四生蠲痹汤治疗类风湿关节炎临床观察

Clinical Observation of Treatment of Rheumatoid Arthritis with Sisheng Juanbi Decoction

目的:观察自拟四生蠲痹汤加减配合甲氨碟呤(MTX)治疗类风湿关节炎的临床疗效。方法:将类风湿性关节炎62例分为两组,治疗组采用自拟四生蠲痹汤加减配合MTX治疗32例,对照组单用MTX治疗30例。结果:治疗组有效31例,总有效率96.88%;对照组总有效23例,总有效率76.67%(P<0.05),两组中医证候疗效比较,差异有统计学意义(P<0.05)。比较两组主要指标疗效,发现在关节压痛数、晨僵时间等方面疗效相同(P>0.05),而在疼痛水平和关节肿胀数变化上,治疗组与对照组相比差异有统计学意义(P<0.05)。而在关节恶寒喜暖、腰膝酸软、神疲乏力等体现肾虚的症候方面,治疗组与对照组比较差异有统计学意义(P<0.05)。比较两组不良反应发生率有统计学差异(P<0.05),提示在药物安全性方面,治疗组要优于对照组。结论:中西医结合治疗类风关在总有效率、中医证候疗效比较、主要指标疗效的疼痛水平和关节肿胀数变化上、不良反应发生率都较对照组好。

Objective：To observe the clinical therapeutic effect of modified Sisheng Juanbi Decoction combined with MTX on treatment of rheumatoid arthritis. Methods： 62 patients with rheumatoid arthritis were divided into two groups. 32 patients in the treatment group were treated with modified Sisheng Juanbi decoction and MTX and 30 patients in the control group were only treated with MTX. Results： 31 patients in the treatment group had effect and the total effective rate of the treatment group was 96.88%. 23 patients had effect in the control group and the total effective rate of the treatment group was 76.67%. There was statistical significance in the comparison of therapeutic effect on syndromes of the two groups （P〈0.05）. In the comparison of therapeutic effect on main indicators of the two group, there were no statistical significance in joint tenderness count and morning stiffness time （P〉0.05）, but there were statistical significance in pain level, joint swollen degree （P〈0.05）. In symptoms of kidney deficiency such as aversion to cold, soreness and weakness of waist and knee, lack of energy and force, there were statistical differences between the treatment group and control group. There was statistical difference between the adverse reaction of the two groups（P〈0.05） as well, which indicated that in improving the safety of drugs, the treatment group was better than the control group. Conclusion： In improving total effective rate, comparison of therapeutic effect on syndromes, changes of pain level and joint swollen degree, incidence of adverse reaction, combination of Chinese and western medicine for rheumatoid arthritis is better than only western medicine.