半夏泻心汤联合西药治疗肝脾失调型类风湿关节炎临床研究

Clinical Study on Banxia Xiexin Tang Combined with Western Medicine for Rheumatoid Arthritis of Liver-Spleen Disharmony Type

目的:观察半夏泻心汤联合艾拉莫德片治疗肝脾失调型类风湿关节炎(RA)临床疗效。方法:选取98例肝脾失调型RA患者,按随机数字表法分成对照组及研究组各49例。对照组给予艾拉莫德片治疗,研究组给予半夏泻心汤联合艾拉莫德片治疗。2组疗程均为1个月。比较2组临床疗效及不良反应发生率,观察2组治疗前后红细胞沉降率(ESR)、类风湿因子(RF)、C-反应蛋白(CRP)、抗环瓜氨酸肽(CCP)抗体及滑膜厚度、关节腔积液、滑膜血流分级的影响。结果:治疗1个月,研究组总有效率为93.88%,高于对照组75.51%,差异有统计学意义(P<0.05)。治疗后,2组ESR、RF、CRP及CCP抗体水平均较治疗前降低(P<0.05),研究组4项水平均低于对照组(P<0.05)。治疗后,2组滑膜厚度、关节腔积液均较治疗前降低(P<0.05),研究组滑膜厚度、关节腔积液均低于对照组(P<0.05)。2组治疗后滑膜血流分级比较,差异均有统计学意义(P<0.05)。研究组治疗期间不良反应发生率为6.12%,高于对照组4.08%,2组比较,差异无统计学意义(P>0.05)。结论:半夏泻心汤联合西药治疗肝脾失调型RA患者可明显提高临床疗效,缓解局部关节炎症症状,用药安全性较高。

Objective:To observe the clinical effect of Banxia Xiexin tang combined with iguratimod for rheumatoid arthritis(RA) of liver-spleen disharmony type. Methods:A total of 98 cases of RA patients of liver-spleen disharmony type were selected and divided into the control group and the study group according to the random number table method,49 cases in each group. The control group was treated with iguratimod, and the study group was treated with Banxia Xiexin tang combined with iguratimod. The clinical effect and adverse reactions in the two groups were compared. Before and after treatment,the effect of erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),C-reactive protein(CRP),anti-cyclic citrullinated peptide(CCP) antibody,synovial thickness,joint effusion and synovial blood flow grading in the two groups was observed. Results:The total effective rate was 93.88% in the study group,higher than that of 75.51% in the control group,the difference being significant(P<0.05). After treatment,the levels of ESR,RF,CRP and CCP antibodies in the two groups were decreased when compared with those before treatment(P<0.05),and the above four levels in the study group were lower than those in the control group(P<0.05). After treatment,synovial thickness and joint effusion in the two groups were decreased when compared with those before treatment(P<0.05),and the above indexes in the study group were lower than those in the control group(P<0.05). After treatment, there were significant differences being found in the comparison of synovial blood flow gradings between the two groups(P<0.05). During treatment,the incidence of adverse reactions was6.12% in the study group,higher than that of 4.08% in the control group,there being no significant difference between the two groups(P>0.05). Conclusion: Banxia Xiexin tang combined with western medicine for RA patients of liver-spleen disharmony type can significantly improve the clinical effect and relieve local joint symptoms with high safety.