益气理顽汤联合西药治疗寒热错杂类风湿关节炎随机平行对照研究

Mixed Cold and Heat Rheumatoid Arthritis Randomized Controlled Study Yiqi Liwan Tang(益气理顽汤) Combined Western Medicine Treatment Coercive

[目的]观察益气理顽汤联合西药治疗寒热错杂类风湿关节炎疗效。[方法]使用随机平行对照方法,将60例门诊患者按病志号抽签方法简单随机分两组;钙尔奇,0.6g/次,1次/d。对照组30例来氟米特,10mg/次,1次/d;醋氯芬酸,0.1mg/次,2次/d。治疗组30例益气理顽汤(黄芪30g,白术、鸡血藤、牛大力各20g,独活、海风藤、乌梢蛇、路路通、威灵仙、杜仲、桑寄生、当归、鸡内金、防风各15g,红花10g,全蝎3g),1剂/d,水煎250m L,早晚口服;西药治疗同对照组。连续治疗30d为1疗程。观测临床症状、晨僵、MMP-3、CRP、ESR、RF、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效11例,有效17例,无效2例,总有效率93.33%;对照组显效9例,有效15例,无效6例,总有效率80.00%;治疗组疗效优于对照组(P<0.05)。MMP-3、CRP、ESR、RF、寒热错杂证候积分两组均有明显改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]益气理顽汤联合西药治疗寒热错杂类风湿关节炎,疗效满意,无严重不良反应,值得推广。

[Objective] To observe Yiqi Liwan Tang（~ji~） combined western medicine treatment stubborn cold and heat mixed rheumatoid arthritis. [Method] Random parallel control method, 60 outpatients by case record number balloting simple random divided into two groups; Cahrate, 0.6 g/times, 1 times/d. 30 patients leflunomide, 10 mg/times, 1 times/d; aceclofenac, 0.1 mg/time, 2 times/d. Treatment group, 30 cases of coercive treatment Yiqi Liwan Tang（益气理顽汤） （Astragalus 30 g, Atractylodes suberectstem great cattle each 20g, independent living, the sea breeze rattan, black snake, Passepartout, Clematis, Eucommia, mistletoe, parsley, chicken inside gold, wind 15g, safflower 10 g, Scorpion 3 g）, 1 Ji/d, decoction 250 mL, sooner or later oral; western medicine with the control group. 30 d for a course of continuous treatment. Observation of clinical symptoms, inflammatory markers （MMP-3, CRP, ESR, RF）, adverse reactions. Continuous treatment 2 courses, to determine efficacy. [Results] The clinical efficacy of the treatment group than the control group （P〈0.05）. Inflammatory markers in both groups improved significantly （P 〈0.01）, to improve the treatment group than the control group （P〈0.01）. [Conclusion] Yiqi Liwan Tang（益气理顽汤） mixed cold and heat combined with western medicine rheumatoid arthritis, results were satisfactory, no serious adverse reactions, should be promoted.