益肾散寒方治疗类风湿关节炎(寒湿痹阻证)65例临床观察

Clinical observation on treating 65 cases of rheumatoid arthritis with Yishen Sanhan recipe

目的:观察益肾散寒方对类风湿性关节炎(寒湿痹阻证)的疗效。方法:将符合类风湿性关节炎诊断标准和寒湿痹阻型痹证分型标准的患者按随机数字表法分为治疗组和对照组各65例,治疗组给予益肾散寒方,1剂/d,水煎服,对照组给予非甾体抗炎药联合慢作用抗风湿药的常规方案,疗程均为8周。观察患者治疗前后症状与体征变化、空腹血清血沉(ESR)、C-反应蛋白(CRP)、白介素-1(IL-1)和肿瘤坏死因子(TNF-α)水平变化,记录不良反应。结果:①治疗组总有效率95.39%显著高于对照组的90.77%in the control(P<0.01,u=79.051);②治疗组治疗后在关节疼痛、关节肿胀、关节压痛、关节功能障碍等指标上显著优于对照组(P<0.05或P<0.01);③治疗组治疗后ESR、CRP、IL-1、TNF-α等炎性生化指标降低均显著优于对照组(P<0.05或P<0.01);④对照组部分患者出现肝功损伤和明显消化道反应,治疗组部分患者出现轻微消化道反应。结论:益肾散寒方是一首治疗类风湿性关节炎(寒湿痹阻证)的有效方剂,且服用安全。

Objective： To observe the effect of the Yishen Sanhan recipe. Methods： 65 Patients with rheumatoid arthritis were randomly divided into treatment group and control group, the treatment group received the Yishen Sanhan recipe, the control group was given anti-inflammatory drugs. Recording serum erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, interleukin-1 （IL-1） and tumor necrosis factor （TNF-α） levels and adverse reactions. Results：①The total efficiency of 95.39%in the treatment was significantly higher than 90.77%in the control （P〈0.01, u=79.051）;②Treatment group on indicators such as joint pain, joint swelling, joint tenderness, joint dysfunction significantly better than the control group （P〈0.05 or P〈0.01）; ③In the treatment group ESR, CRP, IL-1, TNF-α and other inflammatory biochemical parameters were significantly lower than the control group （P〈0.05 or P〈0.01）;④Some patients in the control group showed more obvious liver damage and gastrointestinal reactions gastrointestinal reactions. Conclusion：The Yishen Sanhan recipe is an effective prescription for rheumatoid arthritis （Hanshi Bizu）.