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投稿时间：2024-11-03 网络发布日期：2025-07-21
投稿时间：2024-11-03 网络发布日期：2025-07-21
中文摘要: 目的 探讨黄芪桂枝五物汤加减和枸橼酸托法替布片联合治疗对气血两虚型类风湿关节炎（RA）患者肠道菌群、血清M1、M2型炎症因子的影响。方法 选取2021年3月至2022年3月南京市江宁医院收治的86例气血两虚型RA患者，按随机数字表法分成观察组（43例）和对照组（43例）。两组均予甲氨蝶呤片和枸橼酸托法替布片，观察组另予黄芪桂枝五物汤加减，对比两组治疗前后肠道菌群多样性（Shannon指数、Simpson指数）和丰富度（Chao1指数、ACE指数）及血清M1型炎症因子［白细胞介素（IL）-1β、IL-6）］、M2型炎症因子［IL-10、转化生长因子（TNF）Ⅳβ]水平的变化及患者不良反应发生情况。结果 经治疗，观察组总有效率（93.02%）显著高于对照组（76.74%），差异有统计学意义(χ2=4.441，P<0.05）。治疗后两组中，ACE、Chao1、Simpson、Shannon指数及乳杆菌、双歧杆菌计数均较治疗前升高，观察组高于对照组（P<0.05）；肠杆菌、肠球菌计数均较治疗前降低，观察组低于对照组（P<0.05）；IL-1β、IL-6水平较治疗前降低，观察组低于对照组（P<0.05）；IL-10、TGF-β水平较治疗前升高，观察组高于对照组（P<0.05）。两组不良反应发生率比较差异无统计学意义（P＞0.05）。结论 黄芪桂枝五物汤加减联合枸橼酸托法替布片治疗气血两虚型RA患者，疗效确切，可显著改善其M1、M2型炎症反应，改善肠道菌群紊乱，且未增加不良反应。
Abstract:Objective To investigate the effects of modified Huangqi Guizhi Wuwu Decoction combined with tofacitinib citrate tablet on intestinal flora，serum M1 and M2 type inflammatory factors in patients with Qi-blood deficiency rheumatoid arthritis（RA）. Methods A total of 86 patients with Qi-blood deficiency RA admitted to Nanjing Jiangning Hospital from March 2021 to March 2022 were randomly divided into an observation group（43 cases）and a control group （43 cases）. Both groups were given methotrexate and tofacitinib citrate tablets ，while the observation group was additionally administered modified Huangqi Guizhi Wuwu Decoction. The diversity（Shannon index，Simpson index）and richness（Chao1 index，ACE index）of intestinal flora and the levels of serum M1 inflammatory factors［interleukin（IL）Ⅳ1β,IL-6］and M2 inflammatory factors［IL-10，transforming growth factor（TNF）Ⅳβ] were compared between the two groups before and after treatment，and the adverse reactions of the two groups were observed.Results The total effective rate of the observation group（93.02%）was significantly higher than that of the control group（76.74%），with statistical significance(χ2=4.441，P<0.05）. After treatment，The ACE index，Chao1 index，Simpson index，Shannon index， Lactobacillus count，and Bifidobacterium count in both groups were higher than before treatment，with the observation group higher than the control group（P<0.05）；the counts of Enterobacter and Enterococcus in both groups were lower than before，with the observation group lower than the control group（P<0.05）；the levels of IL-1β and IL-6 in both groups were lower than before treatment，with the observation group lower than the control group（P<0.05）；the levels of IL-10 and TGF-β were higher than before treatment，with the observation group higher than the control group（P<0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups（P>0.05）. Conclusion Modified Huangqi Guizhi Wuwu Decoction combined with tofacitinib citrate tablet is effective in the treatment of RA patients with Qi-blood deficiency，which can significantly improve M1 and M2 inflammatory reactions， improve the disorder of intestinal flora，without increasing adverse reactions.
keywords: Huangqi Guizhi Wuwu Decoction Tofacitinib citrate tablet Rheumatoid arthritis Qi-blood deficiency Intestinal flora Inflammatory factor
文章编号： 中图分类号：R289.5 R259 文献标志码：B
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蒋妍，张瑾，王媛媛.黄芪桂枝五物汤加减联合托法替布片对类风湿关节炎患者肠道菌群和血清M1、M2型炎症因子的影响[J].中国临床研究,2025,38(7):1105-1109.
蒋妍，张瑾，王媛媛.黄芪桂枝五物汤加减联合托法替布片对类风湿关节炎患者肠道菌群和血清M1、M2型炎症因子的影响[J].中国临床研究,2025,38(7):1105-1109.