芙蓉膏外敷联合中药内服治疗活动期类风湿关节炎的临床疗效观察及关联规则分析  

Clinical Observation on the Clinical Curative Effect of Furong Gao(芙蓉膏) Combined with Chinese Medicine in the Treatment of Active Rheumatoid Arthritis and the Association Rules Analysis

作　　者：刘佳佳[1] 郭锦晨 汪元[2] 艾晓飞 LIU Jia-jla GUO Jin-chen WANG Yuan AI Xiao-fei

机构地区：[1]安徽中医药大学,安徽合肥230038 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《风湿病与关节炎》2017年第3期15-21,共7页Rheumatism and Arthritis

基　　金：国家自然科学基金青年基金项目(81302967);国家中医药重点学科中医痹病学建设项目(国中医药发〔2009〕30号);国家临床重点专科中医风湿病科建设项目(财社〔2013〕239号);国家科技支撑计划课题(2012BA126B02);安徽省重点实验室建设项目(1306c083035);安徽省科技攻关项目(1301042211)

摘　　要：目的:观察芙蓉膏外敷联合中药内服治疗活动期类风湿关节炎的临床疗效及关联规则。方法:将60例中医辨证属湿热痹阻证的活动期类风湿关节炎患者随机分为治疗组40例和对照组20例。2组均以来氟米特10 mg,每日1次口服为基础治疗。治疗组加用芙蓉膏外敷,每日1次,每次6 h;并配合中药口服,每日1剂,分早、晚2次服用。2组均以2周为1个疗程。采用SPSS 17.0和SPSS Clementine 14.1软件Aprior模块分析芙蓉膏外敷联合中药内服与实验室免疫炎症指标间的关系。结果:治疗后,治疗组总有效率高于对照组,差异有统计学意义(P<0.05);2组治疗后血小板计数(PLT)、超敏C-反应蛋白(hs-CRP)、抗CCP抗体、红细胞沉降率(ESR)、α1酸性糖蛋白(α1-AGP)、DAS28-3、关节肿胀数、关节压痛数均较治疗前降低,清蛋白(ALB)较治疗前升高,差异均有统计学意义(P<0.05)。治疗后,治疗组类风湿因子(RF)、hs-CRP、ESR、α1-AGP、DAS28-3、关节肿胀数、关节压痛数较对照组降低明显,ALB升高明显,差异有统计学意义(P<0.05或P<0.01)。2组中医症状积分(关节疼痛、大便稀溏、气短疲倦、食欲减退)均有所下降,且治疗组较对照组降低明显(P<0.05或P<0.01)。湿热痹阻型活动期类风湿关节炎患者内服中药频率高于75%的中药为茯苓、陈皮、丹参、甘草、薏苡仁、红花、桃仁、山药。结论:芙蓉膏外敷联合中药内服能有效治疗活动期类风湿关节炎,减轻患者症状,降低实验室免疫炎症指标,且临床疗效好,无不良反应。芙蓉膏外敷配合中药内服可能通过抑制免疫炎症的介导调控细胞免疫反应,并可抗炎、抗氧化等。Objective：To observe the clinical curative effect of Furong Gao（芙蓉膏 ）combined with Chinese medicine in the treatment of active rheumatoid arthritis and analyze the association rules.Methods：Sixty cases with active damp-heat-blockage rheumatoid arthritis were randomly divided into a treatment group （ 40 cases ） and a control group （ 20 cases ） .Both groups were given a basic treatment with 10 mg of leflunomide orally, once a day.Based on that, the treatment group was externally applied Furong Gao,once a day for 6 h each time.which is combined with Chinese medicine,one dose a day. Both groups were treated for two weeks. Soft wares SPSS 17.0 and SPSS Clementine 14.1 were used to analyze the relationship between the combining treatment and laboratory indexes of immune inflammation. Results：After treatment,the total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant （ P 〈 0.05 ） .PLT count,hs-CRP, anti-CCP antibodies,ESR, α-AGP, DAS28-3,joint swollen count and joint tenderness count of the two groups decreased after treatment compared with those before treatment,while its ALB increased,the differences being statistically significant （ P 〈 0.05 ） .After treatment,RF, hs-CRP, ESR, α1- AGP, DAS28-3,joint swollen count and joint tenderness count of the treatment group obviously decreased and its ALB increased significantly compared with those in the control group,the difference being statistically significant （ P 〈 0.05 or P 〈 0.01 ） .TCM symptom scores of the two groups （joint pain,loose stool,shortness of breath,fatigue,loss of appetite ） were decreased,and the treatment group decreased significantly compared with the control group （P 〈 0.05 or P 〈 0.01 ） .Chinese medicine with frequency higher than 75% among patients with damp-heat-blockage rheumatoid arthritis included fuling （ Wolfiporia cocos ） ,chenpi （ Citrus Reticulata Blanto ） ,danshen （ Radix et Rhizoma Salviae Milt

关 键 词：关节炎 类风湿 活动期 芙蓉膏 中药 临床疗效 关联规则 免疫炎症 

分 类 号：R259[医药卫生—中西医结合]