自拟扶正祛邪化瘀汤配合针刺治疗类风湿关节炎的临床观察

Clinical Observation of Rheumatoid Arthritis Treated with Self-made Fuzheng Quxie Huayu Decoction Combined with Acupuncture

目的:观察自拟扶正祛邪化瘀汤配合针刺治疗类风湿关节炎(RA)的临床疗效。方法:RA患者80例随机分为观察组和对照组,每组各40例。对照组给予西药常规治疗,观察组在对照组基础上配合自拟扶正祛邪化瘀汤配合针刺治疗,两组均每日1次,连续治疗4周。治疗结束后观察比较两组治疗前后临床症状、实验室指标[包括类风湿因子(rheumatoid factor,RF)、C-反应蛋白(C-reactive protein,CRP)、血沉(erythrocyte sedimentation rate,ESR)、抗环瓜氨酸肽抗体(A-CCP)水平]以及疾病活动度(DAS28评分)。结果:观察组临床总有效率为90.0%,高于对照组的77.5%,差异有统计学意义(P<0.05);治疗后,两组患者晨僵时间、休息痛、压痛个数、肿胀个数、双手握力和健康状况问卷均较治疗前明显改善(P<0.05),观察组优于对照组(P<0.05);两组患者治疗后RF、CRP、ESR、A-CCP指标均较治疗前降低(P<0.05);观察组较对照组改善明显(P<0.05);两组患者治疗后DAS28评分均较治疗前下降(P<0.05),观察组DAS28评分均低于对照组(P<0.05)。结论 :自拟扶正祛邪化瘀汤配合针刺治疗RA疗效稳定,可改善RA患者的症状,RF、CRP、ESR、A-CCP指标等实验室指标以及RA疾病的活动度。

Objective ：To observe the clinical efficacy of fuzheng quxie huayu decoction combined with acupuncture in the treatment of rheumatoid arthritis （RA）. Methods ： 80 patients with RA were randomly divided into the observation group and the control group, 40 cases in each group.The control group was given treatment with western medicine.The observation group was given self-made fuzheng quxie huayu decoction combined with acupuncture treatment on the basis of the control group. The two groups were treated 1 time·d -1 and total 4 weeks. After the treatment, the clinical symptoms and laboratory indicators including rheumatoid factor （RF）, C-reactive protein（CRP）, erythrocyte sedimentation rate（ESR）, anti cyclic citrullinated peptide antibody （A-CCP） and disease activity were observed before and after treatment in two groups. Results ： The total clinical effective rate of the observation group was 90.0%, higher than that of the control group 77.5% （ P 〈0.05）. After the treatment, the morning stiffness time, rest pain, the number of pain, the number of swelling, the grip strength and the health status of the two groups were significantly improved （ P 〈0.05）, and the observation group was better than the control group （ P 〈0.05）. After treatment, the indexes of RF, CRP, ESR and A-CCP were lower than those before treatment （ P 〈0.05）, and the improvement of the observation group was higher than that of the control group （ P 〈0.05）. The DAS28 scores in the two groups were all lower than those before the treatment （ P 〈0.05）, and the DAS28 scores in the observation group were lower than those in the control group （ P 〈0.05）. Conclusion ： The effect of self-made fuzheng quxie huayu decoction combined with acupuncture in the treatment of RA is stable, and can improve the symptoms of RA patients, laboratory indexes such as RF, CRP, ESR and A-CCP, as well as the degree of activity of RA disease.