壮医立体综合疗法治疗湿热闭阻型类风湿关节炎疗效观察

Clinical observation of Zhuang medicine comprehensive therapy on rheumatoid arthritis

目的观察壮医立体综合疗法治疗湿热闭阻型类风湿关节炎(RA)的临床疗效。方法将90例湿热闭阻型RA患者按照随机数字表法分为2组。对照组45例予常规西药治疗,治疗组45例在对照组治疗基础上予壮医立体综合疗法治疗。2组疗程均为8周。比较2组治疗前及治疗4、8周关节压痛数、肿胀数、疼痛视觉模拟评分(VAS)、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、免疫球蛋白A(IgA)、IgM、IgG及28个关节疾病活动度评分(DAS28)变化情况,统计2组疗效及不良反应发生情况。结果治疗组总有效率93.33%(42/45),对照组总有效率77.78%(35/45),治疗组疗效优于对照组(P<0.05)。治疗4、8周2组关节压痛数、肿胀数均较本组治疗前减少(P<0.05),疼痛VAS均降低(P<0.05),治疗8周2组关节压痛数、肿胀数均较本组治疗4周减少(P<0.05),疼痛VAS均降低(P<0.05),且治疗4、8周治疗组关节压痛数、肿胀数均少于对照组同期(P<0.05),疼痛VAS均低于对照组同期(P<0.05)。治疗4、8周2组ESR、CRP、RF水平均较本组治疗前降低(P<0.05),治疗8周2组ESR、CRP、RF水平均较本组治疗4周降低(P<0.05),且治疗4、8周治疗组ESR、CRP、RF水平均低于对照组同期(P<0.05)。治疗4、8周2组IgA、IgM、IgG水平均较本组治疗前降低(P<0.05),治疗8周2组IgA、IgM、IgG水平均较本组治疗4周降低(P<0.05),且治疗8周治疗组IgG水平低于对照组同期(P<0.05)。治疗4、8周2组DAS28评分均较本组治疗前降低(P<0.05),治疗8周2组DAS28评分均较本组治疗4周降低(P<0.05),且治疗4、8周治疗组DAS28评分均低于对照组同期(P<0.05)。治疗组不良反应发生率低于对照组(P<0.05)。结论壮医立体综合疗法治疗湿热闭阻型RA临床疗效显著,可以明显减轻关节症状,降低炎症及免疫指标水平,减少不良反应发生。

Objective To observe the clinical efficacy of Zhuang medicine comprehensive therapy on rheumatoid arthritis(RA).Methods Totally 90 RA patients were randomly divided into two groups,45 cases in the control group were treated with conventional western medicine treatment,and 45 cases in the treatment group were additionally treated with Zhuang medicine comprehensive therapy on the basis of the control group.Both groups were treated for 8 weeks.tender joint count,number of swelling,visual analogue score(VAS),erythrocyte sedimentation rate(ESR),C reactive protein(CRP),rheumatoid factor(RF)titer,immunoglobulin(IgA,IgM,IgG)and disease activity score in 28 joints(DAS28)were compared between the two groups before treatment and at 4and 8 weeks of post-treatment.The efficacy and occurrence of adverse reactions between the two groups were counted.Results Total effective rate in the treatment group was better than that in the control group[93.33%(42/45)vs 77.78%(35/45),(P<0.05),respectively].After treatment,tender joint count,number of swelling,pain VAS in two groups all decreased with time,at 8 weeks<at 4 weeks<before treatment(all P<0.05),and at 4 and 8 weeks of post-treatment,which in the treatment group were lower than the control group during the same period of time(all P<0.05).After treatment levels of ESR,CRP,and RF titers in the 2 groups decreased with time,at 8 weeks<at 4 weeks<before treatment(all P<0.05);and at 4 and 8 weeks of post-treatment,which in the treatment group were lower the control group during the same period of time(P<0.05).After treatment,levels of IgA,IgM,and IgG in the two groups decreased over time,at 8 weeks<at 4 weeks<before treatment(all P<0.05);and at 8 weeks of post-treatment,IgG level in the treatment group was lower than that in the control group during the same period of time(P<0.05).After treatment,DAS28 scores in the two groups decreased with time,at 8 weeks<at 4 weeks<before treatment(all P<0.05),and at 4 and 8 weeks of post-treatment,DAS28 scores in the treatment group were lower than those in the control group during the same period of time.Incidence of adverse reactions in the treatment group was lower than that in the control group(P<0.05).Conclusion For RA,Zhuang medicine comprehensive therapy can significantly reduce joint symptoms,reduce inflammation and immune index,reduce adverse reactions.