痹肿消汤对类风湿关节炎患者日常生活能力的影响  

Bizhongxiao decoction improves the activities of daily living in patients with rheumatoid arthritis

作　　者：蒋勇前[1] 梁清华[1] 刘小春[1] 熊新贵[1] 范荣[1] 王娟[1] 

机构地区：[1]中南大学湘雅医院中西医结合研究所,湖南省长沙市410008

出　　处：《中国组织工程研究与临床康复》2007年第12期2272-2274,2278,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家自然科学基金资助项目(30371833);湖南省中医管理局课题基金(2000053);湖南省中医管理局课题基金(202048)~~

摘　　要：目的:观察痹肿消汤治疗前后类风湿关节炎患者主动活动度及日常生活能力的改变,论证痹肿消汤的临床疗效。方法:选择于2004-10/2006-05在中南大学湘雅医院中西医结合科治疗的活动期类风湿关节炎患者86例,痹肿消汤组44例和甲氨喋呤组42例。痹肿消汤组用痹肿消汤(白花蛇舌草15g,丹参15g,苡米30g,骨碎补15g,络石藤20g,肿节风30g等共16味药,购自湘雅医院中药房;常规煎汤,药液浓度为1.038g/mL)治疗,2次/d口服,每日1剂。甲氨喋呤组选用甲氨喋呤(20mg,1次/周,配以等量叶酸口服)和尼美舒利片(0.1g,2次/d)联合用药,均治疗3个月为1疗程。比较两组患者关节疼痛指数、关节压痛指数、关节肿胀指数、晨僵时间、握力以及日常生活能力等指标。关节肿胀指数、关节疼痛指数,关节压痛指数评定按美国风湿病协会制订标准。采用改良Barthe1指数分别评定患者治疗前和治疗后的日常生活能力。评估内容10项,包括洗澡、修饰各5分,进餐、穿衣、用厕、可控制大便、可控制小便、上下楼梯各10分,床椅转移、平地行走45m各15分。结果:纳入类风湿关节炎患者86例全部进入结果分析。痹肿消汤组的患者其晨僵时间、关节疼痛、关节肿胀、关节压痛、关节功能障碍指数及双手平均握力以及日常生活能力评分各项指标均较治疗前均显著改善(P<0.01),甲氨喋呤组较治疗前亦有显著改善(P<0.01,0.05),但痹肿消汤组明显优于甲氨喋呤组(P<0.01～0.05)。结论:痹肿消汤和传统的非类固醇抗炎药和慢作用药物联合应用均能改善类风湿关节炎患者关节主动活动度及提高患者日常生活能力,但痹肿消汤效果更为明显。AIM： To observe the alteration of bizhongxiao decoction （BZXD） on the range of active movement and activities of daily living （ADL） in patients with rheumatoid arthritis （RA）, and further investigate the clinical curative effect of BZXD. METHODS： Between October 2004 and May 2006, eighty-six patients with RA on active phase were enrolled from the Institute of Combined Traditional Chinese and Western Medicine in Xiangya Hospital, and were divided into two groups： BZXD treated group （n =44） and control group （n =42）. Treated group： BZXD was consisted of 15 g Hedyotic diffusa, 15 g Danshen Root, 30 g pearl barley, 15 g Fortune＇s Drynaria Rhizome, 20 g Chinese Starjasmine Stem, 30 g zhongjiefeng, etc. All the herbs were purchased by Dispensary of Traditional Chinese Medicine in Xiangya Hospital and then decocted routinely with the concentration of 1.038 g/mL, one preparation daily for two oral administrations. Control group adopted the combination of Methotrexate （20 mg, once per week, taken orally with equal folic acid） and Nimesulide （0.1 g, twice daily）. Both groups were treated for 3 months as one course. Symptoms and signs, such as index of joint pain, joint tenderness, arthroncus, as well as moming stiffness time and grip strength were evaluated in accordance with the criteria of American Rheumatism Association. ADL before and after treatment was determined with modified Barthel index, including 10 items of taking a bath, decorating （5 points for each）, having meal, dressing, going toilet, sedes controls, urination controls, upstairs and downstairs （10 points for each）, transferring between beds and chairs, walking for 45 minutes （15 points for each）. RESULTS： All 86 IRA patients were involved in the result analysis. After 3-month treatment, the index of joint pain, joint tenderness, arthroncus, joint functional impairment index, morning stiffness time, average grip strength of both hands and ADL were significantly ameliorated in BZXD treated group and control

关 键 词：关节炎 类风湿 日常生活活动 中药疗法 消炎药 非甾类 

分 类 号：R593.22[医药卫生—内科学]