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[新风胶囊对改善类风湿关节炎患者肺功能的作用]

[Effect of Xinfeng Capsule on Improving Pulmonary Function in Rheumatoid Arthritis Patients].

作者信息

Sun Yue, Liu Jian, Wan Lei

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Jul;36(7):814-820.

Abstract

OBJECTIVE

To observe the effect of Xinfeng Capsule (XFC) on pulmonary function, peripheral blood B and T lymphocyte attenuator (BTLA), and oxidative stress in rheumatoid arthritis (RA) patients.

METHODS

Totally 100 RA patients were assigned to the treatment group and the control group according to random digit table, 50 in each group. Patients in the treatment group took XFC (0. 5 g/pill, 3 pills each time, 3 times per day) , while those in the control group took Leflunomide (LEF) Tablet (0. 1 g/tablet 1, tablet each time, once every evening). The therapeutic course for all was 90 days. Pulmonary functions were detected including forced vital capacity (FVC), forced expiratory volume in one second (FEV1) , peak expiratory flow (PEF), 25% maximal expiratory flow-volume (MEF25), 50% maximal expiratory flow-volume (MEF50), 25% -75% maximal expiratory flow-volume (MEF25 -75). Levels of erythrocyte sedimentation rate (ESR) and high-sensitivity C-reactive protein (hs-CRP) were observed. The disease activity was assessed using disease activity score in 28 joints (DAS28). The ex- pression of BTLA, levels of methane dicarboxylic aldehyde (MDA) , reactive oxygen species (ROS) , superoxide dismutase (SOD) , total antioxidant capacity (TAOC) , and related cytokines (IL-17, TNF-α, IL- 4, IL-35) were also detected. Results Compared with before treatment in the same group, post-treatment FEV1, PEF, MEF25-75, MEF50, and MEF25 were all increased (P <0. 05, P <0. 01) ; ESR, hypersensi- tive C reactive protein (hs-CRP) , and DAS28 were all decreased (P <0. 01) , peripheral blood levels of BTLA +, CD19 +, CD24 +, CD19 + CD24 +, CD24 + BTLA +, SOD, TAOC, IL-4, and IL-35 all increased (P < 0. 01, P <0. 05) ; levels of ROS, MDA, TNF-α, and IL-17 all decreased (P <0. 01 , P <0. 05) in the two groups. Compared with the control group, levels of FVC, MEF25-75, MEF50, and MEF25 all increased (P <0. 05, P <0. 01) , and levels of ESR, hs-CRP, and DAS28 all decreased (P <0. 05, P <0. 01 ) in the treatment group after treatment. Peripheral blood levels of BTLA+ , CD24 +, CD19 + CD24 + , TAOC, and TNF-α all increased (P<0. 05), and levels of CD24 CD19 +, ROS, and MDA all decreased (P<0. 01, P < 0. 05) in the treatment group after treatment.

CONCLUSIONS

Decreased pulmonary function and attenua- ted BTLA expression generally exist in RA patients. Besides, its disease activity was closely related with attenuated expression of BTLA and imbalanced oxidative stress. XFC could not only improve joint symptoms of RA patients, but also improve lung function by elevating BTLA expression, attenuating tissue damage from immunological inflammation and oxidative stress.

摘要

目的

观察新风胶囊(XFC)对类风湿关节炎(RA)患者肺功能、外周血B和T淋巴细胞衰减器(BTLA)及氧化应激的影响。

方法

将100例RA患者按随机数字表法分为治疗组和对照组,每组50例。治疗组患者服用新风胶囊(0.5g/粒,每次3粒,每日3次),对照组患者服用来氟米特(LEF)片(0.1g/片,每次1片,每晚1次)。两组疗程均为90天。检测肺功能,包括用力肺活量(FVC)、一秒用力呼气容积(FEV1)、呼气峰值流速(PEF)、25%最大呼气流量(MEF25)、50%最大呼气流量(MEF50)、25% - 75%最大呼气流量(MEF25 - 75)。观察红细胞沉降率(ESR)和高敏C反应蛋白(hs-CRP)水平。采用28个关节疾病活动评分(DAS28)评估疾病活动度。检测BTLA表达、丙二醛(MDA)、活性氧(ROS)、超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)及相关细胞因子(IL-17、TNF-α、IL-4、IL-35)水平。结果与同组治疗前比较,两组治疗后FEV1、PEF、MEF25 - 75、MEF50及MEF25均升高(P < 0.05,P < 0.01);ESR、高敏C反应蛋白(hs-CRP)及DAS28均降低(P < 0.01),外周血BTLA +、CD19 +、CD24 +、CD19 + CD24 +、CD24 + BTLA +、SOD、TAOC、IL-4及IL-35水平均升高(P < 0.01,P < 0.05);ROS、MDA、TNF-α及IL-17水平均降低(P < 0.01,P < 0.05)。治疗后与对照组比较,治疗组FVC、MEF25 - 75、MEF50及MEF25水平均升高(P < 0.05,P < 0.01),ESR、hs-CRP及DAS28水平均降低(P < 0.05,P < 0.01)。治疗后治疗组外周血BTLA +、CD24 +、CD19 + CD24 +、TAOC及TNF-α水平均升高(P < 0.05),CD24 CD19 +、ROS及MDA水平均降低(P < 0.01,P < 0.05)。

结论

RA患者普遍存在肺功能下降及BTLA表达减弱,且其疾病活动度与BTLA表达减弱及氧化应激失衡密切相关。新风胶囊不仅可改善RA患者关节症状,还可通过提高BTLA表达、减轻免疫炎症和氧化应激所致组织损伤来改善肺功能。

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