二妙二活汤治疗类风湿关节炎关节镜术后的早期临床观察
发布时间：2018-10-09 13:55
【摘要】：目的研究二妙二活汤治疗类风湿关节炎关节镜滑膜清理术后的早期临床疗效,并与关节镜滑膜清理手术结合常规西医方法治疗类风湿关节炎对比,客观评价二妙二活汤治疗类风湿关节炎的临床疗效及安全性。方法选取被确诊的60例类风湿膝关节炎肿胀患者,均行关节镜滑膜清理术治疗。随机将患者分为对照组30例和观察组30例;对照组术后进行常规西医止痛、抗风湿治疗,观察组在此基础上服用二妙二活汤。分别观察两组患者的膝关节疼痛评分(VAS)、膝关节肿胀度、HSS评分、超敏C反应蛋白(CRP)、类风湿因子(RF)、关节液蛋白多糖(PG),并根据中医疗效判定标准进行评价。结果在术后第7天观察组的VAS评分、术后肿胀度较对照组显著降低(P0.05),而在术后第3天、术后2周的组间比较则无明显统计学差异(P0.05);在术前、术后2周观察组和对照组中血CRP、RF、及膝关节液中PG含量的组内比较均有显著降低(P0.01),在术后2周观察组较对照组有显著的降低(P0.05);术后2周观察组与对照组HSS评分优良率分别为80.0%与73.3%,有明显统计学差异(P0.05);术后2周观察组与对照组中医评分优良率分别为86.6%与83.3%,有明显统计学差异(P0.05)。结论二妙二活汤应用于类风湿膝关节炎患者的关节镜滑膜清理术后,对比常规西医治疗,更大力度地降低CRP、RF、PG的水平,更快地改善患者疼痛、肿胀等症状,通过提高患者的满意度和依从性,获得更好的关节功能康复,提高临床疗效。
[Abstract]:Objective to study the early clinical effect of Ermiao Erhuo decoction in the treatment of rheumatoid arthritis after arthroscopic synovial debridement, and to compare it with arthroscopic synovial debridement combined with routine western medicine in the treatment of rheumatoid arthritis. Objective to evaluate the clinical efficacy and safety of Ermiao Erhuo decoction in the treatment of rheumatoid arthritis. Methods 60 patients with rheumatoid arthritis and swelling were treated by arthroscopic synovial debridement. The patients were randomly divided into control group (n = 30) and observation group (n = 30). The knee pain score (VAS),) and the hypersensitive C-reactive protein (CRP), rheumatoid factor (RF),) (RF), proteoglycan (PG), in the joint fluid of the two groups were observed and evaluated according to the criteria of traditional Chinese medicine (TCM). Results on the 7th day after operation, the VAS score in the observation group was significantly lower than that in the control group (P0.05), but there was no significant difference between the groups on the 3rd day and the 2nd week after operation (P0.05). The levels of CRP,RF, and PG in the knee joint fluid in the observation group and control group were significantly lower than those in the control group at 2 weeks after operation (P0.01), and the HSS scores in the observation group and the control group were better at 2 weeks after operation than in the control group (P0.05). The rate was 80.0% and 73.3% respectively, there was significant difference (P0.05); the observation group and the control group were 86.6% and 83.3%, there was significant statistical difference (P0.05). 2 weeks after operation, the excellent and good rate of TCM score in observation group and control group were 86.6% and 83.3%, respectively. Conclusion Ermiao Erhuo decoction is used in arthroscopic synovial debridement in patients with rheumatoid knee arthritis. Compared with routine western medicine, Ermiao Erhuo decoction can reduce the level of CRP,RF,PG and improve pain and swelling more quickly. By improving patients' satisfaction and compliance, we can obtain better rehabilitation of joint function and improve clinical efficacy.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.22
本文编号：2259585
[Abstract]:Objective to study the early clinical effect of Ermiao Erhuo decoction in the treatment of rheumatoid arthritis after arthroscopic synovial debridement, and to compare it with arthroscopic synovial debridement combined with routine western medicine in the treatment of rheumatoid arthritis. Objective to evaluate the clinical efficacy and safety of Ermiao Erhuo decoction in the treatment of rheumatoid arthritis. Methods 60 patients with rheumatoid arthritis and swelling were treated by arthroscopic synovial debridement. The patients were randomly divided into control group (n = 30) and observation group (n = 30). The knee pain score (VAS),) and the hypersensitive C-reactive protein (CRP), rheumatoid factor (RF),) (RF), proteoglycan (PG), in the joint fluid of the two groups were observed and evaluated according to the criteria of traditional Chinese medicine (TCM). Results on the 7th day after operation, the VAS score in the observation group was significantly lower than that in the control group (P0.05), but there was no significant difference between the groups on the 3rd day and the 2nd week after operation (P0.05). The levels of CRP,RF, and PG in the knee joint fluid in the observation group and control group were significantly lower than those in the control group at 2 weeks after operation (P0.01), and the HSS scores in the observation group and the control group were better at 2 weeks after operation than in the control group (P0.05). The rate was 80.0% and 73.3% respectively, there was significant difference (P0.05); the observation group and the control group were 86.6% and 83.3%, there was significant statistical difference (P0.05). 2 weeks after operation, the excellent and good rate of TCM score in observation group and control group were 86.6% and 83.3%, respectively. Conclusion Ermiao Erhuo decoction is used in arthroscopic synovial debridement in patients with rheumatoid knee arthritis. Compared with routine western medicine, Ermiao Erhuo decoction can reduce the level of CRP,RF,PG and improve pain and swelling more quickly. By improving patients' satisfaction and compliance, we can obtain better rehabilitation of joint function and improve clinical efficacy.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.22
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