地藤痹痛颗粒联合中药熏蒸治疗类风湿关节炎(寒痹)的临床观察

Clinical observation of Diteng Bitong Granules combined with Chinese medicine fumigation in the treatment of rheumatoid arthritis(cold arthritis)

目的观察地藤痹痛颗粒联合中药熏蒸对类风湿性关节炎(寒痹)的疗效及血清炎性因子的影响。方法纳入2016年1月—2018年1月类风湿性关节炎(寒痹)患者165例,随机分为治疗组和对照组,治疗组83例,对照组82例,两组均给予常规药物治疗,对照组在此基础上给予地藤痹痛颗粒,治疗组在对照组基础上联合中药熏蒸法,连续治疗30 d,观察治疗后两组有效率,治疗前后中医证候量表评分、血清核因子(NF-κB)、肿瘤坏死因子(TNF-α)、血清类风湿因子(RF)、C反应蛋白(CRP)、血沉(ESR)、白介素1β(IL-1β)及不良反应。结果两组治疗后,治疗组痊愈率为48.1%,有效率43.3%,总有效率91.5%;对照组痊愈率为34.1%,有效率45.1%,总有效率79.2%,两组痊愈率和有效率比较,差异具有统计学意义(P<0.05);两组治疗前后临床症状指标(关节肿胀度、压痛程度、关节疼痛数目、晨僵持续时间)与中医证候量表评分比较差异具有统计学意义,且治疗组优于对照组(P<0.05);两组治疗前后TNF-α、NF-kB、IL-1β、RF、CRP、ESR比较差异有统计学意义,且治疗组优于对照组(P<0.05)。结论地藤痹痛颗粒联合中药熏蒸治疗类风湿性关节炎(寒痹)确有良好的效果,值得临床应用推广。

Objective To observe the curative effect of Diteng Bitong Granules combined with Chinese medicine Fumigation on rheumatoid arthritis(cold arthritis)and its influence on serum inflammatory factors.Methods 165 patients with rheumatoid arthritis(cold arthritis)from January,2016 to January,2018 were randomly divided into the treatment group(83)and the control group(82).All the patients were treated with routine drugs.The control group was additionally given Diteng Bitong Granules and the treatment group was given Chinese medicine fumigation combined with Diteng Bitong Granules,for 30 days.The effective rate,TCM syndrome scale score,Nuclear Factor-Kappa B(NF-κB),tumor necrosis factor-alpha(TNF-α),serum rheumatoid factor(RF),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),interleukin-1 beta(IL-1β)and adverse reactions were observed.Results After treatment,the cure rate,effective rate,overall response rate in the treatment group were 48.1%,43.3%and 91.5%;and in the control group,34.1%,45.1%and 79.2%,with significant difference in the cure rate and effective rate(P<0.05).After treatment,the clinical symptom indexes(joint swelling,tenderness,number of joint pains,morning stiffness duration)and TCM syndrome score were different between the two groups with significance and the treatment group had better improvement than then control group(P<0.05).After treatment,improvement of TNF-α,NF-κB,IL-1β,RF,CRP,ESR was significant and the treatment group had better effect than the control group(P<0.05).Conclusion Diteng Bitong Granules combined with Chinese medicine fumigation has a good effect on rheumatoid arthritis(cold arthritis),which is worthy of clinical promotion.