健脾生血颗粒治疗类风湿关节炎并发缺铁性贫血的临床观察

Clinical Observation on Jianpi Shengxue Granules in the Treatment of Iron-deficiency Anemia in Patients with Rheumatoid Arthritis

目的:探讨健脾生血颗粒治疗类风湿关节炎并发缺铁性贫血的临床疗效及作用机制。方法:选取2017年1月至2018年12月武汉大学人民医院中医科收治的类风湿关节炎并发缺铁性贫血的患者87例作为研究对象,随机分为观察组(n=47)和对照组(n=40)。2组患者均口服来氟米特和甲氨蝶呤片。对照组给予福乃得口服治疗。观察组给予健脾生血颗粒口服。2组连续治疗8周后观察患者的中医证候积分变化、血生化及铁蛋白指标指标变化、类风湿因子(RF)、红细胞沉降率(ESR)、C-反应蛋白(CRP)水平、基础药物治疗效果、不良反应发生情况。结果:治疗后观察组的中医证候积、RF、ESR、CRP、总铁结合力水平均明显低于对照组(P<0.05),而RBC、Hb、MCV、MCH、MCHC、血清铁水平均明显高于对照组(P<0.05),2组药物不良反应及基础药物疗效比较差异均无统计学意义(P>0.05)。结论:健脾生血颗粒治疗类风湿关节炎并发缺铁性贫血有显著疗效。

Objective:To investigate the clinical effects and the action mechanism of Jianpi Shengxue Granules on iron-deficiency anemia in the patients with rheumatoid arthritis.Methods:A total of 87 cases of iron-deficiency anemia with rheumatoid arthritis admitted to Department of Traditional Chinese Medicine of Renmin Hospital of Wuhan University were randomly into a treatment group(n=47)and a control group(n=40).All patients were treated with methotrexate and leflunomide tablets.The control group was given Funaide oral liquid and the treatment group was treated with Jianpi Shengxue Granules.After 8 weeks of continuous treatment,the changes of TCM syndrome scores,blood biochemical and ferritin index,rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)level,and the effect of basic drug treatment and adverse reactions were observed.Results:After treatment,the TCM syndrome score,RF,ESR,CRP,total iron binding level in the treatment group were significantly lower than those in the control group(P<0.05),while the RBC,Hb,MCV,MCH,MCHC,serum iron were significantly higher the control group(P<0.05).There was no significant difference in the adverse reactions and curative effects of basic drugs between the 2 groups(P>0.05).Conclusion:Jianpi Shengxue Granules have good curative effects on iron-deficiency anemia in patients with rheumatoid arthritis.