白芍总苷胶囊辅助西药治疗难治性类风湿关节炎临床研究

Clinical Study on Total Glucosides of Paeony Capsules Assisting Western Medicine for Refractory Rheumatoid Arthritis

目的:观察白芍总苷胶囊辅助西药治疗难治性类风湿关节炎的临床疗效及对血清炎性因子的影响。方法:将76例难治性类风湿关节炎患者按随机数字表法分为对照组与观察组各38例,对照组口服甲氨蝶呤片,观察组在对照组基础上口服白芍总苷胶囊。比较2组临床疗效,比较2组治疗前后视觉模拟评分法(VAS)评分、病情活动度量表(DAS28)评分、炎性因子水平及中医证候积分。结果:观察组治疗总有效率92.10%,高于对照组71.05%(P<0.05)。治疗前,2组VAS、DAS28评分比较,差异无统计学意义(P>0.05);治疗后,2组VAS、DAS28评分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组血清C-反应蛋白(CRP)、类风湿因子(RF)、红细胞沉降率(ESR)、肿瘤坏死因子-α (TNF-α)、白细胞介素-8 (IL-8)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清CRP、RF、ESR、TNF-α、IL-8水平均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组晨僵、关节疼痛、关节压痛、关节屈伸不利中医证候积分比较,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)。结论:白芍总苷胶囊辅助西药治疗难治性类风湿关节炎可有效降低患者炎性反应,改善临床症状,降低中医证候积分,减少疼痛,提高临床疗效。

Objective:To observe the clinical effect of Total Glucosides of Paeony Capsules assisting western medicine for refractory rheumatoid arthritis and its effect on inflammatory factors in serum.Methods:A total of 76 cases of patients with refractory rheumatoid arthritis were divided into the control group and the observation group according to the random number table method, with 38 cases in each group. The control group was given oral administration of Methotrexate Tablets,and the observation group was additionally given oral administration of Total Glucosides of Paeony Capsules based on the treatment of the control group. The clinical effects in the two groups were compared. Before and after treatment,the Visual Analogue Scale(VAS) scores,scores of Disease Activity Score 28(DAS28),levels of inflammatory factors and traditional Chinese medicine(TCM) syndrome scores were compared between the two groups.Results:The total clinical effective rate was 92.10% in the observation group,higher than that of 71.05% in the control group(P<0.05). Before treatment, there was no significant difference being found in the comparison of scores of VAS and DAS28 between the two groups(P>0.05). After treatment,the scores of VAS and DAS28 in the two groups were decreased(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05). Before treatment,there was no significant difference being found in the comparison of levels of C-reactive protein(CRP), rheumatoid factor(RF), erythrocyte sedimentation rate(ESR),tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) in serum between the two groups(P>0.05). After treatment,the levels of CRP,RF,ESR,TNF-α and IL-8 in serum in the two groups were decreased(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05). Before treatment, there was no significant difference being found in the comparison of TCM syndrome scores including morning stiffness,joint pain,tender joint,and difficulty in extension and flexion in joint between the two groups(P>0.05). After treatment, the above TCM syndrome scores in the two groups were decreased(P<0.05), and the scores in the observation group were lower than those in the control group(P<0.05). Conclusion: Total Glucosides of Paeony Capsules assisting western medicine for refractory rheumatoid arthritis can effectively reduce inflammatory responses,TCM syndrome scores and pain,and improve clinical symptoms and clinical effects.