中西医结合治疗类风湿关节炎临床研究

Clinical Study on Treatment of Rheumatoid Arthritis with Integrated Traditional Chinese and Western Medicine

目的:观察中西医结合治疗对类风湿关节炎(rheumatoid arthritis,RA)患者躯体症状及血清炎症因子、风湿四项因子水平的影响。方法:86例RA患者按照随机数字表法分为观察组和对照组各43例。对照组(中途脱落3例)予以西医常规疗法;观察组(中途脱落5例)在对照组治疗基础上给予三乌芍蝎汤。比较两组患者临床疗效及不良反应发生情况,记录两组患者治疗前后躯体症状(关节疼痛、肿胀、晨僵)评分结果、血清炎症因子白细胞介素-1β(interleukin-1β,IL-1β)、肿瘤坏死因子-α(tumour necrosis factor,TNF-α)检测结果及风湿四项因子[类风湿因子(rheumatoid factors,RF)、抗角蛋白抗体(antikeratin antibodies,AKA)、抗环瓜氨酸肽抗体(anti-cyclic citrullinated peptide antibody,ACCP)、抗链球菌溶血素"O"(antistreptolysin"O",ASO)]阳性率差异。结果:观察组有效率明显高于对照组(P<0.05),两组不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,两组躯体症状评分结果、血清炎症因子(IL-1β、TNF-α)检测结果及风湿四项因子(RF、AKA、ACCP、ASO)阳性率均较治疗前明显降低(P<0.05);观察组治疗后低于同期对照组,差异均有统计学意义(P<0.05)。结论:中西医结合治疗RA疗效显著,可显著改善患者躯体症状,调节炎症因子及风湿相关因子水平。

Objective：To observe the effect of combination of traditional Chinese and Western medicine on physical symptoms,serum inflammatory factors and four factors of rheumatoid arthritis（ RA）. Methods：86 cases of RA patients were randomly divided into the observation group and the control group with 43 cases in each group. The control group（ lost 3 cases） received conventional Western medicine treatment;the observation group（ lost 5 cases） was treated with San Wu Shao Xie soup. Comparison clinical effect and adverse reactions occurrence of the two groups of patients,recorded the two groups before and after treatment of somatic symptoms（ joint pain,swelling,morning stiffness） score,serum inflammatory factor interleukin 1 beta（ IL-1β）,tumor necrosis factor alpha（ TNF-α） test results and rheumatism four the factors of rheumatoid factor（ RF）,antikeratin antibodies（ AKA） and anti cyclic citrullinated peptide antibody（ ACCP）,antistreptolysin ＂ O＂（ ASO） in the positive rate of difference. Results：The observation group was significantly higher than that of the control group（ P〈0. 05）,compared the adverse effects of the two groups showed that the difference was not statistically significant（ P〉0. 05）. After treatment,two groups of somatic symptoms score,serum inflammatory factor（ IL-1β,TNF-α） detection results and rheumatism four factors（ RF,AKA,ACCP,ASO） positive rate was significantly lower than that before treatment（ P〈0. 05）;the patients in the observation group lower than the control group,the differences were statistically significant（ P〈0. 05）. Conclusion： The combination of traditional Chinese and Western medicine treatment of RA has obvious curative effect,which can significantly improve somatic symptoms of patients,regulatite inflammatory cytokines and rheumatoid factors.