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| 消痹汤联合西药治疗瘀血痹阻型类风湿关节炎30例的临床观察 |
| Clinical observation of the efficacy of anti-blockage decoction combined with western medicine on rheumatoid arthritis with blood stasis syndrome in 30 cases |
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| DOI：10.3969/j.issn.1006.7108.2017.07.014 |
| 中文关键词: 中医中药 瘀血痹阻 类风湿关节炎 临床观察 |
| 英文关键词:Chinese traditional medicine Blood stasis syndrome Rheumatoid arthritis Clinical observation |
| 基金项目:甘肃省第二批五级中医药师承教育工作项目；甘肃省卫生行业项目（GSWSKY-2014-36) |
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| 中文摘要: |
| 目的 探讨消痹汤联合西药治疗瘀血痹阻型类风湿关节炎的临床疗效及安全性。方法 将60例类风湿关炎患者根据随机数字表法分为治疗组和对照组各30例。对照组服用甲氨喋呤5 mg每周一次，来氟米特20 mg一日一次，必要时服用依托考昔,并如实记录。治疗组在对照组基础上予消痹汤加减，必要时服用依托考昔，并如实记录。连续治疗12 w后分析两组患者的临床疗效差异，并观察两组患者晨僵时间、休息痛、关节压痛数、关节肿胀数、双手握力、20 m步行时间、健康评价问卷评分以及实验室指标水平变化的情况。结果 两组均有较好的治疗作用，治疗组总有效率为93.3%，对照组总有效率为 83.3%。差异有统计学意义（P <0.05);治疗组在疾病活动度、晨僵时间、休息痛、关节肿胀个数、关节压痛个数、20 m步行时间、双手握力和健康评价问卷方面的改善优于对照组，差异有统计学意义（P<0. 05);治疗组治疗后C-反应蛋白、红细胞沉降率、类风湿因子、肿瘤坏死因子-α、白细胞介素-1水平变化与对照组相比更为明显（P<0.05)。结论 消痹汤联合西药治疗瘀血痹阻型类风湿关节炎在提高疗效、控制症状、改善实验室指标等均有较强的优势，值得临床推广应用。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy and safety of anti-blockage decoction combined with western medicine in the treatment of rheumatoid arthritis with blood stasis syndrome. Methods 60 patients with rheumatoid arthritis were rand omly divided into treatment group and control group, with 30 cases in each group. The patients in control group received 5 mg of methotrexate once a week, 20 mg of leflunomide once a day, and etoricoxib if necessary. The patients in treatment group received anti-blockage decoction in addition of the medicine taken in the control group, and etoricoxib if necessary. After 12 weeks of continuous treatment, the difference of clinical curative effect between the two groups was analyzed. The scores of morning stiffness，rest pain，joint tenderness，joint swelling，hand grip，20 m walking time，HAQ score，and laboratory test were observed. Results The therapeutic effect was good in both groups, and the total effective rate was 93. 3% in the treatment group and 83. 3% in the control group. The difference was statistically significant ( P < 0. 05 ). The improvement in disease activity, morning stiffness, rest pain, joint swelling，joint tenderness, 20 m walking time，double hand grip，and health evaluation questionnaire in the treatment group was better than those in the control group, and the difference was statistically signiflcant ( P < 0. 05 ). The changes of CRP, ESR, RF, TNF-α, and IL-1 levels in the treatment group were more obvious than those in the control group (P < 0. 05). Conclusion Anti-blockage decoction combined with western medicine improves the efficacy of rheumatoid arthritis with blood stasis syndrome in control of symptoms and improvement of laboratory indicators. It is worthy of clinical application. |
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