清热利湿活血综合疗法治疗活动期类风湿关节炎患者212例疗效分析

Analysis on the Efficacy on 212 Cases of Rheumatoid Arthritis at the Active Stage Treated with the Comprehensive Therapy for Clearing-away Heat,Eliminating Damp and Activating Blood Circulation

目的验证清热利湿活血综合疗法对湿热痹阻型活动期类风湿关节炎的疗效。方法采用关节症状体征评分、晨僵时间、疾病活动性评分(DAS28评分)、健康评价调查表指数(HAQ)、ACR疾病疗效评价、安全性指标等,对12家医院212例湿热痹阻型活动期类风湿关节炎患者清热利湿活血综合疗法治疗前后的疗效进行评价。结果治疗4周后,关节屈伸不利积分从治疗前的(1.78±0.84)分降低为(1.24±0.65)分,晨僵时间从治疗前的(117.5±227.31)min降低为(58.37±52.43)min(P<0.01),肿胀积分从治疗前的(1.92±0.69)分降低为(1.50±2.93)分(P<0.05)。治疗12周后,患者的HAQ指数从29.24±15.30降低为10.55±6.89(P<0.01);DAS评分从6.43分降低为4.52分(P<0.01);ACR20/50/70的达标率分别为72.64%、40.56%、9.91%;未发生严重不良事件。结论清热利湿活血综合疗法可迅速改善湿热痹阻型活动期RA患者临床症状体征,改善其生活质量,降低疾病活动性,提高疾病疗效,安全性较好,体现了中医药的优势。

Objective To verify the efficacy on rheumatoid arthritis（RA）at active stage,the pattern/syndrome of blockage by damp and heat treated with the comprehensive therapy for clearing away heat,eliminating damp and activating blood circulation.Methods The scale of joint symptoms and physical signs,time of morning stiffness,DAS28 score,HAQ index,ACR response criteria and safety index were adopted to assess the efficacy of 212 cases of RA at the active stage,the pattern/syndrome of blockage by damp and heat treated with the comprehensive therapy for clearing away heat,eliminating damp and activating blood circulation.Results In 4 weeks of treatment,the score of limited joint flexion and extension was reduced to be（1.24±0.65）from（1.78±0.84）before treatment,the time of morning stiffness time was（58.37±52.43）min from（117.5±227.31）min before treatment（P0.01）and the swelling score was（1.50±2.93）from（1.92±0.69）before treatment（P0.05）.In 12 weeks of treatment,HAQ index was reduced to be（10.55±6.89）from（29.24±15.30）（P0.01）and DAS score was from 6.43 to 4.52（P0.01）;ACR20/50/70 response criteria were 72.64%,40.56% and 9.91% separately;the serious adverse events were not discovered.Conclusion The comprehensive therapy for clearing away heat,eliminating damp and activating blood circulation rapidly relieves the clinical symptoms and physical signs of the patients with RA at the active stage,the pattern/syndrome of blockage by damp and heat,improves the quality of life,reduces the disease activity and increases the efficacy.The therapy is good at the safe treatment and embodies the advantages of Chinese medicine.