清热活血方药治疗类风湿关节炎骨破坏5年期放射学观察  

Five-year radiological research on bone destruction in rheumatoid arthritis treated with the formula for clearing heat and activating blood circulation

作　　者：李光耀 唐晓颇[1] 姜泉[1] 王雷[1] 巩勋[1] 王建[1] 罗成贵[1] LI Guang-yao;TANG Xiao-po;JIANG Quan;WANG Lei;GONG Xun;WANG Jian;LUO Cheng-gui(Guanganmen Hospital,China Academy of Chinese Medical Sciences,Beijing100053)

机构地区：[1]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》2019年第4期516-520,共5页World Journal of Integrated Traditional and Western Medicine

基　　金："十二五"国家科技支撑计划项目(2013BAI02B06)

摘　　要：目的观察及评价清热活血方药治疗类风湿关节炎骨破坏5年期放射学的变化。方法采用开放性随访研究,对28例辨证属湿热瘀阻证的活动期RA患者进行5年期的临床观察,运用国际公认的Sharp评分,对患者基线及治疗5年后双手X光片进行评分,以评价清热活血方药对RA骨破坏进展的远期影响。结果中药组和中西药组患者Sharp总分、关节间隙、关节侵蚀评分在基线和5年时点上比较差异均无统计学意义(P> 0. 05)。两组患者Sharp总分、关节间隙、关节侵蚀进展速率在基线和5年时点比较差异均无统计学意义(P> 0. 05)。基线有破坏组Sharp总分、关节间隙、关节侵蚀在基线和5年治疗后均大于基线无破坏组,差异有统计学意义(P <0. 05)。基线有骨破坏组5年进展速率大于基线无骨破坏组(P <0. 05),差异有统计学意义。结论清热活血方药能延缓RA患者远期5年骨破坏进展速率;清热活血方药联合MTX能延缓RA患者远期5年骨破坏进展速率;基线有骨破坏的RA患者远期骨破坏进展速率大于基线无骨破坏的RA患者。Objective To observe and evaluate the 5-year radiological changes in bone destruction of rheumatoid arthritis(RA)treated with the formula for clearing heat and activating blood circulation.Methods Using open follow-up study,28 patients at active RA stage and identified as damp heat obstruction in TCM were collected in the 5-year clinical observation.Using the internationally-recognized Sharp scale,the X-ray results of the hands at baseline and in 5 years were evaluated.The long-term effects of the formula for clearing heat and activating blood circulation on RA bone destruction were assessed.Results The differences were not significant statistically in Sharp total score,joint space and joint corrosion score at the base line and at the 5-year point between Chinese medication group and the integrated Chinese and western medication group( P >0.05).The differences were not significant statistically in Sharp total score,joint space and joint corrosion progress rate at the baseline and at the 5-year point between Chinese medication group and the integrated Chinese and western medication group( P >0.05).At the baseline and after 5-year treatment,the Sharp total score,joint space and joint corrosion in the baseline destruction group were higher than the baseline non-destruction group,indicating the significant differences( P <0.05).The five-year progress rate in the baseline destruction group was higher than the baseline non-destruction group,indicating the significant differences( P <0.05).Conclusion The formula for clearing heat and activating blood circulation delays the long-term progress rate of bone destruction in RA patients.Such formula combined with MTX delays the long-term progress rate of bone destruction in RA patients.The long-term bone destruction progress rate in RA patient with baseline destruction is higher than that without bone destruction.

关 键 词：类风湿关节炎 清热活血方药 放射学 骨破坏 

分 类 号：R593.22[医药卫生—内科学]