寄生仙灵汤合甲氨蝶呤治疗类风湿关节炎临床观察

Clinical Observation of Rheumatoid Arthritis Treated with Jisheng Xianling Decoction Combined with Methotrexate

目的观察补肾柔肝、蠲痹通络法组方的寄生仙灵汤合甲氨蝶呤治疗类风湿性关节炎的临床疗效。方法 65例类风湿性关节炎(RA)病例按随机数字表法分为寄生仙灵汤合用甲氨蝶呤治疗组(简称治疗组)和单独应用甲氨蝶呤对照组(简称对照组)治疗,治疗组使用寄生仙灵汤每日1剂和甲氨蝶呤5mg/周口服治疗;对照组使用甲氨喋呤15mg/周口服治疗。结果治疗组33例,其中脱落2例,显效10例,进步9例,有效9例,无效3例,总有效率90.32%;对照组32例,显效4例,进步8例,有效10例,无效10例,总有效率68.75%,两组总有效率比较,差异有统计学意义(P<0.05)。中医证候疗效:治疗组显效11例,进步9例,有效10例,无效1例,总有效率96.77%;对照组显效3例,进步8例,有效10例,无效11例,总有效率65.63%,两组总有效率比较,差异有统计学意义(P<0.05)。治疗组各项症状、证候积分改善较对照组明显。结论寄生仙灵汤合甲氨蝶呤治疗类风湿性关节炎安全、有效,并可降低甲氨蝶呤用量,减少副作用。

Objective To observe the clinical efficacy on rheumatoid arthritis treated with jisheng xianling decoction for tonifying kidney,softening liver,removing obstruction and promoting the circulation in collaterals and combined with methotrexate（MTX）.Methods 65 cases of rheumatoid arthritis were divided into jisheng xianling decoction combined MTX group（treatment group）and MTX group（control group）according to random number table.In treatment group,jisheng xianling decoction,1 dose per day,and MTX 5mg/week were taken orally.In control group,MTX,15 mg/week was taken orally.Results Of 33 cases in treatment group,2 cases were dropped off,10 cases effective markedly,9 cases improved,9 cases effective and 3 cases failed.The total effective rate was 90.32%.Of 32 cases in control group,4 cases effective markedly,8 cases improved,10 cases effective and 10 cases failed.The total effective rate was 68.75%.The statistical significant difference was indicated in comparison of the total effective rate between two groups（P0.05）.The improvements in every symptom and syndrome integral in treatment group were obvious as compared with control group.Conclusion Jisheng xianling decoction combined with MTX is safe and effective on rheumatoid arthritis.This combined medication can decrease MTX dose and reduce side effects.