来源：风湿病与关节炎,2017,6（11）:17-20.

纤维肌痛综合征患者血清TRP、IL-1、TNF-α表达及双醋瑞因干预研究

温伟强，周汝云，李　江，陈　辉，廖康汉，谭　宁

　　【摘　要】目的：探讨纤维肌痛综合征（FMS）患者外周血清色氨酸（TRP）、白细胞介素-1（IL-1）、肿瘤坏死因子-α（TNF-α）表达水平与疼痛抑郁相关性及双醋瑞因对其的影响。方法：运用双醋瑞因治疗FMS患者30例（FMS组），同时选取20例健康体检者为对照组，对2组进行麦吉尔疼痛量表（MPQ）评分、压痛点数、汉密尔顿抑郁量表（HAMD）评分，检测血清TRP、IL-1、TNF-α表达水平，分析其变化与MPQ量表评分、压痛点数、HAMD量表评分的相关性。结果：双醋瑞因治疗FMS总有效率为76.67%。治疗前FMS组与对照组比较，TRP、IL-1、TNF-α水平差异有统计学意义（P < 0.05）；FMS组治疗前后TRP、IL-1、TNF-α水平比较差异有统计学意义（P < 0.05）；IL-1、TNF-α水平和MPQ量表评分、压痛点数、HAMD量表评分呈正相关（P < 0.05）；TRP水平和MPQ量表评分、压痛点数、HAMD量表评分呈负相关（P < 0.05）。结论：双醋瑞因治疗FMS的作用机制主要是下调IL-1、TNF-α水平，上调TRP水平，可明显缓解疼痛抑郁症状，TRP、IL-1、TNF-α可作为反映病情活动、评价疗效的指标。

　　【关键词】　纤维肌痛综合征；色氨酸；白细胞介素-1；肿瘤坏死因子-α

Study on the Expressions of TRP,IL-1 and TNF-α in Serum of Cases with Fibromyalgia Syndrome and the Intervention of Diacerein

WEN Wei-qiang,ZHOU Ru-yun,LI Jiang,CHEN Hui,LIAO Kang-han,TAN Ning

　　【ABSTRACT】Objective:To investigate the relationship between the expressions of TRP,IL-1 and TNF-α in serum of cases with fibromyalgia syndrome and pain-related depression,and the intervention of diacerein.Methods:Thirty cases with fibromyalgia syndrome（FMS）were chosen as the FMS group treated with diacerein and 20 healthy people were selected as the control group.MPQ scales,tenderness point and HAMD scales were given for the two groups,testing the expressions of TRP,IL-1 and TNF-α in serum and analyzing their correlation with MPQ scales,tenderness point and HAMD scales.Results:The total efficiency of diacerein in the treatment of FMS was 76.67%.Before treatment,the level differences of TRP,IL-1 and TNF-α between the FMS group and the control group were statistically significant（P < 0.05）;The level differences of TRP,IL-1 and TNF-α were statistically significant in the FMS group before and after treatment（P < 0.05）.The levels of IL-1 and TNF-α were positively correlated with MPQ scales,tenderness point and HAMD scales（P < 0.05）.The level of TRP was negatively correlated with MPQ scales,tenderness point and HAMD scales（P < 0.05）.Conclusion:In the treatment of fibromyalgia syndrome,the main mechanism of diacerein is to down-regulate the levels of IL-1 and TNF-α and up-regulate the level of TRP,which can obviously relieve the pain-related symptoms of depression.TRP,IL-1,TNF-α can be regarded as indexes to reflect the disease activity and evaluate the curative effect.

　　【Keywords】 fibromyalgia syndrome;tryptophan;IL-1;TNF-α