文章摘要
杜明瑞;赵哲;李秦;李华燕;王鑫;崔炎.加味四妙散对湿热痹阻型慢性痛风性关节炎炎症因子的影响及相关性分析[J].中医药信息,2024,41(5):56-63
加味四妙散对湿热痹阻型慢性痛风性关节炎炎症因子的影响及相关性分析
Influence of Modified Wonderfully Effective Four Powder on Inflammatory Factors and Correlation Analysis in Damp-Heat Stagnation Type Chronic Gouty Arthritis
  
DOI:10.19656/j.cnki.1002-2406.20240510
中文关键词: 慢性痛风性关节炎  炎症因子  加味四妙散  作用机制
英文关键词: Chronic gouty arthritis  Inflammatory factors  Modified Wonderfully Effective Four Powder  Mechanism of action
基金项目:
作者单位
杜明瑞;赵哲;李秦;李华燕;王鑫;崔炎  
摘要点击次数: 32
全文下载次数: 40
中文摘要:
      目的:通过分析慢性痛风与白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)与中医症状及临床指标间存在的关联性,探究加味四妙散治疗慢性痛风的作用机制。方法:60例符合纳入标准的湿热痹阻型慢性痛风性关节炎患者,依据随机数字表随机分为观察组和对照组各30例,同时设健康组30例。对照组给予口服非布司他治疗;观察组在对照组的基础上联合加味四妙散治疗,治疗周期为4周。观察患者一般临床资料、中医症状积分、生化学指标,同时采用酶联免疫吸附法(ELISA)测定IL-1β、TNF-α和IL-6水平,分析IL-1β、IL-6、TNF-α与中医证候积分及生化学指标的相关性。结果:与健康组相比,慢性痛风患者IL-1β、TNF-α、IL-6水平显著升高(P <0.01);慢性痛风患者关节疼痛、关节肿胀、大便黏滞及舌象与IL-1β、TNF-α和IL-6呈正相关,关节压痛、关节发热及身体倦怠与IL-1β、TNF-α呈正相关;黏腻、口苦及小便与TNF-α呈正相关,脉象与IL-1β呈正相关,IL-1β与FPG、TC、ESR、VAS评分呈正相关,TNF-α与BMI、UA、HDL、ESR、VAS评分呈正相关,与HDL呈负相关,IL-6与SBP、UA、CRP呈正相关(P <0.05,P <0.01);两组患者治疗后组内比较,IL-1β、TNF-α和IL-6水平显著降低(P <0.01),组间比较,观察组IL-1β水平较治疗组显著降低(P <0.05);与本组治疗前比较,两组患者关节疼痛,关节压痛,关节肿胀,关节发热,活动障碍,身困倦怠,黏腻、口苦,小便黄赤,舌象中医症状评分均明显降低(P <0.05,P <0.01)。与对照组治疗后比较,观察组患者关节发热,身困倦怠,黏腻、口苦,大便黏滞,小便黄赤,舌象,脉象积分均明显降低(P <0.05);与本组治疗前比较,BMI、SBP、DBP、UA、Scr、BUN、FPG、LDL、TG、TC、ESR、CRP、IL-1β、TNF-α、IL-6水平及VAS评分均明显升高(P <0.05,P <0.01);与对照组治疗后比较,观察组患者BMI、ESR、IL-1β水平及VAS评分均明显降低(P <0.05)。观察组总有效率为80.0%(24/30),对照组总有效率为56.7%(17/30),观察组总有效率明显高于对照组,差异具有统计学意义(χ2=11.916,P <0.05)。结论:痛风患者的IL-1β、IL-6、TNF-α水平与肥胖、血糖、血脂、UA、关节肿痛、炎症状况及全身症状密切相关;加味四妙散可有效改善湿热痹阻型慢性痛风性关节炎的临床症状并减轻炎症反应,且有较好的安全性,其机制可能与抑制IL-1β相关炎症信号通路有关。
英文摘要:
      Objective: To explore the mechanism of modified Wonderfully Effective Four Powder(MWEFP) in the treatment of chronic gout by analyzing the correlation between chronic gout and interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), as well as traditional Chinese medicine(TCM) symptoms and clinical indicators. Methods: Sixty patients with damp-heat obstruction type chronic gouty arthritis were randomly divided into an observation group and a control group, with 30 cases in each group. Additionally, 30 healthy subjects were enrolled as the healthy control group. The control group received oral administration of febuxostat, while the observation group received MWEFP in addition to the treatment in the control group, with a treatment cycle of 4 weeks. General clinical data, TCM symptom scores, and biochemical indicators were observed in all patients. Enzyme-linked immunosorbent assay(ELISA) was used to measure the levels of IL-1β, TNF-α, and IL-6, and the correlation of IL-1β, IL-6, TNF-α with TCM syndrome scores and biochemical indexes was analyzed. Results: Compared with the healthy control group, the levels of IL-1β, TNF-α, and IL-6 were significantly elevated in patients with chronic gout(P < 0. 01). In patients with chronic gout, joint pain, joint swelling, sticky stools, and tongue coating were positively correlated with IL-1β, TNF-α, and IL-6, while joint tenderness, joint fever, and fatigue were positively correlated with IL-1β and TNF-α. Additionally, greasy tongue coating, bitterness in the mouth, and urine were positively correlated with TNF-α. The pulse condition was positively correlated with IL-1β, and IL-1β was positively correlated with fasting plasma glucose(FPG), total cholesterol(TC), erythrocyte sedimentation rate(ESR), and visual analog scale(VAS) score. TNF-α was positively correlated with body mass index(BMI), uric acid(UA), high-density lipoprotein(HDL), ESR, VAS score, and negatively correlated with HDL. IL-6 was positively correlated with systolic blood pressure(SBP), UA, and C-reactive protein(CRP)(P < 0. 05, P < 0. 01). After treatment, the levels of IL-1β, TNF-α, and IL-6 were significantly reduced in both groups(P < 0. 01), with the observation group showing a significant decrease in IL-1β levels compared with the control group(P < 0. 05). Compared with baseline, joint pain, joint tenderness, joint swelling, joint fever, activity limitation, fatigue, greasy tongue coating, bitterness in the mouth, dark yellow urine, and TCM symptom score were significantly reduced in both groups after treatment(P < 0. 05, P < 0. 01). When compared with the control group after treatment, the observation group showed significant reductions in joint fever, fatigue, greasy tongue coating, bitterness in the mouth, sticky stools, dark yellow urine, tongue coating, and pulse condition(P < 0. 05). Compared with baseline, BMI, SBP, diastolic blood pressure(DBP), UA, serum creatinine(Scr), blood urea nitrogen(BUN), FPG, low-density lipoprotein(LDL), triglycerides(TG), TC, ESR, CRP, IL-1β, TNF-α, IL-6 levels, and VAS scores were significantly increased(P < 0. 05, P < 0. 01). Compared with the control group after treatment, the observation group showed significant reductions in BMI, ESR, IL-1β levels, and VAS scores(P < 0. 05). The total effective rate was 80. 0%(24/30) in the observation group and 56. 7%(17/30) in the control group, with the observation group having a significantly higher total effective rate than the control group (χ2=11. 916, P < 0. 05). Conclusion: The levels of IL-1β, IL-6, and TNF-α in gout patients are closely related to obesity, blood sugar, blood lipids, UA, joint pain and inflammation status, as well as systemic symptoms. Modified Wonderfully Effective Four Powder can effectively improve the clinical symptoms of damp-heat obstruction type chronic gouty arthritis and reduce inflammation, with good safety.Its mechanism may be related to the inhibition of IL-1β-related inflammatory signaling pathways.
查看全文   查看/发表评论  下载PDF阅读器
关闭
微信公众号
分享按钮