化瘀通痹方联合MTX治疗难治性类风湿关节炎的疗效及对RF、CRP和ESR的影响

Effect of Using Huayu Tongbi Recipe Combined with MTX in the Treatment of Refractory Rheumatoid Arthritis and Its Effects on RF,CRP and ESR

目的:评价化瘀通痹方联合MTX治疗难治性类风湿关节炎的疗效及对类风湿因子(RF)、C反应蛋白(CRP)和血沉(ESR)的影响。方法:选择2015年1月~2016年8月间于我院就诊的92例难治性类风湿关节炎患者,随机分为MTX组(46例)和化瘀通痹+MTX组(46例),分别给予单独应用甲氨蝶呤(MTX)和化瘀通痹方联合MTX治疗,随访24周,比较两组患者治疗后ACR20、ACR50和ACR70疗效的反应率,改良Sharp评分(mTSS),治疗前后的RF、CRP和ESR水平差异,以及两组患者治疗的不良反应发生情况。结果:化瘀通痹+MTX组患者在各时间点的ACR20、ACR50和ACR70疗效反应率均显著高于MTX组(P<0.05);治疗后,化瘀通痹+MTX组患者mTSS与基线的差异显著低于MTX组(P<0.05);治疗前,两组患者的RF、CRP和ESR水平比较无统计学差异(P>0.05)。治疗后,化瘀通痹+MTX组RF、CRP和ESR水平较MTX组降低更为明显(P<0.05);化瘀通痹+MTX组患者治疗相关不良反应的总发生率与MTX组比较差异具统计学意义(P<0.05)。结论:应用化瘀通痹方联合MTX治疗难治性类风湿关节炎的疗效确切,可以显著降低RF、CRP和ESR的水平,值得推广。

Objective:To evaluate the efficacy of Using Huayu Tongbi Recipe combined with MTX in the treatment of refractory rheumatoid arthritis(RA)and its effects on rheumatoid factor(RF),C reactive protein(CRP)and erythrocyte sedimentation rate(ESR).Methods:92 patients with refractory rheumatoid arthritis who came to hospital for treatment from January 2015 to August 2016,were randomly divided into MTX group(46 cases)and Huayu Tongbi+MTX group(46 cases).They were respectively treated with methotrexate(MTX)and Huayu Tongbi Recipe combined with MTX treatment.They were followed up for 24 weeks,then the curative response rate of ACR20,ACR50,and ACR70 after treatment,the modified Sharp score(mTSS),the levels difference of RF,CRP and ESR before and after treatment,and adverse reactions of the two groups were compared.Results:The curative response rate of ACR20,ACR50,and ACR70 in the Huayu Tongbi+MTX group at each time points were significantly higher than those of the MTX group(P<0.05);After treatment,the difference of mTSS and baseline in the Huayu Tongbi+MTX group were significantly lower than those of the MTX group(P<0.05);Before treatment,the levels of RF,CRP and ESR were not statistically different between the two groups(P>0.05).After treatment,the levels of RF,CRP and ESR in the Huayu Tongbi+MTX group were significantly lower than those of the MTX group(P<0.05).The difference of total incidence of treatment-related adverse reactions between the Huayu Tongbi+MTX group and the MTX group was statistically significant(P<0.05).Conclusions:The application of Huayu Tongbi Recipe combined with MTX in the treatment of rheumatoid arthritis is effective and can significantly reduce the levels of RF,CRP and ESR.It is worthy of promotion.