％in the control group(P>0.05).The recurrence rate in CH-DI group was 10.3％during the follow-up,which was significantly lower than that in the control group,which was 32.0％(P<0.05).Conclusions The efficacy of CHDI in improving the OA-WDHB symptoms and reducing the disease recurrence rate may be related to its ability to modulate the dynamic balance of MMPs and their inhibitors,TIMPs.
黄楠;张军;武永刚;郭浩;余磊;梁宏伟;赵宝峰
100027,武警北京总队医院外二科
临床医学
骨关节炎风湿热痹黑地雷方基质金属蛋白酶9组织金属蛋白酶抑制因子1
osteoarthritiswind dampness heat Bi syndromeHeidilei Decoctionmatrix metalloproteinase-9tissue inhibitor of matrix metalloproteinases-1
《武警医学》 2024 (002)
121-124,129 / 5
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