自拟补肝益肾活血汤联合甲氨蝶呤治疗老年类风湿关节炎的效果观察

Effects of self-made Bugan Yishen Huoxue decoction combined with methotrexate in the treatment of elderly rheumatoid arthritis

目的观察自拟补肝益肾活血汤联合甲氨蝶呤治疗老年类风湿关节炎(rheumatoid arthritis,RA)的效果。方法选取本院2016年9月至2019年9月接诊的60例RA老年患者,按随机数字表法分为观察组与对照组,各30例。对照组给予甲氨蝶呤片西药治疗,观察组在对照组基础上给予本院自拟补肝益肾活血汤治疗。治疗4个月后,比较两组患者临床治疗指标[视觉模拟评分(VAS)、健康评估问卷调查(HAQ)、疾病活动度评分(DAS28)];于治疗前、治疗4个月后,记录血常规指标[血红蛋白(Hb)、血小板(PLT)]及炎症因子指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、血清类风湿因子(RF)水平变化。结果治疗4个月后,观察组患者VAS、HAQ、DAS28评分均低于对照组(P<0.05);治疗4个月后,两组患者Hb水平均较治疗前升高,且观察组高于对照组(P<0.05),两组患者PLT、各炎症因子、RF水平均低于治疗前,且观察组均低于对照组(P<0.05)。结论自拟补肝益肾活血汤联合甲氨蝶呤治疗老年类风湿关节炎具有较好的临床疗效,能改善患者的贫血状态,减轻炎症反应,有利于预后康复。

Objective To observe the therapeutic effects of self-made Bugan Yishen Huoxue decoction combined with methotrexate on elderly rheumatoid arthritis(RA).Methods 60 elderly RA patients who were admitted to the hospital from September 2016 to September 2019 were selected and they were divided into observation group and control group according to the random number table method,with 30 cases in each group.Control group was given Western medicine methotrexate tablets,and observation group was treated with self-made Bugan Yishen Huoxue decoction based on control group.After 4 months of treatment,the clinical treatment outcomes indicators[visual analogue score(VAS),health assessment questionnaire(HAQ),disease activity score 28(DAS28)]were compared between the two groups.Before treatment and after 4 months of treatment,the routine blood indicators[hemoglobin(Hb),platelets(PLT)],inflammatory factors[C reactive protein(CRP),tumor necrosis factor-α(TNF-α)]and rheumatoid factor(RF)were recorded.Results After 4 months of treatment,the scores of VAS,HAQ,and DAS28 in observation group were lower than those in control group(P<0.05).After 4 months of treatment,the Hb levels in the two groups of patients were higher than those before treatment,and the level in observation group was higher than that in control group(P<0.05).The levels of PLT,inflammatory factors,and RF of the two groups were lower than those before treatment,and the levels in observation group were lower than those in control group(P<0.05).Conclusion Self-made Bugan Yishen Huoxue decoction combined with methotrexate has a good clinical efficacy,and can improve the anemia status and relieve the inflammatory response of elderly RA patients,and it is beneficial to the prognosis and rehabilitation.