本文選題：類風濕關(guān)節(jié)炎 + 骨質(zhì)疏松　； 參考：《鄭州大學》2015年碩士論文

【摘要】：目的初步探討仙靈骨葆膠囊聯(lián)合金鈣爾奇預(yù)防類風濕關(guān)節(jié)炎(Rheumatoid Arthritis,RA)繼發(fā)骨質(zhì)疏松(Osteoporosis,OP)的效果及可能機制。方法將64例在我院接受診治的RA患者隨機分為對照組和觀察組,每組32例。對照組男13例,女19例,平均年齡(50.8±6.9)歲,平均病程(68.8±13.5)月;觀察組男11例,女21例,平均年齡(51.1±6.8)歲,平均病程(67.4±15.2)月。兩組患者的一般情況具有可比性(P0.05)。在常規(guī)RA治療的基礎(chǔ)上,對照組患者口服金鈣爾奇;觀察組患者口服金鈣爾奇和仙靈骨葆膠囊。兩組觀察期均為3個月。于觀察前后記錄兩組的晨僵時間、關(guān)節(jié)腫脹指數(shù)、關(guān)節(jié)壓痛指數(shù)、關(guān)節(jié)功能指數(shù)、血小板計數(shù)(Platelet Count,PLT)、紅細胞沉降率(Erythrocyte Sedimentation Rate,ESR)、類風濕因子(Rheumatoid Factor,RF)、C反應(yīng)蛋白(C Reactive Protein,CRP)、抗環(huán)瓜氨酸肽(Anti-cyclic Citrullinated Peptide,anti-CCP)抗體、血鈣、血磷、血清堿性磷酸酶(Alkaline Phosphatase,ALP)、骨鈣素(Osteocalcin,OC)、I型前膠原氨基末端前肽(Procollagen Type I Amino-terminal Propeptide,PINP)、抗酒石酸酸性磷酸酶-5b(Tartrate-resistant Acid Phosphatase-5b,TRACP-5b)和I型膠原交聯(lián)羧基末端肽(C-terminal Telopeptides of Type I Collagen,CTX)、骨保護素(Osteoprotegerin,OPG)、細胞核因子-κB受體活化因子配體(Receptor Activator of Nuclear Factor-κB Ligand,RANKL)以及腰椎、股骨頸、Ward三角、大轉(zhuǎn)子骨密度。結(jié)果1兩組藥物干預(yù)前晨僵時間、關(guān)節(jié)壓痛指數(shù)、關(guān)節(jié)腫脹指數(shù)以及關(guān)節(jié)功能指數(shù)無明顯區(qū)別(P0.05);經(jīng)藥物干預(yù)后,兩組晨僵時間明顯縮短,關(guān)節(jié)壓痛指數(shù)、關(guān)節(jié)腫脹指數(shù)以及關(guān)節(jié)功能指數(shù)明顯降低(P0.05);經(jīng)藥物干預(yù)后,觀察組晨僵時間明顯短于對照組(P0.05),關(guān)節(jié)壓痛指數(shù)、關(guān)節(jié)腫脹指數(shù)以及關(guān)節(jié)功能指數(shù)均低于對照組。2兩組藥物干預(yù)前PLT、ESR、RF、CRP、抗CCP抗體、血鈣以及血磷無明顯區(qū)別(P0.05);經(jīng)藥物干預(yù)后,兩組PLT、ESR、RF、CRP、抗CCP抗體明顯降低(P0.05),血鈣和血磷增加;經(jīng)藥物干預(yù)后,觀察組PLT、ESR、RF、CRP、抗CCP抗體低于對照組,血鈣和血磷高于對照組。3兩組藥物干預(yù)前ALP、OC、PINP、TRACP-5b和CTX無明顯區(qū)別(P0.05);經(jīng)藥物干預(yù)后,兩組ALP、TRACP-5b、CTX降低,OC和PINP增加;經(jīng)藥物干預(yù)后,觀察組ALP、TRACP-5b、CTX低于對照組,OC和PINP高于對照組。4兩組藥物干預(yù)前OPG和RANKL水平無明顯區(qū)別(P0.05);經(jīng)藥物干預(yù)后,兩組OPG升高,RANKL降低;經(jīng)藥物干預(yù)后,觀察組OPG明顯高于對照組,RANKL明顯低于對照組(P0.05)。5兩組藥物干預(yù)前腰椎、股骨頸、Ward三角以及大轉(zhuǎn)子骨密度無明顯區(qū)別(P0.05);經(jīng)藥物干預(yù)后,對照組骨密度明顯降低(P0.05),觀察組骨密度無明顯變化,觀察組骨密度明顯高于對照組(P0.05)。結(jié)論在金鈣爾奇基礎(chǔ)上聯(lián)合應(yīng)用仙靈骨葆膠囊能夠有效減輕RA病情,改善患者臨床癥狀、骨代謝,抑制骨密度降低,預(yù)防RA繼發(fā)OP發(fā)生發(fā)展,可能與其調(diào)節(jié)OPG和RANKL水平相關(guān)。
[Abstract]:Objective to investigate the effect and possible mechanism of Xianling Gubao capsule combined with Jincaolai capsule in the prevention of osteoporosis secondary to rheumatoid arthritis (RA). Methods 64 RA patients in our hospital were randomly divided into two groups: control group (n = 32) and observation group (n = 32). There were 13 males and 19 females in the control group, with an average age of 50.8 鹵6.9 years and an average course of disease of 68.8 鹵13.5 months, while in the observation group, there were 11 males and 21 females, with an average age of 51.1 鹵6.8 years and an average course of 67.4 鹵15.2months. The general conditions of the two groups were comparable (P 0.05). On the basis of routine RA treatment, the patients in the control group were treated with Jincailqi, and the patients in the observation group were treated with the capsule of Jincalqi and Xianling Gubao. The observation period was 3 months in both groups. Morning stiffness time, joint swelling index, joint tenderness index and joint function index were recorded before and after observation. Platelet count, erythrocyte sedimentation rate, erythrocyte Sedimentation, erythrocyte sedimentation rate, rheumatoid factoroid factor, rheumatoid factoroid, Sedimentation, C-reactive protein, C-reactive protein, anti-cyclic Citrullinated peptide anti-CCP-antibody, blood calcium, blood phosphorus, erythrocyte sedimentation rate, Rheumatoid Factoroid rDNA, C Reactive protein in CRP, Anti-cyclic Citrullinated Peptidine Anti-CCPP antibody, blood calcium, blood phosphorus, Serum Alkaline Phosphatase, osteocalcin I procollagen Type I Amino-terminal propeptidePIN, tartrate-resistant Acid phosphatase-5bTRACP-5b) and type I collagen cross-linked carboxyl terminal peptide C-terminal Telopeptides of Type I collagen CTX, osteoprotegerin Osteoprotegerin Osteoprotegerin Osteoprotegerin I, osteoprotegerin Osteoprotegerin Osteoprotegerin Osteoprotegerin OPGG, nuclear factor- 魏 B Receptor Activator of Nuclear Factor- 魏 B Ligand RANKL and lumbar vertebrae, Femoral neck Ward triangle, greater trochanter bone mineral density. Results 1there was no significant difference in morning stiffness time, joint tenderness index, joint swelling index and joint function index between the two groups before drug intervention, but after drug intervention, the morning stiffness time was significantly shortened and the joint tenderness index was decreased. The joint swelling index and joint function index significantly decreased P0.05, the morning stiffness time of the observation group was significantly shorter than that of the control group, and the joint tenderness index was significantly shorter than that of the control group. The joint swelling index and joint function index were lower than those in the control group before intervention (P 0.05), but there was no significant difference between the two groups in anti CCP antibody, blood calcium and blood phosphorus. After drug intervention, the levels of anti CCP antibody and anti CCP antibody were significantly decreased, and serum calcium and phosphorus were increased in the two groups. After drug intervention, the levels of anti CCP antibody and serum calcium and phosphorus in the observation group were lower than those in the control group, and the levels of serum calcium and phosphorus were higher than those in the control group before drug intervention. There was no significant difference between the two groups before and after drug intervention (P 0.05); after drug intervention, the levels of OC and PINP in the two groups were decreased, and after drug intervention, the levels of OC and PINP were increased in the two groups. The levels of OPG and RANKL in the observation group were lower than those in the control group (P < 0.05), but the levels of OPG and RANKL in the two groups were lower than those in the control group (P < 0.05). After drug intervention, the levels of OPG in the two groups were higher than those in the control group (P < 0.05), and the levels of OPG in the two groups were lower than those in the control group (P < 0.05). The OPG of the observation group was significantly higher than that of the control group (P 0.05). The bone mineral density of lumbar vertebrae, femoral neck Ward's triangle and greater trochanter had no significant difference between the two groups before and after drug intervention, and after drug intervention, there was no significant difference between the two groups in bone mineral density (BMD). The BMD of the control group was significantly lower than that of the control group (P 0.05), but the BMD of the observation group had no significant change, and the BMD of the observation group was significantly higher than that of the control group. Conclusion combined application of Xianling Gubao capsule on the basis of Jincailqi can effectively alleviate the condition of RA, improve clinical symptoms, bone metabolism, inhibit the decrease of bone density, prevent the development of secondary op in RA, and may be related to its regulation of OPG and RANKL levels.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R593.22;R580

【參考文獻】

相關(guān)期刊論文 前10條

1 劉振海;劉紅;王少君;李艷;;防治骨質(zhì)疏松癥常用單味中藥實驗研究概況[J];環(huán)球中醫(yī)藥;2013年06期

2 鄭新春;楊德才;;痹痛舒膠囊治療類風濕關(guān)節(jié)炎療效觀察[J];湖北中醫(yī)雜志;2013年10期

3 歐陽霞;戴冽;朱浪靜;;骨代謝標志物的檢測在類風濕關(guān)節(jié)炎中的臨床意義[J];新醫(yī)學;2012年02期

4 王莉枝;王彩虹;;類風濕關(guān)節(jié)炎患者發(fā)生骨質(zhì)疏松的機制[J];中國藥物與臨床;2012年01期

5 劉臻;王茵;;鈣、維生素A、D等與骨健康關(guān)系的研究進展[J];中國骨質(zhì)疏松雜志;2010年03期

6 庫爾班江;木亞賽爾;武麗君;;~(99)锝-亞甲基二膦酸鹽治療類風濕關(guān)節(jié)炎繼發(fā)骨質(zhì)疏松骨痛的療效分析[J];中國骨質(zhì)疏松雜志;2011年11期

7 孟迅吾;鈣和骨質(zhì)疏松癥[J];中華內(nèi)科雜志;2005年03期

8 張燕;楊光;孫國珍;;仙靈骨葆含藥血清對小鼠成骨-破骨細胞共培養(yǎng)系統(tǒng)的影響[J];中國老年學雜志;2011年14期

9 沈曉o，

本文編號：1811382