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| Effect of Mufangji Decoction combined with Methotrexate on oxygen free metabolism, bone metabolism and blood stasis in patients with acute rheumatoid arthritis |
| DING Wencong1 CHEN Taofu2 MIAO Huiyu3 |
1.The First Clinical School of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510405, China;
2.Department of Traditional Chinese Medicine, Heyuan Hospital of Traditional Chinese Medicine, Guangdong Province, Heyuan 517000, China;
3.Department of Acupuncture and Massage, the Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510407, China |
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Abstract Objective To explore clinical effect of Mufangji Decoction combined with Methotrexate (MTX) in the treatment of acute attack of rheumatoid arthritis (RA). Methods A total of 122 patients with acute episode RA admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2014 to May 2018 were selected and they were divided into the observation group (61 cases) and the control group (61 cases). The control group was orally treated with MTX + Folic Acid Tablets, and the observation group was treated with Mufangjitang on the basis of the control group. All patients were treated for 8 weeks. The clinical effects, indicators of free oxygen metabolism [total antioxidant capacity (T-AOC), superoxide dismutase (SOD), reactive oxygen species (ROS)], bone metabolism indicators [osteocalcin (BGP), type Ⅰ collagen carboxy terminal peptide β special sequence (β-CTX), propeptide of typeⅠprocollagen (PINP)], blood stasis status indicators [erythrocyte sedimentation rate (ESR), D-dimer (D-D), Fibrinogen (Fbg)] level changes, and adverse reactions of the two groups were compared before and after treatment. Results After treatment, the total effective rate in the observation group was significantly higher than that in the control group (P ＜ 0.05). After treatment, serum T-AOC, SOD, BGP, and PINP levels in the two groups were higher than those before treatment, and those of the observation group were higher than the control group (P ＜ 0.05). The concentrations of serum ROS, β-CTX, the ESR value and plasma D-D, Fbg levels in the two groups were lower than those before treatment, and those of the observation group were lower than the control group (P ＜ 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion Mufangji Decoction combined with Methotrexate helps patients with acute rheumatoid arthritis relieve symptoms, corrects the imbalance of oxygen free radical metabolism in body, maintains the balance of bone metabolism and improves blood stasis state with practical curative effect and high safety.
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[1] Smolen JS，Aletaha D，Barton A，et al. Rheumatoid arthritis [J]. Lancet，2016，388（10055）：2023-2038.
[2] Mena-Vazquez N，Manrique-Arija S，Yunquera-Romero L，et al. Adherence of rheumatoid arthritis patients to biologic disease-modifying antirheumatic drugs：a cross-sectional study [J]. Rheumatol Int，2017，37（10）：1709-1718.
[3] 陈向红，夏欢，黄闰月，等.中药复方治疗类风湿关节炎随机对照试验的系统评价和Meta分析[J].广州中医药大学学报，2018，35（2）：363-370.
[4] 刘思娣，黄传兵，石周珍，等.基于数据挖掘分析《吴鞠通医案》治疗痹证的用药规律[J].陕西中医药大学学报，2019，42（1）：60-63.
[5] 史占军，吕厚山，许建中，等.类风湿关节炎的诊断与治疗骨科专家共识[J].中华骨科杂志，2012，32（12）：1184-1186.
[6] 中华中医药学会发布.中医内科常见病诊疗指南·中医病症部分[M].北京：中国中医药出版社，2008：129-131.
[7] 郑筱萸.中药新药临床研究指导原则（试行）[M].北京：中国医药科技出版社，2002：115-119.
[8] Fleischmann R，Schiff M，van der Heijde D，et al. Baricitinib，Methotrexate，or Combination in Patients With Rhe-umatoid Arthritis and No or Limited Prior Disease-Modifying Antirheumatic Drug Treatment [J]. Arthritis Rheumatol，2017，69（3）：506-517.
[9] Kameyama S，Kase Y，Kurihara S，et al. Influence of High-Dose Folic Acid on Methotrexate Efficacies and Safety in Japanese Rheumatoid Arthritis Patients [J]. Drug Res（Stuttg），2017，67（12）：705-709.
[10] 李晓晨，张杰.活动期类风湿关节炎的中医病机分析[J].环球中医药，2016，9（11）：1412-1413.
[11] Mateen S，Moin，Khan AQ，et al. Increased Reactive Oxygen Species Formation and Oxidative Stress in Rheumatoid Arthritis：[J]. PLoS One，2016，11（4）：e0152925.
[12] Orsolini G，Adami G，Adami S，et al. Short-Term Effects of TNF Inhibitors on Bone Turnover Markers and Bone Mineral Density in Rheumatoid Arthritis [J]. Calcif Tissue Int，2016，98（6）：580-585.
[13] 章平衡，刘健，黄旦，等.基于miR-155/NF-κB信号通路探讨类风湿关节炎患者血瘀状态与肺功能的关系[J].中国中西医结合杂志，2017，37（7）：775-780.
[14] 宋永周，关健，李明，等.姜黄素对体外培养软骨细胞氧化应激反应的影响[J].实用医学杂志，2016，32（2）：188-191.
[15] 邓莉，耿春梅，廖德华，等.姜黄素对慢性应激大鼠的神经保护作用[J].中国医药导报，2019，16（35）：4-7，封4.
[16] 信嘉轩，教传华，商华，等.姜黄素对β-淀粉样蛋白损伤神经干细胞增殖和凋亡的影响[J].中国医药科学，2019， 9（14）：23-26.
[17] 张怡文，汪六英，张颖，等.苍术类药材提取物体外对成骨细胞增殖及酶活性的影响[J].中国实验方剂学杂志，2011，17（22）：226-229.
[18] 章丽，赵冰洁，袁嘉瑞，等.牡丹皮、赤芍与白芍对急性血瘀模型大鼠活血功效的比较研究[J].中草药，2016， 47（15）：2676-2683.
[19] 居艳娟，李荣平，郭迪斌，等.白芍总苷对类风湿关节炎肝功能保护、佐治效果研究[J].中国现代医生，2019，57（30）：34-37.
[20] 殷建保.加味木防己汤联合甲氨蝶呤片治疗类风湿关节炎急性发作效果观察[J].实用中医药杂志，2019，35（4）：459-460.
[21] 孟明，顾立刚，杨菁，等.加味木防己汤对类风湿关节炎大鼠滑膜的基质金属蛋白酶生成的影响[J].细胞与分子免疫学杂志，2007，23（8）：748-750.
[22] 孟明.类风湿关节炎大鼠滑膜细胞类肿瘤样增生及加味木防己汤的调节机制研究[D].北京：北京中医药大学，2006. |
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