三痹汤加减联合来氟米特片治疗寒湿痹阻型类风湿关节炎的疗效观察  

Clinical observation of modified Sanbi decoction plus Leflunomide tablets on rheumatoid arthritis patients of cold-dampness obstruction syndrome

作　　者：焦爽 张春芳[2] 杜晓伟[1] 宫凤秋[1] 郭德强 李天宇[1] JIAO Shuang;ZHANG Chunfang;DU Xiaowei(2016-Grade Master of Heilongjiang University of Chinese Medicine,Heilongjiang,Harbin 150040)

机构地区：[1]黑龙江中医药大学 [2]黑龙江中医药大学附属第一医院风湿病科,黑龙江哈尔滨150040

出　　处：《河北中医》2018年第7期991-995,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：黑龙江省博士后科研启动金资助项目(编号:LBH-Q12011)

摘　　要：目的观察三痹汤加减联合来氟米特片治疗寒湿痹阻型类风湿关节炎(RA)的临床疗效。方法将74例寒湿痹阻型RA患者按照随机数字表法分为2组。治疗组37例予三痹汤加减联合来氟米特片治疗;对照组37例单纯予来氟米特片治疗。2组均治疗4周后统计疗效,比较2组治疗前后中医症状积分变化情况并评价疗效,包括疼痛、肿胀、压痛、屈伸不利、晨僵、舌象及脉象;根据28个关节的疾病活动度评分(DAS28)改善情况评价2组治疗后病情活动度控制情况;比较2组治疗前后类风湿因子(RF)、红细胞沉降率(ESR)及C-反应蛋白(CRP)水平变化情况;比较2组治疗期间的不良反应情况。结果治疗组总有效率91.89%,病情明显控制率67.57%,对照组总有效率75.67%,病情明显控制率45.94%,治疗组疗效及病情控制均优于对照组(P<0.05);2组治疗后疼痛、肿胀、压痛、屈伸不利、晨僵、舌象及脉象评分与本组治疗前比较均明显降低(P<0.05),且治疗组各中医症状改善均优于对照组(P<0.05);2组治疗后RF、ESR及CRP水平与本组治疗前比较均明显降低(P<0.05),且治疗组改善均优于对照组(P<0.05);治疗组不良反应发生率10.81%,对照组不良反应发生率21.6%,治疗组不良反应发生情况低于对照组(P<0.05)。结论三痹汤加减联合来氟米特治疗寒湿痹阻型RA可明显改善患者中医症状,控制RA病情活动,降低RF、ESR及CRP水平,减少不良反应的发生,提高临床疗效,提高患者生活质量。Objective To observe the clinical effects of modified Sanbi decoction plus Leflunomide tablets on rheumatoid arthritis（RA） patients of cold-dampness obstruction syndrome.Methods 74 patients with RA of cold-dampness obstruction syndrome were divided into two groups according to the random number table method.37 cases in treatment group were treated by Sanbi decoction plus Leflunomide tablets,37 cases in control group were treated by Leflunomide tablets.After 4 weeks of treatment,the scores of TCM symptoms before and after treatment were compared and clinical efficacy were evaluated,including pain,swelling,pressure pain,bad flexion and extension,morning stiffness,tongue image and pulse image.According to the disease activity score of 28 joints（DAS28）,the control of disease activity was evaluated in the 2 groups after treatment.The changes of rheumatoid factor（RF）,blood sedimentation rate（ESR）,and C-reactive protein（CRP） before and after treatment in the two groups were compared,and adverse reactions during treatment between the two groups were compared.Results The total effective rate of the treatment group was 91.89%,the control rate of the treatment group was 67.57%,the total effective rate of the control group was 75.67%,the control rate of the treatment was 45.94%,the curative effect and the condition control of the treatment group were superior to the control group（P〈 0.05）.The pain,swelling,pressure pain,bad flexion and extension,morning stiffness,tongue image and pulse image of the two groups after treatment were all significantly lower than those before treatment（P〈 0.05）.After treatment,the improvement of the TCM symptoms improved in treatment group was better than that of control group（P〈 0.05）.The RF,ESR and CRP levels in two groups after treatment were significantly lower than those before treatment（P〈 0.05）,and the improvement of RF,ESR and CRP levels in treatment group was better than that in the control group（P〈 0.05）.The incidence of adverse rea

关 键 词：关节炎 类风湿 三痹汤 消炎药 非甾类 中西医结合 

分 类 号：R289.69[医药卫生—方剂学] R593.22[医药卫生—中药学]