加减四妙散治疗成人Still病疗效观察

Efficacy observation of modified Simiao powder on adult Still disease

目的:观察加减四妙散治疗成人Still病(adult-onset Still’s disease,AOSD)的临床疗效。方法:选择确诊的52例成人Still病患者作为研究对象,随机分为两组各26例。对照组依据体重及病情给予甲泼尼龙琥珀酸钠40~120 mg/d静脉滴注,甲氨蝶呤10~15 mg/周口服。如果病情好转,逐渐减少激素用量,最后改为口服强的松或美卓乐治疗;并予保肝、保胃、补钙等对症支持治疗。治疗组在上述常规治疗基础上,加用四妙散加减。两组均治疗2周,并随访2个月,观察发热、皮疹、关节痛、咽痛及实验室指标变化。结果:治疗后两组的发热、皮疹、咽痛等症状,血白细胞计数、血沉、C反应蛋白、血铁蛋白等实验室指标均有明显好转(P<0.05),治疗组明显优于对照组(P<0.05);且治疗组总有效率(93.31%)高于对照组(80.77%),差异有统计学意义(P<0.05)。结论:常规西药治疗联合四妙散加减治疗成人Still病疗效更佳,尤其在退热、改善皮疹、咽痛等方面更有优势,副作用少。

Objective:To observe the clinical effect of modified Simiao powder on adult still disease(adult-onset still's disease,AOSD).Methods:52 cases of patients with adult still disease,who were treated in our hospital,were selected as researched objects and randomly divided into control group and treatment group,26 cases in each group.Control group was treated with methylprednisolone sodium succinate 40-120 mg/D by intravenous drip and methotrexate 10-15 mg/week by oral administration according to weight and patient's condition;if the patient's condition was improved,the dosage of hormone was reduced gradually;finally,it was changed to treatment with oral prednisone or medrol;and the patients were also given symptomatic and supportive treatment such as liver protection,stomach protection and calcium supplement,etc.Treatment group were treated plus with modified Simiao powder on the basis of above conventional treatment.After both groups were treated for 2 weeks and 2 months,the changes of fever,skin rash,joint pain,sore throat and laboratory indexes were observed.Results:After treatment,in both groups,the symptoms of fever,skin rash,sore throat etc.and the laboratory indexes such as white blood cell count,erythrocyte sedimentation rate,C-reactive protein,serum ferritin,etc.were significantly improved(P﹤0.05),but the treatment group was significantly better than the control group(P﹤0.05),and the total effective rate of treatment group was 93.31%,which was higher than 80.77%of control group(P﹤0.05).Conclusion:The clinical effect of conventional treatment and modified Simiao powder on adult still disease is better,which has more advantages especially in reducing fever and improving skin rash and sore throat,and with less side effects,