蠲痹汤辅助治疗类风湿关节炎活动期的疗效观察

Efficacy Observation of Juanbi Decoction Adjuvant Therapy for Active Stage Rheumatoid Arthritis

目的观察蠲痹汤辅助治疗类风湿关节炎(RA)活动期寒湿痹阻证患者的疗效。方法104例均为2018年8月—2019年8月于江苏省徐州市中医院风湿肾病科就诊的RA活动期患者,中医辨证为寒湿痹阻证,按照随机数字表法分为两组,观察组52例,对照组52例,两组均接受来氟米特片(爱诺华)+双氯芬酸钠缓释片+理疗,观察组在此基础上加服蠲痹汤治疗。比较两组治疗前后中医症状积分、疼痛视觉模拟评分(VAS)、晨僵时间、起效时间及临床疗效;检测两组患者治疗前后血清C反应蛋白(CRP)、类风湿因子(RF)水平和红细胞沉降率(ESR),观察两组治疗期间不良反应发生情况。结果治疗后两组中医症状积分、VAS评分、晨僵时间均下降(P<0.01),观察组下降程度高于对照组(P<0.01),且观察组起效时间短于对照组(P<0.01);观察组总有效率为94.23%(49/52),高于对照组[76.92%(40/52)],两组比较,差异有统计学意义(χ^(2)=6.310,P<0.05);治疗后两组血清CRP、RF、ESR水平均明显下降(P<0.05),且观察组下降较对照组明显(P<0.05);两组不良反应发生情况相似,发生率比较,差异无统计学意义(P>0.05)。结论蠲痹汤辅助治疗RA活动期(寒湿痹阻证)可减轻症状,增强疗效及改善实验室指标。

Objective To observe the efficacy of Juanbi Decoction(JBD)adjuvant therapy for active stage rheumatoid arthritis(RA)patients with cold-dampness obstruction syndrome(CDOS).Methods Totally 104 active stage RA patients at Department of Rheumatic Renopathy of Xuzhou Hospital of Traditional Chinese Medicine from August 2018 to August 2019 were assigned to the observation group and the control group by random digital table,52 in each group.All patients received Lefluorine Tablet(Ainuohua)+Diclofenac Sodium Sustained Release Tablet+physical therapy.Patients in the observation group additionally took JBD.TCM syndrome scores,pain visual analogue scale(VAS),morning stiffness time and onset time before and after treatment were compared between the two groups.Clinical efficacies were compared between the two groups.Serum levels of C-reactive protein(CRP),rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)were detected between the two groups before and after treatment.Adverse reactions during treatment period were also observed in the two groups.Results After treatment the TCM syndrome scores,pain VAS scores,and morning stiffness time decreased in the two groups(P<0.01).They were lower in the observation group than in the control group(P<0.01).The onset time was shorter in the observation group than in the control group(P<0.05).The total effective rate was 94.23%(49/52)in the observation group,higher than that of the control group[76.92%(40/52);χ^(2)=6.310,P<0.05].The serum levels of CRP,RF,and ESR significantly decreased in the two groups after treatment(P<0.05).They were lower in the observation group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The effect of JBD adjuvant therapy for active stage RA patients with CDOS relieved symptoms,enhanced the curative effect and improved laboratory indicators.