中西医结合治疗类风湿关节炎30例临床观察

A clinical observation on combination of traditional Chinese and western medicine treating 30 cases rheumatoid arthritis

目的:观察中西医结合治疗类风湿关节炎对免疫功能、疗效的影响。方法:90例类风湿关节炎病例按性别、年龄、DAS28积分均衡后分为对照组(30例)、观察1组(30例)、观察2组(30例)。对照组采用西药治疗;观察1组采用健脾祛湿、益气养血药膳联合西药治疗;观察2组采用祛风除湿、活血强筋、温阳养阴中药联合西药治疗。3个月后评价治疗疗效及对免疫功能的影响。结果:对照组总有效率40.0%,观察1组73.3%,观察2组76.7%,观察1组优于对照组(P<0.05),观察2组优于对照组(P<0.05),观察1组与观察2组差异无统计学意义(P>0.05)。结论:药膳健脾祛湿、益气养血,可以提高疗效和长期中药治疗的依从性;中药祛风除湿、活血强筋、温阳养阴能改善α1球蛋白、γ球蛋白百分率、CRP、IgG、辅助性T淋巴细胞百分率、辅助性T淋巴细胞/抑制性T淋巴细胞比值、CD4绝对计数指标并提高疗效。

Objective To study the immunologic function and curative effect of rheumatoid arthritis patients treatment intervened by Chinese herb or Chinese herb diet respectively. Methods 90 cases of rheumatoid arthritis were divided into control group (30 cases),observe group 1(30 cases),observe group 2 (30 cases) and balanced by gender,age and DAS28 score. Treated with control group: Western medicine observe group 1:invigorating spleen and removing dampness,tonifying Qi and nourishing blood Chinese herb+ Western medicine,observe group 2:removing wind and dampness,activating blood and strengthening tendons,warming yang and nourishing yin Chinese herb+ Western medicine,respectively for 3 months.To evaluate the effect of treatment on the curative effect and immunologic function. Results Total effect:control group is 40.0%,observe group 1 is 73.3%,observe group 2 is 76.7%,the comparisons between the control group and the observe group 1 (P <0.05),the control group and the observe group 2 (P <0.05), the observe group 1 and the observe group 2 ( P >0.05). Conclusion Treated with invigorating spleen and removing dampness,tonifying Qi and nourishing blood Chinese herb diet+ Western medicine could improve curative effect and maintain the willing of a long-term Chinese herb diet treatment.Treated with removing wind and dampness,activating blood and strengthening tendons,warming yang and nourishing yin Chinese herb+ Western medicine could improve the indexes including percentage ofα1-globulin,percentage ofγ-globulin,hs-CRP,IgG counts,percentage of T helper cells,helper T lymphocyte/inhibitory T lymphocyte ratio,cd4 T-cell counts,meanwhile improve curative effect.