CAJ | 학술논문

目的：观察类风湿关节炎（ rheumatoid arthritis，RA）患者血清抗环瓜氨酸肽抗体（ anti-cyclic cirullinated peptide antibodies，抗CCP抗体）表达的变化，探讨中药新风胶囊（ XFC）改善RA患者临床症状的作用机制。方法选取100例RA患者作为研究对象，按随机数字表分组法分为研究组（ XFC组）和对照组[来氟米特（ LEF）组]各50例。研究组服用XFC，每次3粒，每日3次，4周为1个疗程，连服1个疗程；对照组服用LEF，每次10 mg片，每晚1次，服用天数及疗程同治疗组。采用酶联免疫吸附试验（ELISA）检测外周血抗CCP抗体、葡糖糖6-磷酸异构酶（GPI）、抗角蛋白抗体（AKA）表达水平。结果（1）两组在总有效率方面无明显差异，但研究组的显效率为62％，明显高于对照组（ P＜0．05）。（2）与对照组相比，研究组患者抗CCP抗体、GPI滴度较对照组明显降低（P＜0．05或P＜0．01），两组RA患者治疗前后AKA阳性例数均明显减低（P＜0．05）。（3）治疗后，研究组红细胞计数（RBC）、血红蛋白（HGB）较对照组明显升高（P＜0．05或P＜0．01），血小板计数（PLT）明显减低（P＜0．05）。其中升高患者HGB 方面，研究组明显优于对照组；血小板计数（ PLT）、类风湿因子（ RF）、α1酸性糖蛋白（α1-AGP）、血沉（ESR）均明显降低（P＜0．05或P＜0．01）；其中研究组免疫球蛋白（Ig）G、RF、ESR明显降低（P＜0．05或P＜0．01）。结论86％的RA患者抗CCP抗体升高，XFC能有效降低RA患者外周血抗CCP抗体水平，降低异常免疫反应，减轻多关节损伤，改善患者全身机能，提高生活质量。
목적：관찰류풍습관절염（ rheumatoid arthritis，RA）환자혈청항배과안산태항체（ anti-cyclic cirullinated peptide antibodies，항CCP항체）표체적변화，탐토중약신풍효낭（ XFC）개선RA환자림상증상적작용궤제。방법선취100례RA환자작위연구대상，안수궤수자표분조법분위연구조（ XFC조）화대조조[래불미특（ LEF）조]각50례。연구조복용XFC，매차3립，매일3차，4주위1개료정，련복1개료정；대조조복용LEF，매차10 mg편，매만1차，복용천수급료정동치료조。채용매련면역흡부시험（ELISA）검측외주혈항CCP항체、포당당6-린산이구매（GPI）、항각단백항체（AKA）표체수평。결과（1）량조재총유효솔방면무명현차이，단연구조적현효솔위62％，명현고우대조조（ P＜0．05）。（2）여대조조상비，연구조환자항CCP항체、GPI적도교대조조명현강저（P＜0．05혹P＜0．01），량조RA환자치료전후AKA양성례수균명현감저（P＜0．05）。（3）치료후，연구조홍세포계수（RBC）、혈홍단백（HGB）교대조조명현승고（P＜0．05혹P＜0．01），혈소판계수（PLT）명현감저（P＜0．05）。기중승고환자HGB 방면，연구조명현우우대조조；혈소판계수（ PLT）、류풍습인자（ RF）、α1산성당단백（α1-AGP）、혈침（ESR）균명현강저（P＜0．05혹P＜0．01）；기중연구조면역구단백（Ig）G、RF、ESR명현강저（P＜0．05혹P＜0．01）。결론86％적RA환자항CCP항체승고，XFC능유효강저RA환자외주혈항CCP항체수평，강저이상면역반응，감경다관절손상，개선환자전신궤능，제고생활질량。
Objective This research is aimed to observe the expression changes of serum anti-cyclic cirullinated peptide antibodies( an-ti-CCP) in Rheumatoid Arthritis( RA) patients,thus to explore the mechanism of XinFeng Capsule ( XFC) on improving clinical symp-tom.Method 100RApatientswereinvolvedinthestudywhowererandomlydividedintothetreatmentgroup(XFCgroup)of50ca-ses (3 capsules each time,3 times a day),and the control group leflunomide group (LEF) of 50 cases (1 pellet each time,1 times ev-ery night) .Those two groups were 4 weeks as 1 courses,1 courses.Using enzyme linked immunosorbent assay ( ELISA) to detect the expression changes of serum anti-cyclic cirullinated peptide antibodies ( anti-CCP) ,glucose-6-phosphate isomerase ( GPI) and anti-ker-atin antibody (AKA).Clinical examination and investigations were performed and disease activity was assessed.Results (1) Patients in those two groups all showed effectiveness when compared in the total effective rate of treatment (86%[ XFC] vs 76%[ LEF] ) and did not reach statistical significance.However, the rate of efficiency showed difference between two groups ( 62% [ XFC ] vs 46%[LEF]).(2) After treatment,compared with the LEF group,titers of anti-CCP and GPI were significantly reduced (P<0.05 or P<0.01).The total number of cases of positive AKA decreased profound in RA (P<0.05).(3) After drug intervention,red blood cell count (RBC) and hemoglobin (HGB) were increased while platelet counts (PLT) decreased significantly (P<0.05),and XFC group shows more effective on improving HGB.The disease activity integrals as rheumatoid factor ( RF) ,α1-acid glycoprotein (α1-AGP) and erythrocyte sedimentation rate ( ESR) all decreased in two groups.When compared between the two groups,XFC group were superior to reduceimmuneglobulin(Ig)G,RFandESRthanLEFgroup(P<0.05orP<0.01).Conclusion 86%RApatientshaveincreased level of anti-CCP antidodies.XFC can effectively decrease the expression changes of serum anti-CCP antidodies,improve joint symp-toms,reduce abnormal immune response,alleviate the damage of joints in RA patients,so as to improve the life quality.