复方芪芎方联合甲氨蝶呤治疗肝肾阴虚型类风湿性关节炎疗效的回顾性观察

Retrospective Observation on the Curative Effect of Compound Qixiong Prescription Combined with Methotrexate in the Treatment of Rheumatoid Arthritis with Liver-kidney Yin Deficiency

目的:评价复方芪芎方联合甲氨蝶呤治疗肝肾阴虚型类风湿性关节炎(RA)的疗效及安全性。方法:采用回顾性研究方法,收集2015年5月~2019年5月接受治疗的105例肝肾阴虚型RA患者,根据治疗方法不同分为对照组(n=52,甲氨蝶呤治疗)和观察组(n=53,在对照组基础上加用复方芪芎方治疗)。比较两组治疗3个月后的临床疗效、不良反应发生情况,以及免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)和血清类风湿因子(RF)、C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素8(IL-8)等指标水平和临床症状指标(晨僵时间、关节肿胀数、关节压痛数、DAS28评分、中医证候评分)的变化情况。结果:治疗后,观察组总有效率为92.45%,显著高于对照组的75.00%(P<0.05);整体疗效优于对照组(P=0.01)。治疗后,两组免疫球蛋白和血清RF、CRP、TNF-α、IL-8等治疗水平均较前显著降低;临床症状各项指标均较前均明显好转(P<0.05)。且观察组各项指标均明显优于对照组(P<0.05)。两组药品不良反应总发生率差异无统计学意义(P>0.05)。结论:复方芪芎方联合甲氨蝶呤治疗类风湿性关节炎效果显著,可有效缓解临床症状,改善患者免疫球蛋白、RF和血清炎症因子水平,且不增加不良反应。

Objective:To evaluate the efficacy and safety of compound Qixiong prescription combined with methotrexate in the treatment of rheumatoid arthritis(RA)with liver-kidney Yin deficiency.Methods:A retrospective study was conducted to collect 105 RA patients with liver-kidney Yin deficiency who received treatment from May 2015 to May 2019.According to different treatment methods,they were divided into control group(n=52,methotrexate treatment)and observation group(n=53,compound Qixiong prescription treatment was added on the basis of control group).The clinical efficacy and incidence of adverse reactions were compared between the two groups after 3 months of treatment.And immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM),rheumatoid factor(RF),serum c-reactive protein(CRP),tumor necrosis factor alpha(TNF-α),interleukin 8(IL-8)level indicators,clinical symptoms(time of morning stiffness,joint swelling,joint tenderness,DAS count 28 score,TCM syndrome score)change before and after treatment were compared between the two groups.Results:After treatment,the total effective rate of observation group was 92.45%,significantly higher than 75.00%of control group(P<0.05).The overall efficacy was better than that of the control group(P=0.01).After treatment,the levels of immunoglobulin,serum RF,CRP,TNF-αand IL-8 in both groups were significantly lower than before,all clinical symptoms were significantly improved(P<0.05).All indexes of observation group were significantly better than those of control group(P<0.05).There was no significant difference in the total incidence of adverse drug reactions between the two groups(P>0.05).Conclusion:Compound Qixiong prescription combined with methotrexate has a significant effect on the treatment of rheumatoid arthritis,which can effectively relieve clinical symptoms and improve the levels of immunoglobulin,RF and serum inflammatory factors without increasing adverse reactions.