病证结合优化方案治疗类风湿关节炎22例临床观察

Clinical Study on 22 Rheumatoidarthritis Patients Treated with Optimum Proposal of Integration of Disease and TCM Syndrome

目的探讨病证结合优化方案治疗类风湿关节炎的疗效和安全性。方法将76例类风湿关节炎患者分为中药组、中西组和西药组3组。中药组(22例)采用病证结合优化方案治疗;中西组(29例)在病证结合方案基础上加用洛索洛芬钠片60mg,每日3次,来氟米特20mg,每日1次;西药组(25例)单纯应用上述西药治疗,3个月为1个疗程,连续治疗3个疗程。治疗3个月和9个月后,观察3组患者疼痛视觉模拟评分(VAS)、关节疼痛数、关节肿胀数、双手平均握力、晨僵时间以及血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)以及不良反应。结果治疗3个月和9个月后,与本组治疗前比较,3组在VAS评分、关节疼痛数、关节肿胀数、双手平均握力、晨僵时间以及ESR方面改善均有统计学意义(P<0.05或P<0.01);治疗3个月和9个月后中西组和中药组在改善VAS评分方面明显优于西药组(P<0.05)。3组患者总体疗效比较无统计学意义(P>0.05),中药组不良反应发生率明显低于西药组和中西组(P<0.05)。结论病证结合优化治疗方案治疗RA疗效肯定,在改善疼痛方面疗效明显,不良反应较少。

Objective To study the effect and safety of optimum proposal of integration of disease and TCM syndrome for the treatment of rheumatoidarthritis.Methods Seventy-six rheumatoidarthritis patients were randomized into Chinese herbal group（22 cases）,Chinese herbal plus western medicine group（29 cases）,and western medicine group（25 cases）.The Chinese herbal group was treated with the optimum proposal of integration of disease and TCM syndrome,based on which,the Chinese herbal plus western medicine group was treated with loxoprofen sodium tablets（60mg,twice a day）and leflunomide（20mg,once a day）.The western medicine group was treated with western medicines alone.Three months constitue once course,3 courses in succession were fufilled.Three and nine months after treatment,the scores of visual analogue scale（VAS）,number of painful joints,number of swelling joints,mean grip strength of hands,morning stiffness time,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,rheumatoid factors（RF）,and untoward effect of 3 groups were observed.Results Three and nine months after treatment,there was significant difference in all 3 groups in VAS,number of painful joints,number of swelling joints,mean grip strength of hands,morning stiffness time,and ESR as compared with those before treatment（P0.05 or P0.01）,and the improvement of VAS score in Chinese herbal plus western medicine group and Chinese herbal group was more obvious than that of western medicine group（P0.05）.The general effect of 3 groups was without significant difference（P0.05）.The incidence of untoward effect in the Chinese herbal group was less than that of the western medicine group and the Chinese herbal plus western medicine group（P0.05）.Conclusion The effect of optimum proposal of integration of disease and TCM syndrome in the treatment of rheumatoidarthritis is definit,especially in analgesia,and with less untoward effect.