加味独活寄生汤配合糖皮质激素治疗风湿性多肌痛疗效观察

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

目的:观察加味独活寄生汤治疗风湿性多肌痛的疗效,研究加味独活寄生汤在减少糖皮质激素的剂量及减低糖皮质激素的毒副反应方面的作用。方法:风湿性多肌痛患者64例,随机分为2组,试验组(加味独活寄生汤加泼尼松组)34例,对照组(单用泼尼松组)31例。两组均给予泼尼松15mg/d,2周后根据病情酌情减量,试验组加服加味独活寄生汤煎剂,每次200m l,每日2次,共治疗12周。结果:试验组34例,临床缓解11例(32.34%),显效15例(44.12%),有效7例(20.59%),无效1例(2.94%),总有效率97.06%;对照组31例分别为5例(16.13%),8例(25.81%),13例(41.94%),5例(16.13%),及83.87%。两组比较,差异有显著性(P<0.05);试验组血沉比对照组下降快(P<0.05),试验组泼尼松用量比对照组用量小(P<0.05),不良反应(P<0.01)结论:加味独活寄生汤有利于减少糖皮质激素的剂量,减低糖皮质激素的副作用,提高疗效。

Objective： The study is both to observe the effect of modified duhuojisheng Decoction （DHD） in treating the polymyalgia rheumatica （PMR）. and lowing the dose, the side -effect of glycocorticoid. Methods： Thirty patients with PMR were randomly assigned to two groups, the 16 patients in the treatment group treated with DHD 200ml each time, twice a day and combined with prednisone ; the 14 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 34 patients of the treatment group was remission in 11 （32.34%）, markedly effective in 15（44. 12%） , effective in 7 （20.59%） , and ineffective in 1 （ 2.94% ）, with the total effective rate of 97.06% ; while that for the 31 patients of the control group, the corresponding numbers and percentages were 5 （ 16.13% ）, 8 （ 25. 81% ）, 13 （ 41. 94% ）, 5 （16.13%）, and（83.87% ）. Compared with the control group, the treatment group can alleviatethe activity of PMR more significantly （ P 〈 0.05 ） ; showing a greater and quicker decrease of erythrocyte sedimen - tafion rate P 〈 0.05 ） ; the dosage of prednisone demanded in the treatmentgroup was reduced faster than that in the control group （ P 〈 0.05 ） ; and the side- effect is lower than the control group（： P 〈 0.01 ）. Conclusion DHD was helpfuho shorten the therapeutic course for PMR, decrease the dosage and side - effect of glucocorficoid used and raise the therapeutic efficacy.