高彩霞 强建红 冯彦飞 杨晶 常增伟

摘要 目的：觀察排毒尪痹汤对类风湿性关节炎（RA）的疗效以及对血清粒细胞-巨噬细胞集落刺激因子（GM-CSF）、前蛋白转化酶枯草溶菌素9（PCSK9）的影响。方法：选取2015年1月至2019年12月延安市人民医院收治的RA患者120例作为研究对象，按照治疗方法不同分为对照组和观察组，每组60例。对照组给予常规抗风湿药物，观察组在对照组基础上给予排毒尪痹汤治疗，治疗2个月后观察2组患者的治疗效果、血清炎症介质、血脂水平、血清粒细胞-巨噬细胞集落刺激因子（GM-CSF）以及前蛋白转化酶枯草溶菌素9（PCSK9）水平等。结果：治疗2个月后，观察组的总有效率显著高于对照组，差异有统计学意义（P<0.05）;治疗后2组患者红细胞沉降率（ESR）、类风湿因子（RF）水平均下降，且观察组下降更显著，差异有统计学意义（P<0.05）;治疗后2组GM-CSF、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平均下降，且观察组下降更显著，差异有统计学意义（P<0.05）;治疗后2组高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、极低密度脂蛋白胆固醇（VLDL-C）水平均升高，且观察组升高更显著，差异有统计学意义（P<0.05）;治疗后2组患者的PCSK9水平均下降，且观察组下降更显著，差异有统计学意义（P<0.05）。结论：排毒尪痹汤治疗RA效果较好，可显著改善患者的症状，降低PCSK9水平，改善机体的炎症介质和血脂水平，在临床上可广泛使用。

关键词 排毒尪痹汤;类风湿性关节炎;疗效;炎症介质;血脂水平;类风湿因子

Abstract Objective：To study the effects of Paidu Gubi Decoction on rheumatoid arthritis and its effects on serum GM-CSF and PCSK9.Methods：A total of 120 RA patients who were admitted to Yan′an People′s Hospital of Shannxi Province from January 2015 to December 2019 were randomly selected as the research objects.According to the treatment method，they were divided into an observation group and a control group，with 60 cases in each group.The control group was given routine anti rheumatic drugs，and the observation group was given Paidu Yibi Decoction on the basis of the control group.After 2 months of treatment，the treatment effect，serum inflammatory factors，blood lipid level，serum GM-CSF and PCSK9 levels were observed in the 2 groups.Results：After 2 months of treatment，the total effective rate of the observation group was significantly higher than that of the control group，with significant difference（P<0.05）; after treatment，the ESR and RF levels of the 2 groups decreased，and the decrease of the observation group was more significant，the difference is meaningful（P<0.05）; after treatment，the GM-CSF，IL-6 and TNF-α levels of the 2 groups decreased，and the decrease of the observation group was more significant，the difference was significant（P<0.05）; after treatment，the level of HDL-C，TC，TG，LDL-C，VLDL-C water of the 2 groups increased，and the increase of the observation group was more significant，the difference was significant（P<0.05）; after treatment，the PCSK9 level of the 2 groups decreased significantly，the difference was significant（P<0.05）.Conclusion：The therapeutic effects of Paidugubi Decoction on rheumatoid arthritis is better.It can significantly improve the symptoms of patients，reduce the level of PCSK9，and improve the level of inflammatory factors and blood lipids.It can be widely used in clinics.

Keywords Paidu Gubi Decoction; Rheumatoid arthritis; Efficacy; Inflammation mediator; Blood lipid level; Rheumatoid factor

中图分类号：R255.6文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.24.015

类风湿性关节炎（Rheumatoid Arthritis，RA）是一种……