补阳还五汤加减治疗类风湿性关节炎临床研究

Clinical Study on Modified Buyang Huanwu Tang for Rheumatoid Arthritis

目的:观察补阳还五汤加减治疗类风湿性关节炎(RA)的临床疗效,及对中医证候积分、血液生化指标水平的影响。方法:将100例RA患者按简单随机数字表法随机分成2组,对照组采用常规治疗,观察组联合补阳还五汤加减治疗。比较2组临床疗效及治疗前后中医证候积分、血液生化因子水平。结果:观察组ACR20、ACR50发生率分别为82.00%、42.00%,显著高于对照组56.00%、22.00%(P<0.05)。治疗前,2组疼痛、肿胀、屈伸不利、畏恶风寒、晨僵等中医证候积分比较,差异无统计学意义(P>0.05)。治疗后,2组以上各中医证候积分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组类风湿因子(RF)、血沉(ESR)、血小板/淋巴细胞(PLR)、白细胞介素-17 (IL-17)、高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05);治疗后,2组RF、ESR、PLR、IL-17水平均降低(P<0.05),HDL-C水平升高(P<0.05),且观察组RF、ESR、PLR、IL-17水平低于对照组(P<0.05),HDL-C水平高于对照组(P<0.05)。结论:补阳还五汤加减可显著改善RA患者中医症状,并可能通过降低RF、ESR、PLR、IL-17水平增加HDL-C水平,以提高治疗效果。

Objective:To observe the clinical effect of the therapy of modified Buyang Huanwu Tang on rheumatoid arthritis(RA),and its effect on Chinese medicine syndrome scores and levels of blood biochemical indexes.Methods:A total of 100 patients with RA were selected and divided into the two groups according to the random number table method.The control group was treated with routine treatment,and the observation group was additionally treated with modified Buyang Huanwu Tang.Before and after treatment,the traditional Chinese medicine syndrome(TCM) scores and levels of blood biochemical factors were compared between the two groups.Results:The incidences of ACR20 and ACR50 were 82.00% and 42.00% respectively in the observation group,significantly higher than 56.00% and 22.00% respectively in the control group(P0.05).After treatment,the above five TCM syndrome scores in the two groups were decreased when compared with those before treatment(P0.05);after treatment,the levels of RF,ESR,PLR and IL-17 in the two groups were decreased when compared with those before treatment(P<0.05),the levels of HDL-C were increased(P<0.05),the levels of RF,ESR,PLR and IL-17 in the observation group were lower than those in the control group(P<0.05),and the level of HDL-C in the observation group was higher(P<0.05).Conclusion:The therapy of modified Buyang Huanwu Tang can significantly improve the Chinese medicine symptoms of patients with RA and may enhance the curative effect by decreasing the levels of RF,ESR,PLR and IL-17and increasing the level of HDL-C.