雷公藤及青风藤+中医定向透药治疗湿热内蕴型类风湿性关节炎的临床研究

Clinical study of Tripterygium Wilfordii and Sinomenium Wilfordii+directional penetration of traditional Chinese medicine in the treatment of rheumatoid arthritis with damp heat accumulation

目的观察雷公藤和青风藤联合中医定向透药治疗湿热内蕴型类风湿性关节炎(RA)的临床疗效。方法选取2018年9月至2020年8月上海市第二康复医院骨与关节康复科165例湿热内蕴型RA患者,采用随机数字表法分为治疗组一、治疗组二和对照组,每组各55例。其中治疗组一应用正清风痛宁缓释片(主要成分为青风藤碱)+雷公藤多苷,配合中医定向透药治疗;治疗组二不加中医定向透药治疗(其余同治疗组一);对照组常规应用甲氨蝶呤+小剂量激素,评价3个月后的疗效及安全性指标。结果治疗组一在关节肿胀数、关节压痛数、VAS评分和实验室指标均明显低于对照组,差异有统计学意义(P<0.05),治疗组一、治疗组二安全性指标明显高于对照组。结论雷公藤及青风藤+中医定向透药治疗活动期湿热内蕴型RA安全有效。

Objective To observe the clinical effect of Tripterygium Wilfordii and Sinomenium Wilfordii combined with traditional Chinese medicine on rheumatoid arthritis(RA)with damp heat accumulation.Methods A total of 165 patients with damp heat intrinsic RA from the Department of Orthopedics and Rehabilitation of the Second Rehabilitation Hospital of Shanghai from September 2018 to August 2020 were digital randomly divided into treatment group 1,treatment group 2 and control group,with 55 cases in each group.The treatment group 1 was treated with Zhengqingfengtongning(the main component is sinomenine)+tripterygium glycosides,combined with traditional Chinese medicine directional penetration treatment;Treatment group 2 did not add traditional Chinese medicine directional penetration treatment(the rest were the same as treatment group 1);The control group was treated with methotrexate+low-dose hormone to evaluate the efficacy and safety after 3 months.Results The number of joint swelling,joint tenderness,VAS score and laboratory indexes in treatment group 1 were significantly lower than those in control group(P<0.05).The safety indexes of treatment group 1 and treatment group 2 were significantly higher than those in control group.Conclusion Tripterygium Wilfordii and Sinomenium Wilfordii+directional penetration of traditional Chinese medicine is safe and effective in the treatment of active damp heat intrinsic RA.