白芍总苷治疗未分化脊柱关节病疗效及其机制探讨_药学论文.docVIP

白芍总苷治疗未分化脊柱关节病疗效及其机制探讨_药学论文 白芍总苷治疗未分化脊柱关节病疗效及其机制探讨_药学论文 作者：李志军,梅永君,陈琳洁,侯传云,王 涛,谢长好,李茂胜 【摘要】 目的 观察白芍总苷(TGP)对未分化脊柱关节病(uSpA)的疗效,探讨其作用机制。方法 将116例uSpA患者随机分为2组,分别给予TGP和柳氮磺胺吡啶(SASP)联合双氯芬酸钠治疗,于治疗12周后进行临床疗效及安全性评估;同时,测定其血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)等细胞因子的水平。结果 2组治疗前和治疗12周后主要临床表现和病情活动性评价指标的差异均无统计学意义。胃肠外不良反应的发生率TGP组为8.6%,SASP组为25.9%,差异具有统计学意义(χ2=6.042,P=0.014)。2组血清中IL-6、IL-10、TNF-α水平的差异治疗前均无统计学意义,治疗12周后均有统计学意义(t值分别为2.672、2.483和2.088,P值分别为0.009、0.014和0.039)。结论 TGP治疗uSpA的疗效与SASP相近,但其胃肠道外不良反应较少,安全性较好。TGP的疗效可能与抑制uSpA患者血清中IL-6、IL-10和TNF-α等细胞因子的产生有关。 【关键词】 未分化脊柱关节病;白芍总苷;白细胞介素;肿瘤坏死因子-α 　　Abstract：Objective To evaluate the efficacy of total glucosides of paeony (TGP) in the treatment of undifferentiated spondyloarthropathies (uSpA) and investigate its mechanism. Methods One hundred and sixteen cases of uSpA were randomly assigned to 2 groups, one group was treated with TGP and diclofenac sodium, the other group with SASP and diclofenac sodium. The efficacy and side effects of the two groups were compared after 12 weeks treatment. The level of IL-6, IL-10 and TNF-α was determined at the same time. Result After 12 weeks treatment, the major clinical manifest and the indexes of disease activity were no difference of statistical significance in the two groups. The incidence of parenterally side effects was 8.6% in TGP group, and 25.9% in SASP group. There was difference at statistical significance between the two groups (χ2=6.042, P=0.014). Before treatment, the level of IL-6, IL-10 and TNF-α in the serum of two groups were no statistical difference, while there was obviously difference after 12 weeks treatment (t=2.672, 2.483 and 2.088, P=0.009, 0.014 and 0.039). Conclusion The efficacy of TGP and SASP has no significant difference in the treatment of uSpA. But the incidence of parenterally side effects in the TGP group was less than SASP group. The mechanism of efficacy of TGP may be related to inhibiting the production of IL-6, IL-10 and TNF-α. 　　Key words：undifferent