从寒热辨证探讨雷公藤片对类风湿性关节炎的临床疗效

Clinical Observation of Therapeutic Effect of Tripterygium Wilfordii Tablets on Rheumatoid Arthritis from Differentiation of Cold and Heat

目的:观察雷公藤片对类风湿关节寒湿痹阻证(寒痹)、湿热痹阻证(热痹)两种不同证型的临床疗效。方法:选取80例类风湿关节炎患者,其中40例寒痹,40例热痹,随机分为对照组寒痹、对照组热痹、治疗组寒痹、治疗组热痹四组。对照组予以甲氨蝶呤片治疗,治疗组在对照组的基础上加用雷公藤片,12周为1个疗程。观察并记录四组患者治疗前后症状及体征、中医证候积分变化。结果:治疗后四组患者中医症状积分较前下降,治疗组总有效率(82.5%)高于对照组(62.5%),差异具有统计学意义(P<0.05);四组患者各项指标较治疗前均有显著改善,治疗前后比较,差异有统计学意义(P<0.05),其中治疗组热痹疗效显著(P<0.01)。结论:雷公藤片治疗类风湿关节炎可以改善临床症状及相关体征,其中对热痹疗效更明显,值得临床应用。

Objective:To observe the clinical effect of Tripterygium wilfordii tablets on rheumatoid arthritis syndrome of cold-dampness obstruction(cold-dampness obstruction)and damp-heat obstruction(heat-dampness obstruction).Methods:80 patients with rheumatoid arthritis were randomly divided into four groups:control group,control group,treatment group and treatment group.The control group was treated with methotrexate tablets,while the treatment group was treated with Tripterygium wilfordii tablets on the basis of the control group,12 weeks as a course of treatment.To observe and record the changes of symptoms,signs and integrals of TCM syndromes before and after treatment in four groups.Results:After treatment,the scores of TCM symptoms in the four groups decreased.The total effective rate in the treatment group(82.5%)was higher than that in the control group(62.5%).The difference was statistically significant(P<0.05).The indexes in the four groups were significantly improved compared with those before treatment,and the difference was statistically significant(P<0.05).Therapeutic effect of heat arthralgia in group A was significant(P<0.01).Conclusion:Tripterygium wilfordii tablets can improve clinical symptoms and related signs of rheumatoid arthritis,especially for heat arthralgia,which is worthy of clinical application.