加味桂枝芍药知母汤治疗寒热错杂型类风湿关节炎的临床研究

发布时间：2019-01-05 00:25

【摘要】：目的:讨论、总结加味桂枝芍药知母汤治疗寒热错杂型类风湿关节炎的理论依据,并评估其临床疗效及安全性,为临床治疗中应用此方药治疗类风湿关节炎提供理论依据及数据支持。方法:1.理论研究:查阅相关文献,剖析加味桂枝芍药知母汤治疗寒热错杂型类风湿关节炎的理论依据及其方药配伍关系;2.临床研究:将72例寒热错杂型RA患者,采取随机、开放、平行对照的研究方法,分为治疗组(包含患者36例)和对照组(包含患者36例),分别采用加味桂枝芍药知母汤配合甲氨蝶呤片、白芍总苷胶囊配合甲氨蝶呤片治疗,8周后,记录两组患者治疗前后的相关疾病临床症状及体征(如晨僵时间、关节压痛数、关节肿胀数、双手平均握力)及相关化验指标,进行分析比较后对两组药物疗效做出对比和评价。结果:两组总疗效进行对比,加味桂枝芍药知母汤组优于对照组,差异明显(P0.05)。治疗前后比较,两组患者晨僵持续时间、关节压痛数、关节肿胀数、双手平均握力、血沉、C-反应蛋白及相关临床症状均有显著改善,差异有显著统计学意义(P0.01)。比较两组患者治疗后相关临床症状和实验室指标,加味桂枝芍药知母汤组优于对照组(P0.05或P0.01)。结论:比较临床观察结果后可得出结论,加味桂枝芍药知母汤治疗寒热错杂型类风湿性关节炎疗效显著,优于白芍总苷胶囊;在降低相关实验室炎性指标方面,其也有确切疗效;同时,加味桂枝芍药知母汤安全性良好,无明显毒副作用。
[Abstract]:Objective: to discuss and summarize the theoretical basis of Jiawei Guizhi Shaoyao Anemarrhena decoction in the treatment of rheumatoid arthritis with cold and heat disorder, and to evaluate its clinical efficacy and safety. To provide theoretical basis and data support for the treatment of rheumatoid arthritis. Methods: 1. Theoretical study: refer to relevant literature, analyze the modified Guizhi Shaoyao Anemarrhena decoction for the treatment of cold and heat complex rheumatoid arthritis theoretical basis and prescription compatibility; 2. Clinical study: 72 patients with RA with cold and heat disorder were divided into two groups: the treatment group (including 36 patients) and the control group (including 36 patients). After 8 weeks of treatment, the clinical symptoms and signs of related diseases (such as morning stiffness time, joint tenderness and joint tenderness) were recorded after 8 weeks of treatment with modified Guizhi-Shaoyaozhengmu decoction combined with methotrexate tablet, total paeony glucoside capsule and methotrexate tablet respectively. The number of joint swelling, the average grip strength of both hands) and the related test indexes were compared and evaluated after the analysis and comparison between the two groups. Results: the total curative effect of the two groups was compared, the modified Guizhi Shaoyao Anemarrhena decoction group was superior to the control group, the difference was significant (P0.05). Before and after treatment, the duration of morning stiffness, the number of joint tenderness, the number of joint swelling, the mean grip strength, erythrocyte sedimentation rate, C-reactive protein and related clinical symptoms of the two groups were significantly improved (P0.01). Compared the two groups of patients after treatment related clinical symptoms and laboratory indicators, Jiawei Guizhi Shaoyao Anemarrhena decoction group was better than the control group (P0.05 or P0.01). Conclusion: after comparing the clinical observation results, it can be concluded that the modified Guizhi Shaoyao Anemarrhena decoction is more effective than the total paeony glucoside capsule in the treatment of rheumatoid arthritis of the type of cold and heat disorder. At the same time, the modified Guizhi Shaoyao Anemarrhena decoction is safe and has no obvious side effects.
【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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