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目的:观察草木樨流浸膏片对HLA-B27阳性强直性脊柱炎(ankylosing spondylitis,AS)患者临床疗效及血清炎症因子的影响,探讨草木樨流浸膏片对AS的作用机制。方法:将40例HLA-B27阳性AS患者随机分为两组,试验组给予草木樨流浸膏片1mg/kg,tid,对照组给予双氯芬酸钠片1mg/kg,tid,分别于治疗前及治疗4后周评估患者病情活动性,采用酶联免疫法测定各受试者血清中炎症因子的浓度。结果:(1)治疗前,两组患者病情活动指标AS活动指数(BASDAI)、脊柱痛VAS评分、晨僵时间、ESR、CRP、胸廓扩张度、Schober试验、脊柱侧弯评价指标无显著差异;炎症因子水平无显著差异;(2)治疗4周后所有受试者病情明显改善,其中与对照组相比,草木樨流浸膏片1mg/kg(tid)组BASDI、Scober试验指标差异具有显著性,且胃肠道不良反应发生率(0/20)显著低于对照组(4/20);炎症因子TNF-α、IL-2、IL-6水平明显降低,草木樨流浸膏片1mg/kg(tid)组血清TNF-α、IL-6水平显著低于对照组。结论:草木樨流浸膏片对AS患者具有明显的临床疗效,其机制可能与调节患者炎症因子水平有关。
OBJECTIVE: To observe the clinical effect and the serum inflammatory cytokines in the patients with ankylosing spondylitis (HLA) B-26 infection and to explore the mechanism of action of the herbal medicine extract extract on AS. Methods: 40 cases of HLA-B27-positive AS patients were randomly divided into two groups. The experimental group was given Radix Aconiti Kusnezoffii extract 1mg / kg, tid, the control group was given diclofenac sodium tablets 1mg / kg, tid, respectively before treatment and treatment 4 weeks after the assessment of the patient’s disease activity, the use of enzyme-linked immunosorbent assay serum concentrations of inflammatory cytokines. Results: (1) There was no significant difference of ASDA (BASDAI), spinal VAS score, morning stiffness time, ESR, CRP, thoracic dilatation, Schober test and scoliosis before treatment in both groups. (2) After 4 weeks of treatment, the condition of all subjects improved obviously. Compared with the control group, the differences of BASDI and Scober indexes in 1mg / kg tid of the herb group were significant (0/20) in the gastrointestinal tract were significantly lower than those in the control group (4/20). The levels of inflammatory cytokines TNF-α, IL-2 and IL-6 were significantly decreased. / kg (tid) group serum TNF-α, IL-6 levels were significantly lower than the control group. Conclusion: Herba Epimedii Extract has obvious clinical curative effect on AS patients, and its mechanism may be related to the regulation of inflammatory cytokines in patients.