甲氨蝶呤联合蠲痹补肾汤治疗类风湿性关节炎疗效及对ESR、CRP、RF、抗CCP抗体的影响

Efficacy of methotrexate combined with Juanbi Bushen decoction in the treatment of rheumatoid arthritis and its effect on ESR,CRP,RF and anti-CCP antibody

目的探讨甲氨蝶呤联合蠲痹补肾汤治疗类风湿性关节炎的临床疗效及对实验室指标的影响。方法选择该院2016年10月至2018年6月收治的类风湿性关节炎患者76例,随机分为对照组与观察组,各38例。对照组患者采用甲氨蝶呤治疗,观察组患者采用甲氨蝶呤联合蠲痹补肾汤治疗。结果观察组治疗后总有效率为92.11%,显著高于对照组的总有效率73.68%,差异有统计学意义(P<0.05);观察组临床症状及体征(晨僵时间、关节肿胀数、关节压痛数、关节疼痛度)治疗后疗效显著优于对照组,差异有统计意义(P<0.05);观察组实验室指标红细胞沉降率(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP抗体)治疗后下降水平高于对照组,差异有统计学意义(P<0.05)。结论甲氨蝶呤联合蠲痹补肾汤治疗类风湿性关节炎,可显著改善关节压痛、肿胀、晨僵、关节疼痛度及ESR、CRP、RF、抗CCP抗体水平,抗炎及免疫抑制效果比单用甲氨蝶呤更加显著。

Objective To investigate the clinical effect of methotrexate combined with Juanbi Bushen decoction on rheumatoid arthritis and its effect on laboratory indexes.Methods Totally76patients with rheumatoid arthritis treated in the hospital from October2016to June2018were randomly divided into control group and observation group with38cases each.The patients in the control group were treated with methotrexate and the patients in the observation group were treated with Juanbi Bushen decoction and methotrexate.Results The total effective rate of the observation group was92.11%,which was significantly higher than that of the control group(73.68%)(P<0.05).The clinical symptoms and signs(morning stiffness time,joint swelling number,joint tenderness number,joint pain degree)in the observation group were significantly better than those in the control group(P<0.05).The levels of ESR,CRP,RF,anti-CCP antibody in the observation group were higher than those in the control group(P<0.05).Conclusion The treatment of rheumatoid arthritis with methotrexate combined with Juanbi Bushen decoction can significantly improve the joint tenderness,swelling,morning stiffness,joint pain and the levels of ESR,CRP,RF,and anti-CCP antibody.The anti-inflammatory and immunosuppressive effects are more significant than those of methotrexate alone.