重骨颗粒治疗肝肾亏虚型类风湿关节炎临床疗效观察

Clinical Observation of Zhonggu Granules in the Treatment of Rheumatoid Arthritis with Deficiency of Liver and Kidney

目的:观察重骨颗粒治疗肝肾亏虚型类风湿关节炎(RA)的临床疗效。方法:用随机数字表法将60例RA患者分为观察组和对照组,每组30例。2组均予来氟米特作为基础治疗,观察组在此基础上予重骨颗粒,2次/d,餐后1h用温水冲服10 g,疗程均为12周。比较2组中医证候积分、临床疗效、28处关节疾病活动度评分(DAS28)和患者数据指标常规评估值3(RAPID3)变化,检测治疗前后C反应蛋白(CRP)、血沉(ESR)、类风湿因子(RF)、血清钙(Ca2+)和葡萄糖-6-磷酸异构酶(GPI)的水平。结果:中医临床有效率观察组(93.33%)显著高于对照组(70.00%),差异有统计学意义。治疗后观察组中医证候积分均显著低于治疗前,其中关节肿胀、关节疼痛和晨僵的积分均低于对照组,腰膝酸软和眩晕耳鸣的积分显著低于对照组;治疗后的观察组ESR、CRP、RF、GPI、DAS28评分和RAPID3评分显著低于治疗前,血清Ca2+水平显著高于治疗前;其中ESR、CRP、GPI、DAS28评分、RAPID3评分显著低于对照组,RF水平低于对照组,血清Ca2+水平显著高于对照组,差异均有统计学意义。结论:重骨颗粒能有效改善RA免疫炎症反应,控制疾病活动,缓解证候表现。

Objective:To observe the clinical efficacy of Zhonggu Granules in treating rheumatoid arthritis(RA)with deficiency of liver and kidney.Methods:60 cases of RA patients were divided into observation group and control group by random number table method,30 cases in each group.Both groups received leflunomide as the basic treatment,and the observation group received Zhonggu Granules on this basis,twice a day,10 g with warm water 1 hour after meals,and the course of treatment was 12 weeks.The changes in TCM syndrome scores,clinical efficacy,disease activity score in 28 joints(DAS28)and Routine Assessment of Patient Index Data3(RAPID3)were compared between the two groups,and C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and Rheumatic factor(RF),serum calcium(Ca2+)and glucose-6-phosphate isomerase(GPI)levels.Results:The clinical effective rate of TCM in the observation group(93.33%)was significantly higher than that in the control group(70.00%),and the difference was statistically significant.After treatment,the TCM syndrome scores of the observation group were significantly lower than those before treatment,among which the scores of joint swelling,joint pain and morning stiffness were all lower than those of the control group,and the scores of soreness of the waist and knees and vertigo and tinnitus were significantly lower than those of the control group.After treatment,the ESR,CRP,RF,GPI,DAS28 and RAPID3 scores of the observation group were significantly lower than those before treatment,and the serum Ca2+level was significantly higher than that before treatment;among them,the ESR,CRP,GPI,DAS28 and RAPID3 scores were significantly lower than the control group,the RF level was low,and the serum Ca2+level was significantly higher than the control group.The differences were statistically significant.Conclusion:Zhonggu Granules can effectively improve the immune inflammatory response of RA,control disease activity,and alleviate syndrome manifestations.