愈痹汤联合甲氨蝶呤、塞来昔布治疗寒湿痹阻型类风湿关节炎43例临床观察

Clinical Observation on 43 Cases of Rheumatoid Arthritis with Cold-damp Obstruction Syndrome with Yubi Tang(愈痹汤)Combining Methotrexate and Celecoxib

目的:观察愈痹汤联合甲氨蝶呤、塞来昔布治疗寒湿痹阻型类风湿关节炎的临床疗效及安全性。方法:将86例类风湿关节炎患者按照随机数字表法分为对照组和治疗组,每组43例。对照组给予甲氨蝶呤每次10 mg,每周1次,口服;塞来昔布胶囊每次0.2 g,每日2次,口服。治疗组在对照组治疗基础上加服愈痹汤。2组1个疗程均为12周。观察2组临床疗效,以及治疗前后临床症状、体征、实验室指标。结果:治疗组显效25例,有效15例,无效3例,总有效率为93.02%;对照组显效14例,有效19例,无效10例,总有效率为76.74%。2组比较,差异有统计学意义(P<0.05)。治疗后,2组压痛关节数、肿胀关节数、晨僵时间、疼痛视觉模拟评分法(VAS)评分和美国健康评估问卷(HAQ)评分较治疗前均有改善(P<0.05),且治疗组压痛关节数、晨僵时间、VAS评分和HAQ评分均明显低于对照组(P<0.05)。2组DAS28评分及实验室指标较治疗前均明显改善(P<0.05),且治疗组优于对照组(P<0.05)。治疗组不良反应发生率4.65%,明显低于对照组的23.26%(P<0.05)。结论:愈痹汤联合甲氨蝶呤、塞来昔布治疗寒湿痹阻型类风湿关节炎,较使用甲氨蝶呤、塞来昔布有更好的临床疗效,并可减少不良反应的发生。

Objective：To explore the clinical efficacy and safety of Yubi Tang（愈痹汤）combined with methotrexate and celecoxib in the treatment of rheumatoid arthritis with cold-damp obstruction syndrome.Methods：Eighty-six patients with rheumatoid arthritis were randomly divided into a control group and a treatment group,43 cases in each group.The control group was given 10 mg of methotrexate once a week,and 0.2 g of Celecoxib Capsules twice a day.The treatment group was treated with Yubi Tang based on the treatment for the control group.The two groups were treated for 12 weeks.The clinical efficacy and clinical symptoms,signs and laboratory indexes of the two groups were observed.Results：In the treatment group,25 cases were markedly effective,15 cases were effective,3 cases were invalid,and the total effective rate was 93.02%;while in the control group,14 cases were markedly effective,19 cases were effective and 10 cases were ineffective,and the total effective rate was 76.74%.The difference between the two groups was statistically significant（P 〈0.05）.After treatment,tenderness joint count,swelling joint count,morning stiffness time,VAS scores and HAQ scores were improved（P〈 0.05）,and tenderness joint count,morning stiffness time,VAS scores and HAQ scores in the treatment group were significantly lower than those in the control group（P 〈0.05）.The DAS28 scores and laboratory indexes of the two groups were significantly improved compared with those before treatment（P〈 0.05）,and the treatment group was better than the control group（P 〈0.05）.The incidence of adverse reactions in the treatment group was 4.65%,which was significantly lower than 23.26% of the control group.Conclusion：Yubi Tang combined with methotrexate and celecoxib has a better clinical efficacy than methotrexate and celecoxib in the treatment of rheumatoid arthritis with cold-damp obstruction,and it can reduce the occurrence of adverse reactions.