通络开痹片治疗寒、热痹症的临床效果

Clinical efficacy of Tongluo Kaibi Tablets in the treatment of cold Bi and heat Bi syndromes

目的 探讨通络开痹片治疗寒、热痹症的临床效果。方法 回顾性分析重庆市永川区中医院2019年3月至2020年12月收治的中医诊断为寒、热痹症类风湿关节炎患者105例,根据治疗方法不同将患者分为对照组(n=40,常规治疗)和观察组(n=65,常规治疗+通络开痹片),观察组根据病邪性质不同将患者分为寒痹组(n=27)和热痹组(n=38)。观察对照组、寒痹组和热痹组症状改善情况,治疗前后C反应蛋白(CRP)、白介素-6(IL-6)、类风湿因子(RF)水平及疾病活动评分(DAS)、视觉模拟评分(VAS),记录临床有效率和不良反应发生情况。结果 三组患者治疗后晨僵时间、关节肿胀数、关节压痛数较治疗前下降,且寒痹组、热痹组治疗后低于对照组(P <0.05)。三组患者治疗后CRP、IL-6、RF水平及DAS、VAS评分较治疗前下降,且寒痹组、热痹组治疗后低于对照组(P <0.05)。寒痹组和热痹组临床总有效率高于对照组(P <0.05);三组患者不良反应总发生率差异无统计学意义(P> 0.05)。结论 通络开痹片治疗寒、热痹症的临床效果无明显差异,可有效改善患者症候体征、实验室指标,具有较好的临床疗效,无明显不良反应。

Objective To explore the clinical efficacy of Tongluo Kaibi Tablets in the treatment of cold Bi(painful arthralgia) and heat Bi(heat arthralgia) syndromes. Methods A total of 105 patients diagnosed as rheumatoid arthritis of cold Bi and heat Bi syndromes by traditional Chinese medicine theory in Yongchuan Hospital of Traditional Chinese Medicine in Chongqing from March 2019 to December 2020were retrospectively analyzed. According to different treatment methods, the patients were divided into the control group(n=40, routine treatment) and the observation group(n=65, routine treatment + Tongluo Kaibi Tablets). The observation group was further divided into the cold Bi group(n=27) and the heat Bi group(n=38) according to the nature of pathogens. The improvement of symptoms, the levels of C-reactive protein(CRP), interleukin-6(IL-6) and rheumatoid factor(RF), the disease activity score(DAS) and visual analog score(VAS) before and after treatment were observed in the control group, the cold Bi group and the heat Bi group, and the clinical effective rate and the occurrence of adverse reactions were recorded. Results The morning stiffness duration, swollen joint counts and tender joint counts in the three groups shortened and decreased after treatment, and the levels in the cold Bi group and the heat Bi group were lower than those in the control group after treatment(P < 0.05). After treatment, the levels of CRP, IL-6, RF and the scores of DAS and VAS in the three groups were lower than those before treatment, and the levels and scores in the cold Bi group and the heat Bi group were lower than those in the control group after treatment(P < 0.05). The total clinical effective rate of the cold Bi group and the heat Bi group was higher than that of the control group(P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions among the three groups(P > 0.05). Conclusion There is no significant difference in the clinical efficacy of Tongluo Kaibi Tablets in the treatment of cold Bi and heat Bi syndromes. It can effectively improve the symptoms, signs and laboratory test indicators of patients, and has good clinical efficacy without obvious adverse reactions.