摘要
目的筛选治疗类风湿关节炎(RA)贫血的有效方剂。方法将60例RA贫血患者随机分为治疗组和对照组各30例,治疗组用独活寄生汤联合甲氨蝶呤、来氟米特治疗,对照组用归脾汤联合甲氨蝶呤、来氟米特治疗;两组均以4周为1个疗程,3个疗程后观察临床综合及疾病疗效,进行RA主要症状体征及贫血症状评分,同时进行实验室指标检测及健康指数调查(HAQ),并观察药物的不良反应。结果对照组临床综合疗效总有效率70.0%,治疗组总有效率90.0%,治疗组优于对照组(P<0.05)。两组治疗后临床症状及体征均较治疗前有所改善(P<0.05),并且治疗组改善程度优于对照组(P<0.05)。治疗组患者治疗后贫血症状积分及HAQ积分较治疗前明显减少(P<0.05),两组治疗后各积分比较差异有统计学意义(P<0.05)。两组治疗后血红蛋白含量升高,而血小板、类风湿因子、血沉、C反应蛋白下降(P<0.05),两组治疗后组间比较差异有统计学意义(P<0.05)。治疗组美国风湿病学会(ACR)指定标准50%改善率为86.7%,优于对照组的66.7%(P<0.05)。两组不良反应均较轻,均能完成临床观察。结论独活寄生汤治疗RA贫血疗效优于归脾汤。
Objective To select the effective formulas for rheumatoid arthritis （RA） with anemia. Methods Sixty RA pa- tients with anemia were randomized into the treatment group and control group, with 30 in each. The treatment group was giv- en Duhuo Jisheng Decoction （Pubescent Angelica and Mistletoe Decoction） combined with leflunomide and methopterin. The control group was given Guipi Decoction （Spleen-Returning Decoction） and the same chemotherapy as the treatment group. One treatment course lasted for 4 weeks in both groups. After 3 courses of treatment, rest pain, time of morning stiffness, grasp force, tender joint count （TJC）, swollen joint count （SJC）, evaluation by patients or doctors, symptoms of TCM, blood routine, rheumatoid factor （RF）, erythrocyte sedimentation rate （ESR）, C-reaction protein （CRP）, liver function, renal func- tion, urine routine and adverse effect were observed. Results There were one ease of cure, 13 cases of excellence, 7 cases of validity and 9 cases of invalidity in the control group, with a total effective rate of 70.0%. There were 4 cases of cure, 16 cases of excellence, 7 cases of validity and 3 cases of invalidity in the treatment group, with a total effective rate of 90. 0%. The difference in the total effective rate was statistically significant between groups （P〈0.05）. After treatment, the differences in rest pain, time of morning stiffness, grasp force, TJC, SJC and the evaluation by patients or doctors were statistically significant both between groups and in group （P〈0.05）. The content of hemoglobin increased and the levels of platelet, RF, ESR and CRP decreased significantly in both groups （P〈0.05）, especially in the treatment group （P〈0.05）. Symptoms of anemia were significantly relieved in both groups （P〈0. 05）, especially in the treatment group （P〈0.05）. The quality of life signifi- cantly improved in both groups （P〈0.05）, especially in the treatment group （P〈0.05）. 26 cases （86.7%） and 20 c
出处
《中医杂志》
CSCD
北大核心
2012年第14期1219-1222,共4页
Journal of Traditional Chinese Medicine
关键词
类风湿关节炎
贫血
独活寄生汤
归脾汤
临床疗效
rheumatoid arthritis
anemia
Duhuo Jisheng Decoction
Guipi Decoction
integrated Chinese and western medicine
