顽痹清丸与白芍总苷胶囊治疗湿毒瘀热型类风湿关节炎的对比研究  

A clinical comparison of Wanbiqing Wan( 顽痹清丸) and total glucosides of paeony capsules for treatment of type DAMP TOXIN STAGNATED HEAT rheumatoid arthritis

作　　者：张永红[1] 王笑青[1] 张万义[1] 沙莎[1] 许素琴[1] 王玉丽[1] 侯宏理[1] 曹焱[1] 张丽丽[1] 

机构地区：[1]河南省洛阳正骨医院,河南省骨科医院,河南洛阳471002

出　　处：《中医正骨》2014年第12期10-15,共6页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:比较顽痹清丸与白芍总苷胶囊治疗湿毒瘀热型类风湿关节炎的临床疗效。方法:将60例湿毒瘀热型类风湿关节炎患者随机分为2组,治疗组患者(40例)采用口服顽痹清丸联合右旋布洛芬胶囊、甲氨蝶呤片和来氟米特片治疗,对照组患者(20例)采用白芍总苷胶囊联合右旋布洛芬胶囊、甲氨蝶呤片和来氟米特片治疗。治疗2个疗程后比较2组患者血沉,C反应蛋白、类风湿因子、肿瘤坏死因子α、白介素-1的血清含量,关节疼痛评分变化情况及总体疗效。结果:1急性期反应物、炎性细胞因子及关节疼痛评分。治疗2个疗程后,治疗组血沉、C反应蛋白、类风湿因子、肿瘤坏死因子α、白介素-1及关节疼痛视觉模拟评分均较治疗前降低[(69.30±35.20)mm·h-1,(42.40±29.20)mm·h-1,t=3.305,P=0.001;(42.40±33.00)mg·L-1,(12.00±14.80)mg·L-1,t=5.846,P=0.000;(131.10±93.90)IU·m L-1,(91.70±71.50)IU·m L-1,t=2.161,P=0.034;(124.80±31.20)pg·m L-1,(110.00±28.70)pg·m L-1,t=3.198,P=0.002;(33.10±7.39)ug·g-1,(29.50±8.59)ug·g-1,t=4.561,P=0.000;(6.12±0.89)分,(3.46±1.44)分,t=4.482,P=0.005],对照组血沉、C反应蛋白、类风湿因子、肿瘤坏死因子α、白介素-1及关节疼痛视觉模拟评分均较治疗前降低[(58.50±33.70)mm·h-1,(41.70±27.80)mm·h-1,t=2.206,P=0.034;(31.70±28.00)mg·L-1,(13.80±16.70)mg·L-1,t=2.449,P=0.019;(159.30±83.80)IU·m L-1,(105.00±53.70)IU·m L-1,t=2.569,P=0.014;(114.20±32.70)pg·m L-1,(117.60±31.80)pg·m L-1,t=2.038,P=0.049;(35.80±8.26)ug·g-1,(34.90±8.03)ug·g-1,t=2.509,P=0.016;(5.85±1.12)分,(3.75±1.18)分,t=2.850,P=0.007];2组C反应蛋白、类风湿因子、肿瘤坏死因子α比较,差异均无统计学意义[(33.20±32.80)mg·L-1,(17.80±33.70)mg·L-1,t=1.687,P=0.097;(39.30±55.20)IU·m L-1,(53.40±69.90)IU·m L-1,t=-0.848,P=0.400;(12.80±39.10)pg·m L-1,(-3.40±41.50)pg·m L-1,t=1.485,P=0.143];治疗组血沉、白介素-1及关节疼痛视觉模拟评分下降幅度均大于对照组[Objective：To compare the clinical curative effect of Wanbiqing Wan（顽痹清丸）versus total glucosides of paeony capsules for treatment of type DAMP TOXIN STAGNATED HEAT rheumatoid arthritis（RA）.Methods：Sixty patients with type DAMP TOXIN STAGNATED HEAT RA were randomly divided into two groups.The patients in treatment group（40 cases）were treated with oral applica-tion of Wanbiqing Wan,dexibuprofen capsules,methotrexate tablets and leflunomide tablets;while the others in the control group（20 cases） were treated with oral application of total glucosides of paeony capsules,dexibuprofen capsules,methotrexate tablets and leflunomide tablets. After two-course treatment,the two groups were compared with each other in joint pain visual analogue scores（VAS）,total curative effects and serum contents of erythrocyte sedimentation rate（ESR）,c-reactive protein（CRP）,rheumatoid factor（RF）,tumor necrosis factor-alpha （TNF-α）and interleukin-1 （IL-1 ）.Results：ESR,CRP,RF,TNF-α,IL-1 and VAS decreased in treatment group after two-course treat-ment（69.30＋/-35.20 vs 42.40＋/-29.20 mm/h,t=3.305,P=0.001;42.40 ＋/-33.00 vs 12.00 ＋/-14.80 mg/L,t=5.846,P=0.000;131.10＋/-93.90 vs 91.70＋/-71.50 IU/mL,t=2.161,P=0.034;124.80＋/-31.20 vs 110.00＋/-28.70 pg/mL,t=3.198, P=0.002;33.10＋/-7.39 vs 29.50 ＋/-8.59 ug/g,t =4.561,P=0.000;6.12 ＋/-0.89 vs 3.46 ＋/-1.44 points,t =4.482,P=0.005）.ESR,CRP,RF,TNF-α,IL-1 and VAS decreased in control group after two-course treatment（58.50 ＋/-33.70 vs 41.70 ＋/-27.80 mm/h,t=2.206,P=0.034;31.70＋/-28.00 vs 13.80＋/-16.70 mg/L,t=2.449,P=0.019;159.30＋/-83.80 vs 105.00＋/-53.70 IU/mL,t=2.569,P=0.014;114.20＋/-32.70 vs 117.60＋/-31.80 pg/mL,t=2.038,P=0.049;35.80＋/-8.26 vs 34.90＋/-8.03 ug/g,t=2.509,P=0.016;5.85 ＋/-1.12 vs 3.75 ＋/-1.18 points,t=2.850,P=0.007）.There were no statistical differences in CRP,RF and TNF-αbetween the 2 groups（33.20 ＋/-32.80 vs 17.80 ＋/-33.70 mg/L,t =1.687,P=0.097;39.30 ＋/-55.20 vs 53.40＋/-

关 键 词：关节炎 类风湿 顽痹清丸 白芍 消炎药 非甾类 抗风湿药 治疗 临床研究性 

分 类 号：R259[医药卫生—中西医结合]