高免疫奶粉在類風濕關節炎所扮演之角色－－臨床及實驗室分析

The Role of Hyperimmune Milk in Patients with Rheumatoid Arthritis-- A Clinical and Laboratory Assessment

本篇研究探討高免疫奶粉使用于類風濕關節炎患者之療效。同時亦研究其對免疫功能之影響。半年內共有25例確定為類風濕關節炎患者接受高免疫奶粉之治療，在服用前後風濕科醫師臨床評估之項目包括關節疼痛數目、關節腫漲數目、關節壓痛指數與主觀疼痛分數等，而實驗室評估項目則包括淋巴球分類比率，淋巴球增生分化反應與細胞激素測量。結果顯示，20例完全服用高免疫奶粉者，12例有明顯之症狀改善，其中主觀疼痛分數與關節壓痛指數在服用奶粉後皆有明顯改善，但以前者在統計學上具有顯著的意義(p< 0.01 )，除2例腹瀉需停用奶粉外，高免疫奶粉並不具有明顯副作用。有關實驗室檢查，高免疫奶粉服用後患者之PHA刺激淋巴球其分化增生較服用前有明顯地抑制（服用前為68742±37600，而服用後則為47846±32085)(p< 0.01)總結，然其它之細胞激素檢查包括IL2、IFn-γ及ICAM-1等並無明顯差異高免疫奶粉與傳統治療藥物合併使用或許可提供類風濕關節炎另一種治療的選擇，但是其療效有待更一步的評估。

In the present study, hyperimmunized milk was used to evaluate the efficacy in the treatment of clinical rheumatoid arthritis (RA). Effects of this milk on immune function were also studied. Within one-half year, 25 cases with definite RA were enrolled in this study. Before and after milk treatment, clinical assessment including number of painful and swollen joints, articular index and pain score were examined by one rheumatologist. The laboratory tests included lymphocyte subpopulation, proliferation and cytokine measurement. The results showed that, after milk treatment, 12 of the 20 cases felt symptomatic improvement. Both pain score and articular index were decreased but only the former is statistically significant (p< 0.01) before and after the milk treatment. No evident side effects were noted except diarrhea was observed in 2 cases. The laboratory findings before and after milk treatment did not show a significant change except the increased PHA-stimulated lymphocyte proliferation response in RA patients was statisically inhibited (pre-milk 68742 ± 37600 to post-milk 47846 ± 32085) (p< 0.01). In conclusion, hyperimmune milk can exert inhibitory effect on PHA-induced lymphocyte proliferation when combine with other medications in RA patients. The beneficial effect of hyperimmune milk on RA patients needs further investigation.