益气养血通络法对类风湿关节炎血红蛋白、血小板的影响

Effects of the Therapy of Replenishing Qi,Nourishing Blood and Dredging Collaterals on Hemoglobin and Platelet of Rheumatoid Arthritis Patients

目的:观察益气养血通络方对类风湿关节炎(Rheumatoid Arthritis,RA)疗效及血红蛋白、血小板(PLT)的影响。方法:将60例RA贫血患者随机分为两组,治疗组30例用益气养血通络方联合来氟米特、甲氨喋呤治疗;对照组30例用琥珀酸亚铁片联合来氟米特、甲氨喋呤治疗;两组均以4周为1个疗程,3个疗程后观察疗效,观测患者血沉(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)、血常规、肝、肾功能及尿常规,中医症候、休息痛、晨僵时间、握力、关节肿胀数(SJC)、关节压痛数(TJC)及患者和医生的总体评价积分、同时观察药物的不良反应。结果:总有效率治疗组为93.4%,对照组为73.3%,两组比较,差异有统计学意义(P<0.05);中医证候疗效治疗组优于对照组(P<0.05);在晨僵、握力、关节肿胀数、关节压痛数、休息痛的改善,提高血红蛋白含量、降低ESR、CRP、RF、PLT方面治疗组优于对照组(P<0.05)。结论:益气养血通络方对RA疗效显著,能降低血小板计数,提高患者血红蛋白含量。

Objective：To observe effects of the therapy of replenishing qi,nourishing blood and dredging collaterals on hemoglobin and platelet of rheumatoid arthritis（RA）patients.Methods：Sixty patients with RA and anemia were randomly divided into two groups,30 patients in the treatment group were treated with therapy of replenishing qi,nourishing blood and dredging collaterals combined with leflunomide and methopterin,and 30 patients in the control group were treated with Ferrous succinate combined with leflunomide and methopterin.Both of the two groups were treated for 4 weeks as a course of treatment.After 3 courses of treatment,the erythrocyte sedimentation rate（ESR）,creaction protein（CRP）,rheumatoid factor（RF）,blood routine,liver function,renal function,urine routine,the symptoms of traditional Chinese medicine,rest pain,time of morning stiffness,grasp force,swollen joint count（SJC）,tender joint count（TJC）,evaluation of doctor and patients,as well as adverse effect of medicine were observed.Results：The total effective rates were 93.4% and 73.3% in the treatment group and control group respectively.The clinical efficacy of treatment group was apparently superior to that of control group,indicating significant difference in comparison（P〈0.05）.The syndrome relief of the treatment group showed a better outcome（P〈0.05）.The treatment group also showed better results on improvement of morning stiffness,grasp force,swollen joint count（SJC）,tender joint count（TJC）and rest pain and increasing the blood levels of hemoglobin and down-regulation of ESR,CRP,RF and PLT levels（P〈0.05）.Conclusion：Therapy of replenishing qi,nourishing blood and dredging collaterals presents significant efficacy on RA.It can decrease PLT and increase the blood levels of hemoglobin.