[论著]独活寄生汤加味配合常规疗法对类风湿性关节炎的干预作用

Time:2016-02-22 00:23:41 来源:410100长沙,湘雅博爱康复医院骨科等 作者:谢友明 冯颜杰 杜若晨 黄翰

《国际中医中药杂志》[ISSN:1673-4246/CN:CN11-5398/R]

卷: 36 期数: 2014年08期

页码: 685-688

栏目: 论著

出版日期: 2014-08-05

文章信息/Info

Title: Clinical observation on rheumatoid arthritis treated with modified Duhuo-Jisheng decoction and Western conventional treatment

作者: 谢友明 冯颜杰 杜若晨 黄翰 410100长沙,湘雅博爱康复医院骨科

Author(s): Xie Youming' target="_blank" rel="external"> Xie Youming;  Feng Yanjie;  Du Ruochen; ' target="_blank" rel="external"> Huang Han. Department of Orthopedic, Xiangya-boai Rehabilitation Hospital, Changsha 410100, China

关键词: 类风湿性关节炎; 独活寄生汤; 临床研究

Keywords: Rheumatoid arthritis; Duhuo-Jisheng decoction; Clinical study

DOI: 10.3760/cma.j.issn.1673-4246.2014.08.004

摘要: 目的 观察独活寄生汤加减配合西医常规疗法治疗类风湿性关节炎(rheumatoid arthritis,RA)的临床疗效。方法 收集2010年1月至2013年8月湘雅博爱康复医院骨科门诊患者120例,均符合RA诊断标准,按病例尾号将患者随机分为两组各60例,对照组口服甲氨蝶呤(7.5 mg/次,1次/周),柳氮磺吡啶(2~3 g/d),美洛昔康片(7.5 mg/次,2次/d),有胃肠道反应时减量或停服,待症状缓解后续服。治疗组在对照组治疗基础上加服独活寄生汤。两组均治疗1个月为1个疗程,治疗3个疗程后观察并比较两组患者临床疗效,以及红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)等指标变化。结果 治疗后治疗组总有效率为90.0%(54/60);对照组为70.0%(42/60),两组总有效率比较,差异有统计学意义(χ2=4.193,P<0.05)。治疗后CRP、ESR、RF[治疗组分别为(22.06±10.31)mg/L、(25.18±17.80)mm/h、(28.19±4.17)IU/L,对照组分别为(14.11±7.32)mg/L、(24.16±22.09)mm/h、(36.08±5.24)IU/L]均较同组治疗前[治疗组分别为(82.16±21.37)mg/L、(68.84±9.71)mm/h、(84.92±15.31)IU/L,对照组分别为(52.46±22.26)mg/L、(62.72±33.31)mm/h、(85.17±14.23)IU/L]降低(P<0.01);治疗组的CRP降低情况优于对照组(P<0.05)。治疗后关节压痛数、关节肿胀数、晨僵时间、双手握力、20 m步行时间[治疗组分别为(3.43±1.46)个、(2.95±1.35)个、(19.32±16.54)min、(79.35±22.14)mmHg、(19.32±4.81)s,对照组分别为(4.63±4.21)个、(3.55±2.47)个、(21.23±19.37)min、(77.81±16.22)mmHg、(25.15±5.81)s]均较同组治疗前[治疗组分别为(10.71±5.12)个、(7.95±3.97)个、(109.32±68.52)min、(47.12±18.22)mmHg、(36.21±6.62)s,对照组为(11.54±5.32)个、(7.64±4.01)个、(96.02±58.39)min、(49.67±16.48)mmHg、(36.33±7.23)s]改善(P<0.05),其中治疗组关节压痛数、关节肿胀数、20 m步行时间均优于对照组(P<0.05)。结论 独活寄生汤加味配合常规疗法可有效减轻RA患者的临床症状,降低ESR、CRP、RF水平。

Abstract: Objective To evaluate the effects of rheumatoid arthritis treated with modified Duhuo-Jisheng decoction and western conventional treatment. Methods 120 patients with heumatoid arthritis of our hospital from January 2010 to 2013 August were recruited and randomly divided into a treatment group and a control group, 60 patients in each group. The control group was treated with oral intake of Methotrexate, Sulfasalazine and Meloxicam in acute stage and oral intake of diclofenc in stable stage, while the treatment group was further added modified Duhuo-Jisheng decoction on the basis of the control group. TCM symptom score, arthritis symptom score, symptomatic relief time, ESR, CRP, RF were observed after 3 months’ treatment. Results After 3 mouths’ treatment, the total effective rate was 90.0%(54/60) in the study group and 70.0%(42/64) in the control group. There was no significant difference(χ2=4.193,P<0.05) between the two groups. CRP,ESR,RF[The treatment group respectively(22.06±10.31)mg/L, (25.18±17.80)mm/h, (28.19±4.17)IU/L,the control group respectively (14.11±7.32)mg/L, (24.16±22.09)mm/h, (36.08±5.24)IU/L]decreased after the treatment in both groups compared with the values before the treatment[The treatment group respectively (82.16±21.37)mg/L, (68.84±9.71)mm/h, (84.92±15.31)IU/L,the control group respectively (52.46±22.26)mg/L, (62.72±33.31)mm/h, (85.17±14.23)IU/L, P<0.01],while the decrease of CRP in the treatment group was much obvious than the control group(P<0.05),but the change of ESR had no statistical significance between the two group after the treatment(P>0.05);Number of joint tenderness, The number of swollen joints, Time of morning stiffness, Dual hands grip strength , 20 m walking time decreased obviously in both groups after the treatment[After the treatment, the treatment group respectively (3.43±1.46), (2.95±1.35), (19.32±16.54)min,(79.35±22.14)mmHg,(19.32±4.81)s,the control group respectively (4.63±4.21), (3.55±2.47), (21.23±19.37)min,(77.81±16.22)mmHg,(25.15±5.81)s before the treatment, the treatment group respectively(10.71±5.12), (7.95±3.97), (109.32±68.52)min, (47.12±18.22)mmHg, (36.21±6.62)s, the control group respectively (11.54±5.32), (7.64±4.01), (96.02±58.39)min, (49.67±16.48)mmHg, (36.33±7.23)s](P<0.05). Conclusion Duhuo-Jisheng decoction could effectively improve the clinical symptoms of aged patients with osteoporosis and reduce the levels of their ESR, CRP, and RF.

参考文献/References:

 [1] Felson DT,Anderson JJ,Boers M,et al. American College of Rheumatology.Preliminary definition of improvement in rheumatoid arthritis[J]. Arthritis Rheum,1995,38(6):727-735.

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