摘要
目的观察当归拈痛汤加减辅助治疗湿热痹阻型类风湿关节炎(RA)的临床疗效。方法将76例湿热痹阻型活动性RA患者,随机分为试验组和对照组各38例。试验组采用甲氨蝶呤、来氟米特、加减当归拈痛汤联合治疗;对照组采用甲氨蝶呤、来氟米特联合治疗。治疗12周后,2组采用欧洲抗风湿病联盟(EULAR)疗效标准评估疗效。对比2组不同治疗方案前后的各项临床指标的变化情况。结果试验组患者总有效率为92.1%高于对照组的81.6%,差异有统计学意义(P<0.05)。试验组在达到ACR20、ACR50、ACR70方面疗效明显优于对照组,差异有统计学意义(P<0.05)。试验组在晨僵时间、关节压痛数、关节肿胀数、血沉、VAS评分、DAS28等方面的改善程度明显优于对照组,差异均有统计学意义(P<0.05)。治疗期间2组患者的白细胞减少及转氨酶升高的发生率比较差异均无统计学意义(P>0.05)。结论加减当归拈痛汤能显著改善湿热痹阻型RA的各项活动性指标,控制RA患者的急性期病情活动,无明显不良反应发生。
Objective To observe the effect of modified came pain angelica decoction in the treatment of damp heat obstruction type rheumatoid arthritis.Methods 76 patients with damp heat obstruction type rheumatoid arthritis were randomly divided into eXperimental group and control group,38 cases in each group.EXperimental group was treated with methotreXate,leflunomide and modified came pain angelica decoction.Control group was treated with methotreXate combined with leflunomide.After twelve weeks＆#39; treatment,Chinese medicinal clinical efficacy of the two groups were observed,and the European League Against Rheumatism（EULAR） clinical curative effect standard was adopted to evaluate the effect evaluation.The changes of the clinical indicators of patients before and after treatment between two group were compared.Results The total effective rate of eXperimental group（92.1%） was higher than that of control group（81.6%）,the difference was statistically significant（P〈0.05）.The eXperimental group was significantly better than control group in terms of ACR20,ACR50,ACR70,the differences were statistically significant（P〈0.05）.In eXperimental group,the improvement of morning stiffness time,joint tenderness,joint swelling,ESR,VAS score,DAS28 were all significantly better than control group,the differences were statistically significant（P〈0.05）.There was no significant difference between two groups in the incidence of white blood cell decrease and transaminase elevations during the treatment（P〈0.05）.Conclusion Modified came pain angelica decoction can significantly improve the activity indeX of RA,and control the acute phase of RA patients,no obvious adverse reactions occurred.
作者
邹庆华
石颖
蒋毅
牟方祥
方勇飞
ZOU Qinghua SHI Ying JIANG Yi et al(Integrated TCM ＆ Western Medicine Department, The First Affiliated Hospital of Third Military Medical University, Chongqing 400038, Chin)
出处
《临床合理用药杂志》
2017年第16期44-45,47,共3页
Chinese Journal of Clinical Rational Drug Use
关键词
加减当归拈痛汤
类风湿关节炎
湿热痹阻型
Modified came pain angelica decoction
Rheumatoid arthritis
Damp heat obstruction type
