摘要
目的:观察四妙汤联合氟米特治疗湿热痹阻型类风湿性关节炎的临床疗效。方法:将92例患者随机分为对照组和观察组,每组46例。对照组口服来氟米特,20 mg/次,每日1次;观察组在对照组治疗基础上服用四妙汤,每日1剂,早晚分服。两组疗程均为1个月。通过比较两组临床疗效、治疗前后DAS28评分、VAS评分、晨僵时间、压痛指数、中医证候评分、血液检测指标,进行安全性评价。结果:总有效率对照组为78.26%(36/46),观察组为91.30%(42/46),两组比较差异有统计学意义(P<0.05)。关节肿胀个数、疼痛个数、晨僵时间和压痛指数、DAS28评分、VAS评分、证候评分、白细胞介素1β(interleukin-1β,IL-1β)、白细胞介素6(interleukin-6,IL-6)和肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、血浆黏度(plasma viscosity,PV)和红细胞压积(packed cell volume,PCV)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白E(immunoglobulin E,IgE)、血清C反应蛋白(C-reaction protein,CRP)、类风湿因子(internal rheumatoid factors,RF)等指标治疗前两组比较,差异无统计学意义(P>0.05)。两组治疗后与治疗前比较,差异均有统计学意义(P<0.05);治疗后两组比较,差异有统计学意义(P<0.05)。两组在治疗过程中均未出现呕吐等不良反应及与试验药物相关检查的异常改变。结论:四妙汤联合氟米特治疗湿热痹阻型RA临床疗效显著,可较好的改善临床症状、血清炎症因子、免疫指标、血液流变学指标等,且未见明显不良的反应。
Objective:To observe clinical effects of Simiao Tang combined with leflunomide in treating rheumatoid arthritis(RA)of damp-heat obstruction pattern.Methods:A total of 92 patients were randomized into the control group and the observation group,46 cases each group,the control group took leflunomide orally,20 mg each time,once each day;the observation group took Simiao Tang based on the therapy the control group accepted,one dose each day,taking in the morning and evening.The course was one month.Safety evaluation was performed through comparing clinical effects between both groups,DAS28 scores,VAS scores,morning stiffness time,tenderness index.TCM syndrome scores and the indexes of blood test.Results:Total effective rate of the control group was 78.26%(36/46),lower than 91.30%(42/46)of the observation group,and the difference had statistical meaning between both groups(P<0.05).The difference had no statistical meaning in the number of joint swelling,the number of pain,morning stiffness time,tenderness index,DAS28 scores,VAS scores,TCM syndrome scores,IL-1β,IL-6,TNF-α,ESR,PV,PCV,IgG,IgA,IgE,CRP,RF and others between both groups before treating(P>0.05).The difference was statistically significant between both groups before and after treating(P<0.05);the difference showed statistical meaning between both groups after treating(P<0.05).During therapeutic course,there was no adverse reaction and abnormal changes related to experimental drugs.Conclusion:Simiao Tang combined with leflunomide could obtain notable clinical effects in treating RA of damp-heat obstruction pattern,it could better improve clinical symptoms,serum inflammatory factors,immune indexes,hemorrheological indexes and others,and no obvious adverse reaction happen.
作者
张佳红
周淑红
杨栋
宫宁宁
ZHANG Jiahong;ZHOU Shuhong;YANG Dong;GONG Ningning(Rheumatology and Immunology Department,Gansu Provincial Hospital,Lanzhou 730000,China)
出处
《西部中医药》
2020年第8期8-11,共4页
Western Journal of Traditional Chinese Medicine
基金
甘肃省青年科技基金计划项目(17JR5RA032)。
关键词
关节炎
类风湿性
湿热痹阻
四妙汤
来氟米特
临床疗效
arthritis,rheumatoid
damp-heat obstruction
Simiao Tang
leflunomide
clinical effects
