从肝论治风湿三病临床观察及探讨  

Clinical Observation on Three Rheumatism from Liver in Traditional Chinese Medicine

作　　者：袁征[1] 王向红[2] 吴娅妮[2] 周珺[3] 陈晓云[3] 陈湘君[3] 顾军花[3] 

机构地区：[1]上海市第八人民医院,上海200233 [2]上海市黄浦区中西医结合医院,上海200010 [3]上海中医药大学附属龙华医院,上海200032

出　　处：《辽宁中医药大学学报》2015年第6期109-113,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：上海市科委课题(12401904000)

摘　　要：目的：在既往从肝论治干燥综合征的研究基础上,结合中医异病同治理念,观察舒肝法对三种最具代表性的风湿病——以腺体病变为主的干燥综合征（SS）、以皮肤和小血管病变为主的系统性红斑狼疮（SLE）及以关节和滑膜病变为主的类风湿性关节炎（RA）的疗效及其差别,同时探索运用更符合中医临床习惯的临床阳性症状数目减少的疗效评判方法。方法：收集2011年9月—2012年4月龙华医院门诊诊断符合肝郁气滞证型的干燥综合征、系统性红斑狼疮和类风湿性关节炎共37例,采用自拟经验方舒肝方加减治疗4-8周,观察治疗前后临床症状阳性数目、临床症候积分等变化,以评价舒肝方法治疗三种风湿病的临床效果,及该方法在治疗此三病的疗效差别。结果：（1）通过舒肝法治疗后三种风湿病患者临床症候积分均较治疗前明显减少（P〈0.01）,三种疾病的症候积分总改善率达81.1%,其中SS为80.0%,SLE为86.7%,RA为74.1%,且治疗后的临床阳性症状数目较治疗前明显减少（P〈0.01）。（2）三种风湿病患者三组之间临床症候积分改善率无统计学差异及治疗前后临床阳性症状数目变化无明显差异（P〉0.05）。结论：在从肝论治理论指导下,用舒肝为主的方法治疗风湿病,可明显减少和改善患者临床症状,减少临床症候积分,并且疗效相似,符合中医异病同治理论,值得临床推广和运用。Objective ： Rheumatism is a non-specific term for medical problems affecting the joints and connective tissue which are just like tendons. Liver governs tendons in traditional chinese clinical theories and there is a concept of traditional chinese medicine which is treating different diseases with same method. We design the research in order to observe the effects of shugan raised by my tutor Dr. GU Junhua on the three most representative cases of rheumatism. Sjogren＇s syndrome （ SS ） is largerly disorder in glandulars. Systemic lupus erythematosus （ SLE ） is mainly disorder in skin and small vessels and rheumatoid arthritis （ RA ） is mainly disorder in synovium and joints. Also to explore the method of clinical evaluation through anlalyzing the change with the number of positive clinical symptoms. Method ： Cases were selected from the patients of Dr.Gu during from september 2011 to april 2012. They were diagnosed with sjogren＇s syndrome, systemic lupus erythematosus or rheumatoid arthritis. They had the familiar syndromes of ganyuqizhi （ liver depression and qi stagnation ）. We took the number of positive clinical symptoms, clinical signs score and related laboratory parameters for the observation from the cases before and after the treatment. The course of the treatment are 4 to 12 weeks. In help of the software named spss18.0, we analyzed the data of the positive number of clinical symptoms, clinical signs score to evaluated of the efficacy on the treatment of rheumatism by shugan. Result ： （ 1 ） The number of positive clinical symptoms were reduced significantly after the treatment than before （ P〈0.01 ） in the observation. （ 2 ） It had no significant difference from the changes of the number of positive clinical symptoms in sjogren＇s syndrome, systemic lupus erythematosus or rheumatoid arthritis （ P〉0.05 ） in the observation. （ 3 ） The clinical signs score was reduced significantly after the treatment than before （ P〈O.01 ） in the observation.the rate

关 键 词：从肝论治 风湿病 异病同治 

分 类 号：R593.21[医药卫生—内科学]