宣痹汤治疗类风湿关节炎湿热瘀阻证的疗效及安全性分析

Efficacy and safety analysis of Xuanbi Decoction on dampness and heat stasis syndrome in rheumatoid arthritis

目的:观察分析宣痹汤治疗类风湿关节炎湿热瘀阻证的疗效及安全性。方法:选取黄石普仁医院2017年5月-2018年5月收治的100例类风湿关节炎患者作为本次研究对象,采取随机抽签的方式将其分为观察组和对照组,两组各50例。给予对照组口服甲氨蝶呤,观察组则在其常规治疗基础上给予宣痹汤。对两组患者的总有效率、随访4、8、16个月复发率、WOMAC评分和DAS28以及不良反应发生率进行比较;检测两组患者C-反应蛋白(C-Reactive Protein,CRP)、血清肿瘤坏死因子(Tumour Necrosis Factor-α,TNF-α)、红细胞沉降率(Erythrocyte Sedimentation Rate,ESR)的含量。结果:观察组治疗总有效率92%(46/50),显著高于对照组72%(36/50)(P <0.05);观察组随访患者第4、8、16个月病情复发率分别是2%(1/50)、4%(2/50)、8%(4/50),显著低于对照组的10%(5/50)、14%(7/50)、24%(12/50)(P <0.05)。两组患者在治疗后西安大略和麦克马斯特大学骨性关节炎指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)和28个关节的疾病活动度评分(Disease Activity Score of 28 Joints,DAS28)均显著降低(P <0.05),且观察组在WOMAC和DAS28评分比较上均优于对照组(P <0.05)。观察组患者在CRP、TNF-α、ESR上均显著优于对照组(P <0.05)。观察组在不良反应(皮疹、口腔炎、咽喉炎、食欲减退、腹痛腹泻)发生率上显著低于对照组(P <0.05)。结论:宣痹汤能使类风湿关节炎湿热瘀阻证患者的临床疗效比较显著,不仅仅患者的病情得到改善,且复发率和不良反应低,安全有效,具有临床推广应用价值。

Objective:To observation and analyze the efficacy and safety of Xuanbi Decoction(宣痹汤)on dampness and heat stasis syndrome in rheumatoid arthritis.Methods:100 patients with rheumatoid arthritis admitted to our hospital from May 2017 to May 2018 were selected as the subjects of this study.They were randomly divided into the observation group and the control group,with 50 patients in each group.The control group was given methotrexate orally,while the observation group was given Xuanbi Decoction on the basis of routine treatment.The total effective rate,recurrence rate,WOMAC score,DAS28 and incidence of adverse reactions were compared between the two groups.CRP(C-reactive protein),TNF-α(serum tumor necrosis factor)and ESR(ESR)were measured in the two groups.Results:The total effective rate was 92%(46/50)in the observation group,which was significantly higher than 72%(36/50)in the control group(P<0.05).The recurrence rates of patients in the observation group at the 4 th,8 th and 16 th months were 2%(1/50),4%(2/50)and 8%(4/50),respectively,which were significantly lower than those in the control group at 10%(5/50),14%(7/50)and 24%(12/50)(P<0.05).The WOMAC and DAS28 scores in both groups were significantly lower after treatment(P<0.05),and the WOMAC and DAS28 scores in the observation group were better than those in the control group(P<0.05).CRP,TNF-αand ESR in the observation group were significantly better than those in the control group(P<0.05).The incidence of adverse reactions(rash,stomatitis,pharyngitis,anorexia,abdominal pain and diarrhea)in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Xuanbi decoction has more significant clinical efficacy in treating rheumatoid arthritis dampness-heat stasis syndrome patients,not only the patient’s condition has been improved,and the recurrence rate and adverse reactions are low,it is safe and effective,which is with clinical application value.