分型治疗早期类风湿关节炎对腕关节MRI变化的影响  

Influence on MRI of Wrist Joint in Early Stage of Rheumatoid Arthritis Treated Based on Syndrome Differentiation

作　　者：陶娟[1] 徐雯[1] 吴斌龙[1] 蒋兆贯[1] 张志斌[1] 程立[1] 

机构地区：[1]南京中医药大学附属无锡市中医院风湿科,江苏南京214001

出　　处：《辽宁中医杂志》2012年第1期111-113,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：江苏省中医药管理局资助项目(HZ07096)

摘　　要：目的:观察中医药辨证分型结合基础治疗早期类风湿关节炎,观察对腕关节的MRI变化。方法:选择早期类风湿关节炎患者60例,随机分为对照组(采用基础治疗:扶他林+柳氮磺胺吡啶)、寒湿组(寒湿方+基础治疗)、湿热组(湿热方+基础治疗)各20例,每组均治疗3个月,观察MRI的改善情况。结果:寒湿组、湿热组在降低ESR、CRP、IL-6、TNF-a与对照组比较,具有统计学意义(P<0.05)。但寒湿组、湿热组之间比较无统计学差异(P>0.05)。寒湿组、湿热组在改善腕关节MRI滑膜增生、骨髓水肿方面与对照组比较有统计学意义。抗CCP、RF、骨侵蚀3组比较无统计学意义,且经过治疗后骨侵蚀均有不同程度的进展。结论:中医药辨证分型结合基础治疗对早期类风湿关节炎腕关节MRI滑膜增生、骨髓水肿的改善、病情活动的控制与单纯基础治疗相比,具有一定的优势。Objective ： To observe the therapeutic effect and variance on wrist joint MRI of the foundation with combinating the traditional Chinese medicine differentiation of symptoms and signs for classification of syndrome treating early rheumatoid arthritis. Methods ： The early rheumatoid arthritis 60 patients were randomly divided into 3 groups ： the control group （ foundation treatment ：Diclofenac ＋ SASP）20 cases, the cold wetness group （foundation treatment ＋ the cold wetness recipe）20 cases, the moist heat group（ foundation treatment ＋ the moist heat recipe）20 cases. We have observed the amelioration of the laboratory index and MRI after 3 months. Results ：3 groups comparisons were of statistical significance in pretherapy and post - treatment （P 〈 0. 05）. There was no significant difference in the CCP and RF in comparison to the control group （P 〉 0. 05 ）. There is a significant difference in lowering ESR, CRP, IL - 6, TNF - a, synovium hyperplasia, bone marrow edema of the wrist joint MRI compared with in the control group and the differentiation of symptoms and signs for classification of syndrome group（ P 〈 0. 05 ）. The cold wetness and moist heat group comparison has no significant difference in statistics （P 〉 0.05 ）. There is no significant difference in bone erosion among the 3 groups. It was of different degree progression after 3 months. Conclusion ： The differentiation of symptoms and signs for classification of syndrome group treating early rheumatoid arthritis could better in improving synovium hyperplasia, bone marrow edema of the wrist joint MRI and control disease activity than that of the control group, which was of dominance.

关 键 词：早期类风湿关节炎 中医辨证分型 腕关节MRI 

分 类 号：R593.22[医药卫生—内科学]