散寒除湿汤联合西药治疗老年类风湿关节炎对患者DAS28、HAQ评分的影响

Effects of Sanhan Chushi Decoction(散寒除湿汤)Combined with Western Medicine onDAS28 and HAQ Scores in Patients with Elderly-Onset Rheumatoid Arthritis

目的观察散寒除湿汤联合西药治疗老年类风湿关节炎(elderly-onset rheumatoid arthritis,EORA)对患者类风湿关节炎疾病活动(disease activity score for rheumatoid arthritis 28,DAS28)、健康评估问卷(health assessment questionnaire,HAQ)评分的影响。方法选取2020年6月—2022年8月濮阳市安阳地区医院收治的98例EORA患者,随机分为对照组与研究组各49例。对照组给予常规西药治疗,研究组给予散寒除湿汤联合西药治疗,均治疗3个月。比较两组患者的临床疗效、晨僵时间、关节肿胀数(swollen joint count,SJC)、关节压痛数(tenderness joint count,TJC)、DAS28评分、HAQ评分、红细胞沉降率(erythrocyte sedimentation rate,ESR)水平、类风湿因子(rheumatoid factor,RF)水平、C-反应蛋白(C-reactive protein,CRP)水平以及不良反应发生情况。结果治疗后,研究组患者的总有效率为93.88%(46/49),高于对照组的75.51%(37/49)(P<0.05);研究组患者的晨僵时间、SJC及TJC均低于对照组(P<0.05);研究组患者的DAS28评分及HAQ评分均低于对照组(P<0.05);研究组患者的ESR、RF及CRP水平均低于对照组(P<0.05);两组患者的不良反应发生率比较差异无统计学意义(P>0.05),且均未见有明显严重不良反应发生。结论散寒除湿汤联合西药治疗EORA,可提升疗效,有效缓解患者症状,改善机体炎性反应与健康状况,安全性好。

Objective To observe the effects of Sanhan Chushi Decoction(散寒除湿汤)combined with western medicine on disease activity score for rheumatoid arthritis 28(DAS28)and scores of health assessment questionnaire(HAQ)in patients with elderly-onset rheumatoid arthritis(EORA).Methods A total of 98 patients with EORA admitted to the hospital between June 2020 and August 2022 were enrolled and randomly divided into control group and study group,49 cases in each group.The control group was treated with routine western medicine,while the study group was additionally treated with Sanhan Chushi Decoction for 3 months.The clinical curative effect,morning stiffness time,swollen joint count(SJC),tenderness joint count(TJC),DAS28,HAQ score,erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),C-reactive protein(CRP)and the occurrence of adverse reactions in the two groups were compared.Results After treatment,total response rate of the study group was higher than that of the control group[93.88%(46/49)vs 75.51%(37/49),P<0.05].The morning stiffness time,SJC and TJC in the study group were lower than those in the control group(P<0.05),DAS28 and HAQ scores were lower than those in the control group(P<0.05),and the levels of ESR,RF and CRP were lower than those in the control group(P<0.05).There were no serious adverse reactions and no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Sanhan Chushi Decoction combined with western medicine can improve the curative effect,effectively relieve the symptoms,improve the nflammatory response and health status in EORA patients,with good safety.