补肾壮骨法治疗类风湿关节炎的临床观察

Clinical observation of rheumatoid arthritis treated with Strong Kidney-bone Formula

目的:观察补肾壮骨法治疗类风湿关节炎(RA)肾虚寒盛证的临床疗效及对放射学改变的影响。方法:共80例RA患者且中医辨证属肾虚寒盛证者,随机分为治疗组40例,对照组40例。治疗组给予补肾祛寒治尪汤加甲氨蝶呤及白芍总苷治疗,对照组给予甲氨蝶呤加白芍总苷治疗,两组疗程均为24周。观察两组治疗前后症状、体征、患者及医生对病情的评估、健康状况评估(HAQ)、红细胞沉降率(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)等实验室指标、疾病活动指数(DAS28)、放射学评估(SHS)及中医证候积分情况。结果:治疗组在压痛关节数、肿胀关节数、患者对疾病评估、D AS28、中医证候积分方面明显好于对照组(P<0.05)。且治疗组患者治疗后SHS增加情况明显小于对照组值(P<0.05)。结论:补肾壮骨法能有效缓解RA患者的病情,且对于延缓RA患者的影像学进展有较好的疗效。

Objective： To observe the therapeutic effect and change of radiological features of patients with rheumatoid arthritis which treated with Strong Kidney-bone Formula. Methods： 80 patients of RA with kidney deficiency and cold syndrome in TCM were divided into two groups, each group had 40 patients. One group were treated with Biangshen Quhan Zhiwang Tang plus Methotrexate and total glucosides of paeony capsules, the other were treated with Methotrexate and total glucosides of paeony capsules. The courses of treatment were all 24 weeks. All patients were measured the symptoms, objective signs, evaluation of pathogenetic condition by patients and doctors, HAQ, ESR, CRP, RF, DAS28, SHS and integration of TCM symptom before and after the course. Results： The patients of healing group showed significant better levels in tenderness joint number, swell joint number, evaluation of pathogenetic condition by patient, DAS28 and integration of TCM symptom （P〈0.05）. The changes of SHS after treatment in healing group were obviously less than that in the control group （P〈0,05）. Conclusion： The Strong Kidney-bone Formula can effectively relieve the clinical illness and retard joint damage.