温阳通络方治疗类风湿关节炎的临床研究

发布时间：2018-05-17 02:20

本文选题：类风湿关节炎 + 温阳通络方　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:1.为中医温阳通络方治疗类风湿关节炎提供临床依据;2.评价温阳通络方治疗类风湿关节炎的疗效及其安全性。方法:将云南省中医医院风湿门诊64例符合纳入标准的低活动度的类风湿关节炎患者按随机的原则(采用SPSS19.0进行随机,随机码20151228)分为治疗组和对照组,两组均予甲氨蝶呤片10mg/周,口服;治疗组在口服甲氨蝶呤片的基础上加服温阳通络方中药免煎剂,2次/日,饭后温服。分别在治疗前、治疗第4周、第8周记录患者症状体征、各项评分、疗效性指标及安全性指标:各症状体征、ESR、CRP、RF因子、PGA值、MDGA值、DAS28评分、中医证候评分、CDAI、三大常规、肝肾功能、心电图,对所得数据进行统计分析,以中医证候改善率、疾病改善率分别评价患者全身症状体征、主要症状体征的改善情况,以ACR20达标率综合评价温阳通络方的临床疗效,初步评估温阳通络方的安全性。结果:两组治疗方法均能有效改善患者症状、体征,降低疾病活动度指标(ESR、CRP、DAS28、CDAI值),治疗组改善以上各指标均优于对照组(P0.05)。两组患者的RF因子在治疗前后无差异(P0.05)。中医证候改善方面,治疗组总有效率为93.3%;对照组总有效率为78.2%;疾病疗效方面,治疗组总有效率为80.0%;对照组总有效率为40.6%;ACR20达标治疗方面,治疗组总达标率为80.0%,对照组总达标率为34.3%。两组患者均未出现血尿便常规、肝肾功、心电图的异常;治疗组不良反应发生率为3.0%,对照组不良反应发生率为9.4%。结论:1温阳通络方联合甲氨蝶呤片治疗寒湿痹阻型RA能进一步改善患者临床症状及体征、VAS评分、中医证候积分;降低RA的活动性指标;能提高ACR20达标治疗。2温阳通络方联合MTX治疗RA尚无毒副作用发生,治疗期内温阳通络方是安全有效的。
[Abstract]:Purpose 1. To provide a clinical basis for the treatment of rheumatoid arthritis with traditional Chinese medicine Wenyang Tongluo prescription. To evaluate the efficacy and safety of Wenyang Tongluo recipe in the treatment of rheumatoid arthritis. Methods: a total of 64 rheumatoid arthritis patients in rheumatoid clinic of Yunnan traditional Chinese Medicine Hospital were randomly divided into treatment group and control group according to the principle of randomization (randomized with SPSS19.0, random code 20151228). Both groups were given methotrexate tablets for 10mg/ week, and the treatment group took Wenyang Tongluo prescription for 2 times a day on the basis of oral methotrexate tablets. Before treatment, 4 weeks and 8 weeks of treatment, the symptoms and signs, scores, efficacy and safety indexes of patients were recorded respectively: every symptom and sign: ESR-CRPPU RF factor and MDGA value and DAS28 score, TCM syndrome score, CDAI3 routine, liver and kidney function, liver and kidney function. Electrocardiogram, statistical analysis of the obtained data, the improvement rate of TCM syndromes and diseases were used to evaluate the improvement of patients' systemic symptoms and signs, the improvement of main symptoms and signs, and the clinical efficacy of Wenyang Tongluo recipe (WYTL) were comprehensively evaluated by ACR20 standard rate. To evaluate the safety of Wenyang Tongluo recipe. Results: the two treatment methods could effectively improve the symptoms and signs of the patients, and reduce the disease activity index and the CDAI value of the CRPAS28 and CDAI. The improvement of the above indexes in the treatment group was better than that in the control group (P 0.05). There was no difference in RF factor between the two groups before and after treatment (P 0.05). In the improvement of TCM syndrome, the total effective rate of the treatment group was 93.3; the total effective rate of the control group was 78.2; the total effective rate of the treatment group was 80.0; the total effective rate of the control group was 40.6 ACR20; the total effective rate of the treatment group was 80.0; the total effective rate of the control group was 34.3. The incidence of adverse reactions was 3.0 in the treatment group and 9.4 in the control group. Conclusion the treatment of wenyangtongluo decoction combined with methotrexate tablet can further improve the clinical symptoms and signs of RA patients with VAS score, TCM syndromes score, reduce the activity index of RA. It was safe and effective to improve the standard of ACR20 in the treatment of RA with the combination of Wenyang Tongluo recipe and MTX. There were no side effects in the treatment of RA, and the Wenyang Tongluo recipe was safe and effective in the treatment period.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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