祛风除湿活血养阴中药治疗类风湿关节炎活动期临床观察  

Clinical Observation on Treatment of Active Rheumatoid Arthritis with Chinese Herbal Medicine

作　　者：盛正和[1] 刘毅斌[1] 黄艳霞[1] 陈柳芳[1] 刘溯章[1] 赵志雄[1] 陈大宇[1] 

机构地区：[1]广西医科大学第五附属医院中医科,广西柳州545001

出　　处：《中国中西医结合杂志》2008年第11期990-993,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：广西壮族自治区卫生厅基金资助项目(No.Z2006248)

摘　　要：目的研究祛风除湿活血养阴中药对类风湿关节炎活动期的影响。方法67例活动期类风湿关节炎病例按病情、年龄、性别均衡后分为基础治疗组(22例)、激素组(23例)及中药组(22例),分别采用非类固醇抗炎药+免疫抑制剂、小剂量泼尼松+非类固醇抗炎药+免疫抑制剂、中药+非类固醇抗炎药+免疫抑制剂治疗8周,评价疗效和不良反应积分。结果基础治疗组总有效率20.0%(4/20),激素组81.0%(17/21),中药组85.7%(18/21),激素组和中药组优于基础治疗组(P<0.01)。治疗前疾病活动分数(DAS)3组组间比较差异无统计学意义。治疗后中药组和激素组Ritchie关节指数(RAI)、肿胀关节数目(SwJ+s)、红细胞沉降率(ESR)、通过100mm视力对照表进行的一般健康状态(GH)评估、DAS均有明显改善(P<0.05);基础治疗组仅GH有明显改善(P<0.05)。DAS治疗前后差值3组组间比较:中药组(0.92±0.59)和激素组(0.87±0.60)比较,Z=0.422,P=0.673;中药组和基础治疗组(0.25±0.77)比较,Z=3.836,P=0.000;激素组和基础治疗组比较Z=3.795,P=0.000。不良反应的累计积分3组排序为中药组(3.76±2.72)<基础治疗组(9.10±6.01)<激素组(14.38±9.36),3组组间比较差异有统计学意义(P<0.05)。结论中西医结合治疗类风湿关节炎活动期具有较好疗效,且不良反应较少。Objective To study the efficacy and safety of Chinese drugs for expelling evil-wind, removing dampness, promoting blood circulation and invigorating yin in treating active rheumatoid arthritis （ RA）. Methods Sixty-seven patients with active RA were randomized into 3 groups, the Group A, B and C. They were made coequal in terms of age, sex and condition of disease and treated respectively with basic treatment （ non-steroid anti-in- flammation drug combined with immune inhibitor） only, basic treatment ± small dose prednisone, and basic treatment ± Chinese herbal medicine, all for 8 weeks. The efficacy and adverse effects of treatment were analyzed by scoring. Results The total eftective rate was 20.0% （4/20） in Group A, 81.0% （17/21） in Group B and 85.7% （18/21） in Group C, the latter two were superior to the former one （P 〈0.01 ）. Before treatment, comparison of disease activity score （DAS） among the three groups showed no significant difference （P 〉 0.05）. After treatment, improvements of Ritchie arthritis index （RAI） , number of swollen joint, erythrocyte sedimentation rate （ ESR）, general health （ GH）, and DAS were shown in Group B and C （P 〈 0.05 ）, while in Group A, improvement was only shown in GH （ P 〈 0.05）. The difference of DAS between pre- and post-treatment was 0.25 ± 0.77 in Group A, 0.87 ± O. 60 in Group B and O. 92 ± O. 59 in Group C, showing statistical significance between Group A vs B and A vs C （P = 0. 0000）. The total accumulative score of adverse reaction was 3.76 ± 2.72 in Group C, 9. 10 ±6.01 in Group A and 14.38 ±9.36 in Group B, also showing statistical significance among groups （P 〈 0.05）. Conclusion The combination of Chinese and Westerw medicine for active RA is effective and safe.

关 键 词：关节炎 类风湿 祛风除湿 活血养阴 中药 

分 类 号：R259[医药卫生—中西医结合]