断藤益母汤对类风湿关节炎贫血患者的疗效观察

Observation of Clinical Curative Effect of Duanteng Yimu Decoction in Patients with Rheumatoid Arthritis Anemia

目的:观察断藤益母汤治疗类风湿关节炎伴贫血患者的临床疗效并探讨其作用机制。方法:按照随机数字表法将108例RA贫血患者分为试验组和对照组,每组各54例。对照组予甲氨蝶呤片治疗,试验组予断藤益母汤治疗,观察期均为12周。观察两组患者临床疗效,于治疗前及治疗后第4、8、12周评价两组贫血中医证候积分、生活质量评分、红细胞计数(RBC)、血红蛋白(HB)、红细胞比积(HCT)、平均红细胞体积(MCV)、血清铁(SI)、铁蛋白(SF)、转铁蛋白(TF)、红细胞沉降率(ESR)、C-反应蛋白(CRP)等水平,并记录不良反应情况。结果:治疗12周后,试验组的总有效率为96.1%,对照组为84%;试验组优于对照组,差异有统计学意义(P<0.05);两组均能提高患者贫血中医证候评分及患者生活质量评分,改善RBC、HB、SI、TF、SF水平,降低炎症指标,试验组优于对照组且起效更快,差异有统计学意义(P<0.01或P<0.05)。结论:断藤益母汤治疗类风湿关节炎活动及贫血临床疗效确切,其作用机制可能与调控炎症因子水平、改善铁代谢紊乱有关。

Objective： To observe the clinical curative effect of Duanteng Yimu Decoction in the treatment of rheumatoid arthritis anemia and explore its mechanism of action. Methods： A total of 108 cases of RA anemia were divided into experimental group and control group according to the random number table method,54 cases in each group. The control group was treated with Methotrexate and the experimental group was given Duanteng Yimu Decoction. The observation period was 12 weeks. We observed the clinical efficacy of the two groups of patients and evaluated the levels of TCM syndrome integral anemia,life quality score,red blood cell count（ RBC）,hemoglobin（ HB）,hematocrit（ HCT）,mean corpuscular volume（ MCV）,serum iron（ SI）,ferritin（ SF）,transferrin（ TF）,erythrocyte sedimentation rate（ ESR） and C-reactive protein（ CRP） before and 4,8,12 weeks after treatment and recorded the adverse reaction. Results： After 12 weeks treatment,the total effective rate of the experimental group was 96. 1% and that of the control group was 84%. The experimental group was better than the control group and the difference was statistically significant（ P〈0. 05）. Two groups can both improve the patients＇ anemia TCM syndrome score and the quality of life score,ameliorate the levels of RBC,HB,SI,TF and SF and reduce inflammation index degree. The experimental group was better than the control group and had a faster onset,and the difference was statistically significant（ P〈0. 01 or P〈0. 05）. Conclusion： There is a definite curative effect of Duanteng Yimu Decoction in the treatment of rheumatoid arthritis and anemia. Its mechanism may be related to the regulation of the levels of inflammatory factors and improving the disorder of iron metabolism.