外用清热利湿通络中药治疗湿热痹阻型类风湿关节炎临床研究

Effect of external application of Chinese medicine of clearing heat,draining dampness and dredging collaterals on rheumatoid arthritis in dampness-heat obstruction pattern

目的探讨外用清热利湿通络中药治疗湿热痹阻型类风湿关节炎的临床疗效。方法选取2018年1月-2019年6月收治的辨证为湿热痹阻型类风湿关节炎患者107例,根据患者意愿分为对照组和试验组。对照组53例采用甲氨蝶呤及塞来昔布治疗,试验组54例在对照组治疗基础上加外用清热利湿通络中药外敷关节局部并配合背俞穴贴敷,末次治疗结束后,评估两组临床疗效、临床症状、体征评分,炎症因子水平及安全性。结果治疗后,试验组总有效率较对照组高(P<0.05),差异具有统计学意义。治疗结束后,试验组关节肿胀评分、疼痛评分、晨僵评分、皮温评分均较对照组低(P<0.05),差异具有统计学意义;试验组RF、ESR、TNF-α、IL-1、CRP水平均较对照组低(P<0.05),差异具有统计学意义;试验组不良反应发生率与对照组相比差异无统计学意义(P>0.05)。结论在常规西药治疗基础上,采用清热利湿通络中药外用可提升湿热痹阻型类风湿关节炎治疗效果,减轻临床症状、体征,降低炎症因子,且不良反应少,安全性较高。

Objective To investigate the clinical efficacy of external application of Chinese medicine for clearing heat,draining dampness and dredging collaterals on rheumatoid arthritis(RA)in dampness-heat obstruction pattern.Methods 107 patients with RA in dampness-heat obstruction pattern admitted to the hospital from January,2018 to June,2019 were divided into the control group(n=53)and the treatment group(n=54)according to the patients′preference.The control group was given methotrexate and celecoxib,while the treatment group was additionally given external application of Chinese medicine of clearing heat,draining dampness and dredging collaterals on the joints and the back-transport points.At the end of the treatment,the clinical effect,symptoms,signs,inflammatory factor level and safety were evaluated and compared between the two groups.Results After the treatment,the treatment group had higher total effective rate than the control group(P<0.05),with significance.The scores of joint swelling,pain,morning stiffness,skin temperature in the treatment group were lower than those in the control group(P<0.05),with significance.The treatment group had lower levels of RF,ESR,TNF-α,IL-1,CRP than the control group(P<0.05),with significance.There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Based on conventional treatment,external application of Chinese medicine of clearing heat,draining dampness and dredging collaterals on RA in dampness-heat obstruction pattern can improve curative effect,alleviate symptoms and signs,decrease the level of inflammatory factors,with less adverse reactions and high safety.