通络开痹片联合来氟米特片治疗类风湿关节炎临床观察

Clinical Observation on Tongluo Kaibi Tablet Combined with Leflunomide Tablet in the Treatment of Rheumatoid Arthritis

目的观察通络开痹片联合来氟米特片治疗类风湿关节炎(RA)的临床疗效。方法将72例寒热错杂兼瘀血阻络型RA患者按照数字表法随机分为西药组(36例)和中西药组(36例)。西药组口服来氟米特片,中西药组加服通络开痹片,2组均治疗3个月。比较2组临床疗效,并观察治疗前后2组患者晨僵时间、压痛关节数、肿胀关节数、VAS评分、DAS28评分及血沉、C反应蛋白、类风湿因子、免疫球蛋白G的变化,并记录不良反应。结果中西药组总有效率为91. 7%,西药组总有效率88. 9%,2组疗效等级的构成比差异有统计学意义(P <0. 05),中西药组优于西药组;治疗后2组患者晨僵时间、压痛关节数、肿胀关节数、VAS评分、DAS28评分、红细胞沉降率、C-反应蛋白、类风湿因子、免疫球蛋白G较治疗前均有显著改善(P <0. 01),且中西药组效果优于西药组(P <0. 05),不良反应少。结论通络开痹片联合来氟米特片能明显改善寒热错杂兼瘀血阻络型RA患者的临床症状及实验室指标,临床疗效显著,安全性较高,值得临床进一步推广应用。

Objective To observe the clinical efficacy of Tongluo Kaibi tablet combined with leflunomide tablets in the treatment of rheumatoid arthritis(RA).Methods Seventy-two cases of rheumatoid arthritis with cold and heat and blood stasis syndrome were randomly divided into western medicine group(36 cases)and Chinese and western medicine group(36 cases).The western medicine group was treated with leflunomide tablets,and traditional Chinese and western medicine group was treated with leflunomide tablets combined with Tongluo Kaibi tablet.The two groups were treated for three months.The clinical curative effects of two groups was compared and all symptoms including morning stiffness duration,the number of tenderness joints,the number of swollen joints,the VAS score,the DAS28 score and experimental indexes including erythrocyte sedimentation rate(ESR),C reactive protein(CRP),Rheumatoid factor(RF),immunoglobulin G(Ig G)before and after treatment were observed,and the adverse reactions were recorded.Results The total effective rate of the traditional Chinese and western medicine group was 91.7%,and the total effective rate of the western medicine group was88.9%.There was significant difference between the two groups in the composition ratio of the curative effect grades(P<0.05).The traditional Chinese and western medicine group was better than the western medicine group.Time of morning stiffness,number of tenderness joints,number of swollen joints,VAS score,DAS28 score,ESR,CRP,RF,Ig G was significantly improved comparing with that before treatment(P<0.01).The effect of traditional Chinese and western medicine group was better than that of western medicine group(P<0.05),and the adverse reaction was less.Conclusion Tongluo Kaibi tablet combined with leflunomide tablets can obviously improve the clinical symptoms and laboratory indexes of RA patients with cold and heat disorder and blood stasis blocking collaterals.The clinical effect is remarkable and the safety is high,which is worthy of further clinical application.