麻桂宣肺除痹汤治疗早期类风湿关节炎风寒湿痹证的临床观察

发布时间：2018-04-27 21:52

本文选题：早 + 痹证　；参考：《湖南中医药大学》2016年硕士论文

【摘要】：目的:探讨麻桂宣肺除痹汤治疗早期类风湿关节炎风寒湿痹证患者的有效性和安全性。方法:选取符合纳入标准的60例风寒湿痹阻型早期期类风湿关节炎患者,按随机数字表进行随机分组,分为治疗组(麻桂宣肺除痹汤+甲氨蝶呤+叶酸)、对照组(甲氨蝶呤+叶酸),每组各30人,疗程3个月,分别观察并记录两组治疗前后中医临床证候积分、实验室检查指标、治疗后中医临床疗效评价、中医症候积分、DAS28指数、疾病疗效评价,客观地反映佐用麻桂宣肺除痹汤治疗早期期类风湿关节炎风寒湿痹阻型患者的临床疗效及安全性。所获得的资料采用SPSS21.0软件进行统计学分析。结果:1.治疗后中医证候疗效比较,治疗组总有效率为86.67%,对照组总有效率为73.33%,差异具有统计学意义(P0.05)。2.两组治疗自身前后比较,单项症状积分比较,差异有统计学意义(P0.05);两组患者临床症状体征在治疗后均有明显改善,差异有统计学意义(P0.05)。3.两组治疗后中医证候总积分比较,差异有统计学意义P=0.0080.05),治疗后治疗组与对照组比较差异有统计学意义(P0.05)。4.两组治疗后DAS28积分差值比较,差异具有统计学意义(P=0.040.05);两组治疗后疾病活动度比较,差异具有统计学意义(P=0.028,P0.05)。5.两组患者治疗后实验室指标ESR、CRP均有明显下降,结果比较差异有统计学意义(P0.05),但RF治疗前后差异无统计学意义(P0.05)。6.两组治疗后疾病疗效比较,治疗组总有效率=93.3%,对照组总有效率=73.3%,差异具有统计学意义(P=0.038,P0.05)。7.两组治疗后不良反应发生率比较,治疗组不良反应发生率10%,对照组不良反应发生率23.33%,发生不良反应的概率相当,差异无统计学意义(P=0.1660.05)。结论:MTX联合麻桂宣肺除痹汤治疗ERA风寒湿痹证患者,不仅能改善症状体征及降低患者ESR、CRP水平等,而且安全性较好。
[Abstract]:Objective: to explore the efficacy and safety of Ma Gui Xuanfei Qi Bi decoction in treating rheumatoid arthritis patients with rheumatoid arthritis. Methods: 60 cases of rheumatoid arthritis with rheumatoid arthritis of wind-cold and dampness arthralgia type were selected and randomly divided into two groups according to the random digital table. The patients were divided into treatment group (magui Xuanfei debi decoction methotrexate folate) and control group (methotrexate folate, 30 persons in each group for 3 months). The clinical syndromes and laboratory indexes were observed and recorded before and after treatment in two groups. The evaluation of clinical curative effect of TCM, the integral of TCM symptom and DAS28 index, and the evaluation of disease curative effect objectively reflect the clinical efficacy and safety of the patients with rheumatoid arthritis at early stage of rheumatoid arthritis. The obtained data were statistically analyzed by SPSS21.0 software. The result is 1: 1. After treatment, the total effective rate of TCM syndrome was 86.67 in the treatment group and 73.33 in the control group. The difference was statistically significant. Two groups of patients before and after treatment, single symptom score comparison, the difference was statistically significant (P 0.05), the two groups of patients with clinical symptoms and signs were significantly improved after treatment, the difference was statistically significant (P 0.05). 3. After treatment, the total score of TCM syndromes in the two groups was significantly higher than that in the control group (P = 0.0080.05), and the difference between the treatment group and the control group was statistically significant (P < 0.05). The difference of DAS28 score between the two groups was statistically significant (P < 0.05), and the difference was statistically significant between the two groups (P < 0.05). The levels of ESR-CRP in the two groups were significantly decreased after treatment, and the difference was statistically significant (P 0.05), but there was no significant difference between the two groups before and after RF treatment. The total effective rate of the treatment group was 93. 3%, while that of the control group was 73. 3%. The difference was statistically significant. The incidence of adverse reactions was 10 in the treatment group and 23.33 in the control group. There was no significant difference in the incidence of adverse reactions between the two groups (P = 0.1660.05). Conclusion the treatment of ERA patients with wind-cold-dampness arthralgia syndrome not only can improve symptoms and signs and decrease the level of ESR-CRP, but also has good safety.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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