加味阳和汤配合糖皮质激素治疗风湿性多肌痛临床观察

Clinical Observation on Effect of Modified Yanghe Decoction Combined with Glycocorticoid for Treatment of Polymyalgia Rheumatica

目的观察加味阳和汤对糖皮质激素治疗风湿性多肌痛使用剂量的影响。方法风湿性多肌痛患者61例,随机分为2组,中药组(加味阳和汤加泼尼松组)32例,对照组(单用泼尼松组)29例,两组均给予泼尼松20mg/d,2周后根据病情酌情减量,中药组加服加味阳和汤煎剂,每天1剂,共治疗12周。结果两组对风湿性多肌痛活动性疗效:中药组32例临床缓解9例(28.1%),显效15例(46.9%),有效7例(21.9%),无效1例(3.1%),总有效率96.9%;对照组29例分别为3例(10.3%),11例(37.9%),10例(34.5%),5例(17.2%)及82.8%。两组比较,差异有显著性(u=2.109,P<0.05);中药组血沉比对照组下降快(t=2.957,P<0.05);中药组泼尼松用量比对照组用量小(t=10.23,P<0.05)。结论加味阳和汤有助于缩短治疗风湿性多肌痛的疗程,减少糖皮质激素的剂量,提高疗效。

Objective To observe the effect of modified Yanghe Decoction （YHD） on the dose of glucocor-ticoid demanded in treating polymyalgia rheumatica （PMR）. Methods Sixty-one patients with PMR were ran-domly assigned to two groups, the 32 patients in the treatment group treated with YHD two doses per day com-bined with prednisone and the 29 patients in the control group treated with prednisone alone. The dosage of prednisone used was started from 20 mg/d and decreased step by step as possible after 2 weeks according to patient＇s condition. The therapeutic course for them all was 12 weeks. Results The therapeutic efficacy of PMR in the 32 patients of the treatment group was remission in 9 （28.1% ）, markedly effective in 15 （46.9%）, effective in 7 （21.9%）, and ineffective in 1 （3.1%）, with the total effective rate of 96.9%; while that for the 29 patients of the control group, the corresponding numbers and percentages were 3 （10.3 % ）, 11 （37.9 % ）, 10 （34.5%）, 5 （17.2%）, and 82.8%. Compared with the control group, the treatment group can alleviate the activity of PMR more significantly （ u = 2. 109, P 〈 0.05） showing a greater and quicker decrease of erythrocyte sedimentation rate （t = 2. 957, P 〈 0.05）; and the dosage of prednisone demanded in the treatment group was reduced faster than that in the control group （t=10.23, P 〈 0.05）. Conclusion YHD was helpful to shorten the therapeutic course for PMR, decrease the dosage of glucocorticoid used and raise the therapeutic efficacy.