摘要
目的 研究清胃通络汤联合甲氨蝶呤对类风湿关节炎急性发作期的疗效及安全性。方法 选择2020年2月—2022年3月医院收治的110例类风湿关节炎急性发作期患者,以随机数字表法分为研究组、对照组,各55例。对照组接受甲氨蝶呤治疗,研究组在对照组的基础上接受清胃通络汤治疗,两组治疗8周。对比两组中医证候积分、类风湿关节炎病情活动度评价表(disease activity score 28,DAS28)、视觉模拟评分(visual analogue scale, VAS)、滤泡性辅助性T细胞(follicular helper T cell, Tfh)、白细胞介素-21(interleukin, IL-21)、类风湿因子(rheumatoid factor, RF)、红细胞沉降率、血液流变学、安全性以及临床疗效。结果 治疗后,两组中医证候积分均降低(P<0.05),且研究组更低(P<0.05)。治疗后,两组DAS28评分与VAS评分均降低(P<0.05),且研究组更低(P<0.05)。治疗后,两组Tfh、IL-21、RF、红细胞沉降率均降低(P<0.05),且研究组更低(P<0.05)。治疗后,两组纤维蛋白原、血浆黏度、血细胞比容与全血高切黏度均降低(P<0.05),且研究组更低(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。研究组总有效率(96.36%,53/55)比对照组(81.82%,45/55)高(P<0.05)。结论 清胃通络汤联合甲氨蝶呤治疗类风湿关节炎急性发作期疗效确切,可改善患者的临床症状,改善血液流变学,减轻炎症反应,可降低Tfh细胞占比,且安全可靠。
Objective To study the efficacy and safety of Qingwei Tongluo Decoction(清胃通络汤)combined with methotrexate in the treatment of acute rheumatoid arthritis.Methods A total of 110 patients with acute onset of rheumatoid arthritis admitted to the hospital from February 2020 to March 2022 were randomly divided into study group and control group,with 55 cases in each group.The control group was treated with methotrexate,and the study group was treated with Qingwei Tongluo Decoction on the basis of the control group.The two groups were treated for 8 weeks.The TCM syndrome scores,rheumatoid arthritis activity scale(disease activity score 28,DAS28),visual analogue scale(VAS),follicular helper T cells(Tfh),interleukin-21(IL-21),rheumatoid factor(RF),erythrocyte sedimentation rate,hemorheology,safety and clinical efficacy were compared between the two groups.Results After treatment,the TCM syndrome scores of the two groups were decreased(P<0.05),and the scores of the study group were lower(P<0.05).After treatment,the DAS28 score and VAS score of the two groups were decreased(P<0.05),and the score of the study group was lower(P<0.05).After treatment,the levels of Tfh,IL-21 and RF and erythrocyte sedimentation rate were decreased in the two groups(P<0.05),and even lower in the study group(P<0.05).After treatment,fibrinogen,plasma viscosity,hematocrit and high shear viscosity of whole blood were decreased in the two groups(P<0.05),and even lower in the study group(P<0.05).There was no difference in the total incidence of adverse reactions between the two groups(P>0.05).The total effective rate of the study group(96.36%,53/55)was higher than that of the control group(81.82%,45/55)(P<0.05).Conclusion Qingwei Tongluo Decoction combined with methotrexate is effective in the treatment of rheumatoid arthritis in the acute attack stage,which can improve the clinical symptoms and the hemorheology of patients,reduce the inflammatory reaction and the proportion of Tfh cells,and is safe and reliable.
作者
陈礼荣
贾超
李树岗
吴志红
杨惠琴
CHNE Lirong;JIA Chao;LI Shugang;WU Zhihong;YANG Huiqin(Wuhan Hospital of Traditional Chinese and Western Medicine,Wuhan 420022,Hubei,China)
出处
《中华中医药学刊》
CAS
北大核心
2024年第3期229-232,共4页
Chinese Archives of Traditional Chinese Medicine
基金
湖北省自然科学基金项目(2019CFB246)。
关键词
清胃通络汤
甲氨蝶呤
类风湿关节炎
急性发作期
疗效
安全性
Qingwei Tongluo Decoction(清胃通络汤)
methotrexate
rheumatoid arthritis
acute episode
curative effect
security
