中西医结合治疗难治性类风湿关节炎

发布时间：2018-10-19 18:40

【摘要】：目的:探讨桂枝芍药知母汤联合甲氨蝶呤(MTX)和柳氮磺吡啶(SSZ)治疗难治性类风湿关节炎(RA)的疗效和安全性。方法:选择符合纳入标准患者81例,随机分为治疗组和对照组,治疗组40例给予桂枝芍药知母汤、MTX和SSZ治疗,对照组41例给予MTX和SSZ治疗,疗程均为12周。采用美国风湿病学会(ACR)推荐的RA疾病活动评价核心指标对两组治疗前后进行评估。结果:治疗后2组病情活动主要指标评分均有显著降低,治疗前后比较,差异均有非常显著性意义(P0.01),治疗组评分降低优于对照组,差异有显著性意义(P0.05)。治疗组达到ACR20,ACR50,ACR90疗效标准的分别为:37.5%,32.5%,20%,总有效率90%;对照组达到ACR20,ACR50,ACR90疗效标准的分别为:46.34%,19.51%,4.88%,总有效率70.73%。结论:桂枝芍药知母汤联合MTX和SSZ治疗难治性RA疗效明显优于MTX联合SSZ的疗效,且具有较好的安全性。
[Abstract]:Objective: to investigate the efficacy and safety of Guizhi Shaoyao Anemarrhena decoction combined with methotrexate (MTX) and Salazapyridine (SSZ) in the treatment of refractory rheumatoid arthritis (RA). Methods: 81 patients were randomly divided into treatment group and control group. 40 patients in the treatment group were treated with Guizhi Shaoyao Anemarrhena root decoction, MTX and SSZ, and 41 patients in the control group were treated with MTX and SSZ for 12 weeks. The core index of RA disease activity evaluation recommended by the American Rheumatology Society (ACR) was used to evaluate the two groups before and after treatment. Results: after treatment, the scores of the main indexes of disease activity in the two groups were significantly decreased, the difference was very significant before and after treatment (P0.01), the score of the treatment group was lower than that of the control group, and the difference was significant (P0.05). In the treatment group, the total effective rate was 90 and that in the control group was 46.34 and 19.51 respectively, and the total effective rate was 70.730.The treatment group reached the standard of ACR20,ACR50,ACR90 curative effect as follows: 37.5% and 32.5% and 20%, respectively, and the total effective rate was 90%, respectively, and the control group reached the standard of ACR20,ACR50,ACR90 curative effect as follows: 46.34% and 19.51%; Conclusion: the curative effect of Guizhi-Shaoyaozhou-zhengmu decoction combined with MTX and SSZ in the treatment of refractory RA is better than that of MTX combined with SSZ and has better safety.
【作者单位】：洛阳市第三人民医院风湿免疫科;
【分类号】：R593.22

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