乌梅透骨汤治疗肝肾亏虚夹瘀证类风湿关节炎临床观察

Clinical observation of Wumei Tougu decoction in treating rheumatoid arthritis of liver and kidney deficiency and stasis

目的:观察乌梅透骨汤治疗肝肾亏虚夹瘀证类风湿关节炎(RA)的临床效果。方法:回顾性分析2017年7月～2018年7月期间于我院确诊并接受治疗的RA患者118例,按照不同治疗方案分为观察组与对照组各59例,对照组给予甲氨蝶呤联合扶他林缓释片口服,观察组在对照组之上加服乌梅透骨汤,连续治疗12周后,比较两组临床症状及体征、实验室指标[C反应蛋白(CRP)、类风湿因子(RF)水平、红细胞沉降率(ESR)]、中医症候积分及疗效、生活质量[关节炎生活质量测评量表2-短卷(AIMS2-SF)]。结果:治疗后,两组晨僵时间、关节压痛指数、关节肿胀指数、VAS评分均显著低于治疗前(P<0.05),且观察组降低幅度大于对照组(P<0.05);两组CRP、RF、ESR水平均显著低于治疗前(P<0.05),且观察组改善程度优于对照组(P<0.05);两组中医症候积分均显著低于治疗前(P<0.05),且观察组降低幅度大于对照组(P<0.05);观察组总有效率94.92%,显著高于对照组的81.36%(P<0.05);两组AIMS2-SF评分中躯体、症状、影响、社会各维度评分及总分均显著高于治疗前(P<0.05),且观察组各维度及总分上升幅度大于对照组(P<0.05)。结论:将乌梅透骨汤用于肝肾亏虚夹瘀证RA患者治疗中,可以更好减轻患者临床症状及体征,改善相关临床指标,减轻中医症候,提高疗效及生活质量。

Objective:To observe the clinical effects of Wumei Tougu decoction in the treatment of rheumatoid arthritis(RA)of liver and kidney deficiency and stasis.Methods 118 cases of patients with RA diagnosed and treated in our hospital from July 2017 to July 2018 were retrospectively analyzed and were divided into observation group and control group according to different treatment regimens,with 59 cases in each group.Control group was orally given methotrexate combined with voltaren sustained-release tablets,and observation group was treated with Wumei Tougu decoction on the basis of control group.After 12 weeks of continuous treatment,the clinical symptoms and signs,laboratory parameters[C-reactive protein(CRP),rheumatoid factor(RF),erythrocyte sedimentation rate(ESR)],TCM syndromes scores and efficacy,quality of life[Short-form Arthritis Impact Measurement Scales 2(AIMS2-SF)]were compared between the two groups.Results After treatment,the morning stiffness time,joint tenderness index,joint swelling index and VAS score in the two groups were significantly lower than those before treatment(P<0.05),and the decrease in observation group was greater than that in control group(P<0.05).The levels of CRP,RF and ESR in the two groups were significantly lower than those before treatment(P<0.05),and the improvement in observation group was better than that in control group(P<0.05).The TCM syndromes scores in the two groups were significantly lower than those before treatment(P<0.05),and the decrease in observation group was greater than that in control group(P<0.05).The total effective rate in observation group was significantly higher than that in control group(94.92%vs 81.36%)(P<0.05).The dimensions scores of body,symptoms,effects and society and the total score of AIMS2-SF scale in the two groups were significantly higher than those before treatment(P<0.05),and the increase of each dimension score and total score in observation group was greater than that in control group(P<0.05).Conclusions Wumei Tougu decoction for RA patients with liver and kidney deficiency and stasis can alleviate clinical symptoms and signs,improve relevant clinical indicators,reduce TCM symptoms,and improve efficacy and quality of life.