身痛逐瘀汤联合西药治疗类风湿关节炎瘀血痹阻证的临床观察

发布时间：2018-05-15 15:22

本文选题：身痛逐瘀汤 + 联合用药　；参考：《中国实验方剂学杂志》2017年24期

【摘要】：目的:探讨身痛逐瘀汤联合西药治疗类风湿关节炎的临床疗效及安全性。方法:将120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60例。基础治疗给予甲氨喋呤10 mg/次,1次/周,口服,来氟米特20 mg/次,1次/d,口服,对照组在基础治疗上加用雷公藤多苷片,治疗组在基础治疗上加用身痛逐瘀汤。连续治疗12周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,关节压痛数,肿胀数,休息痛,双手握力,20 m步行时间及健康评价问卷评分以及实验室指标血沉(ESR),C-反应蛋白(CRP),类风湿因子(RF),瘤坏死因子-α(TNF-α),白细胞介素-1(IL~(-1))水平变化情况。结果:治疗组总有效率91.7%,高于对照组的83.3%(P0.05);治疗后与对照组比较,治疗组DAS28评分,患者晨僵时间,休息痛,关节压痛个数,肿胀个数,20 m步行时间、和健康状况问卷(HAQ)评分均低于对照组,双手握力高于对照组(P0.05);治疗组患者CRP,ESR,RF,TNF-α及IL~(-1)水平低于对照组(P0.05)。结论:身痛逐瘀汤联合西药治疗类风湿关节炎在提高疗效、控制症状、改善实验室指标等方面均有较强的优势,且安全性较高,值得临床推广应用。
[Abstract]:Objective: to explore the clinical efficacy and safety of Shentong Zhuyu decoction combined with western medicine in the treatment of rheumatoid arthritis. Methods: 120 patients with rheumatoid inflammation were randomly divided into treatment group (n = 60) and control group (n = 60). The patients in the control group were treated with tripterygium polyglycoside tablets at the basic treatment level, and those in the treatment group were treated with Shentong Zhuyu decoction on the basis of basic treatment, while those in the control group were given 10 mg/ of methotrexate once a week, and leflunomide was given orally for 20 mg/ d, and the control group was treated with tripterygium polyglycoside tablets. After 12 weeks of continuous treatment, the difference of clinical efficacy between the two groups was analyzed, and the time of morning stiffness, the number of tenderness of joint, the number of swelling and the pain of rest were observed. The 20 m walking time of grip strength, the score of health assessment questionnaire, and the changes of ESR C- reactive protein (CRP), rheumatoid factor (RF), tumor necrosis factor- 伪 (TNF- 伪), interleukin-1 (IL-1). Results: the total effective rate of the treatment group was 91.7%, which was higher than that of the control group (83.3% P 0.05). Compared with the control group, the DAS28 score of the treatment group, the time of morning stiffness, rest pain, the number of joint tenderness and the number of swelling were 20 m walking time. The scores of HAQs and HAQs were lower than those of the control group, the grip strength of both hands was higher than that of the control group (P0.05), and the levels of CRPS-ESR-RFFNF- 伪 and ILTNF-1 in the treatment group were lower than those in the control group (P 0.05). Conclusion: Shentong Zhuyu decoction combined with western medicine in the treatment of rheumatoid arthritis has strong advantages in improving curative effect, controlling symptoms and improving laboratory indexes, and has high safety, which is worthy of clinical popularization and application.
【作者单位】：甘肃中医药大学附属医院;
【基金】：甘肃省第二批全省五级中医药师承教育工作项目(2014-123)
【分类号】：R593.22

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