清热活血方药治疗类风湿关节炎骨破坏2年期放射学研究  

2-year Radiological Research of Bone Destruction of Rheumatoid Arthritis Treated with the Formula for Clearing Away Heat and Activating Blood Circulation

作　　者：姜泉[1,2] 殷海波[2] 罗成贵[2] 王雷[2] 焦娟[2] 周新尧[2] 

机构地区：[1]福建中医药大学 [2]中国中医科学院广安门医院,北京100053

出　　处：《世界中西医结合杂志》2012年第4期343-347,共5页World Journal of Integrated Traditional and Western Medicine

摘　　要：目的探讨清热活血方药联合甲氨蝶呤片(methotrexate,MTX)对类风湿关节炎(Rheu-matoid Arthritis,RA)骨破坏的影响及骨破坏与病情之间关系。方法本研究采取开放性随访研究,对36例证属湿热痹阻的RA患者进行2年期的临床随访,设计问卷调查表,每3个月复查患者疗效指标,进行DAS28及ACR疗效评价,同时于治疗前及1年、2年时点进行双手X片拍摄,运用国际公认Sharp评分,评价清热活血方药对RA骨破坏进展的影响。结果清热活血方药联合MTX可延缓RA患者的骨破坏进展速率,与治疗前比较差异有统计学意义(P<0.05);ACR20达标率情况与骨破坏进展不一致(P>0.05),与DAS28高低基本一致(P<0.05)。结论清热活血方药联合MTX可延缓RA骨破坏的进程,清热活血方药联合MTX安全性较好,不良反应发生率低。Objective To discuss the impacts on bone destruction of rheumatoid arthritis（RA）treated with the formula for clearing away heat and activating blood circulation（formula）and methorexate（MTX）as well as the relationship between bone destruction and disease situation.Methods The open,follow-up research was adopted.36 cases of RA,differentiated as blockage by damp and heat were followed up clinically for 2 years.The questionnaire investigation form was designed.The efficacy indicators were re-checked once every 3 months for DAS28 and ACR assessments.Meanwhile,separately,before treatment,in 1 year and 2 years,the hand x-ray filming was performed.The international recognized Sharp grade was adopted to assess the impacts of the formula on the progression of RA bone destruction.Results The allied therapy with the formula and MTX delayed the progression of bone destruction for RA patients.The statistical significant differences presented as compared with those before treatment（P0.05）.ACR20 success rate was not in compliance with the progression of bone destruction（P0.05）,but was basically in accordance with DAS28 level（P0.05）.Conclusion The formula for clearing away heat and activating blood circulation allied with MTX delays the progression of RA bone destruction.The allied therapy is quite safe and has low incidence of adverse reactions.

关 键 词：类风湿关节炎(RA) 骨破坏 影像学 清热活血方药 

分 类 号：R593.22[医药卫生—内科学] R812[医药卫生—临床医学]