桂枝附子汤加味联合西药治疗类风湿关节炎继发骨质疏松临床观察  

Clinical Observation on Treatment of Rheumatoid Arthritis Secondary Osteoporosis with Guizhi Fuzi Decoction and Western Medicine

作　　者：曾翠青[1] 谈平[1] 张洞于 吴东明 吴翔[1] ZENG Cuiqing;TAN Ping;ZHANG Dongyu;WU Dongming;WU Xiang(Department of Rheumatism,Hainan Provincial Hospital of Traditional Chinese Medicine,Haikou 570203,Hainan,China)

机构地区：[1]海南省中医院肾病风湿科

出　　处：《中华中医药学刊》2019年第11期2737-2740,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：海南省重点研发计划项目(ZDYF2018161)

摘　　要：目的:探讨桂枝附子汤加味联合西药治疗类风湿关节炎继发骨质疏松临床观察。方法:类风湿关节炎继发骨质疏松患者60例,按照随机数字表法随机分成对照组和观察组,每组30例。对对照组予以常规西药治疗,而对观察组在予以常规西药治疗的基础上联合予以桂枝附子汤加味治疗。干预治疗3个月后,分别对两组的炎症因子水平、症状改善水平、各部位骨密度值(BMD)以及临床疗效进行比较。结果:①观察组的类风湿因子(RF)、C反应蛋白(CRP)、血沉(ESR)以及血清骨源性碱性磷酸酶(BALP)水平均显著低于对照组,差异有统计学意义(t=5.945、3.656、22.889、3.469;P<0.05);②观察组的关节功能指数、关节肿胀指数、晨僵时间以及关节压痛指数均明显低于对照组,差异有统计学意义(t=5.380、7.165、4.211、5.545;P<0.05);③观察组的腰椎BMD、左侧前臂BMD以及左侧髋关节BMD均显著高于对照组,差异有统计学意义(t=-3.468、-3.798、-2.786;P<0.05);④观察组的总治疗有效率为93.33%,显著高于对照组的总治疗有效率56.67%,差异有统计学意义(χ^2=10.756;P<0.05)。结论:采用桂枝附子汤加味联合西药对类风湿关节炎继发骨质疏松患者进行治疗,能够有效降低患者的风湿炎症因子水平,提高骨密度,改善关节功能以缓解疼痛,取得较好的临床治疗效果,值得临床上广泛推广。Objective:To explore the effect of rheumatoid arthritis secondary osteoporosis treated with Guizhi Fuzi Decoction and Western Medicine. Methods:Sixty patients with osteoporosis secondary to rheumatoid arthritis were randomly divided into the control group and the observation group according to the random number table method, with 30 cases in each group. Patients in the control group were treated with conventional Western medicine, while those in the observation group were treated with Guizhi Fuzi Decoction on the basis of conventional Western medicine. Three months after intervention, the levels of inflammatory factors, symptoms improvement, bone mineral density(BMD) and clinical efficacy of the two groups were compared. Results:①The levels of rheumatoid factor(RF), C-reactive protein(CRP), erythrocyte sedimentation rate(ESR) and serum bone-derived alkaline phosphatase(BALP) in the observation group were significantly lower than those in the control group(t=5.945, 3.656, 22.889, 3.469, P<0.05). ②The joint function index, joint swelling index, morning stiffness time and joint tenderness index of the observation group were significantly lower than those of the control group(t=5.380, 7.165, 4.211, 5.545, P<0.05). ③The lumbar BMD, left forearm BMD and left hip joint BMD in the observation group were significantly higher than those in the control group(t=-3.468,-3.798,-2.786, P<0.05). ④The total effective rate of the observation group was 93.33%, which was significantly higher than that of the control group(56.67%)(χ^2=10.756, P<0.05). Conclusion:Guizhi Fuzi Decoction combined with western medicine for the treatment of rheumatoid arthritis patients with osteoporosis secondary to rheumatoid arthritis can effectively reduce the level of inflammatory factors, improve bone mineral density, improve joint function to alleviate pain, and achieve better clinical treatment results, that is worthy of promoting.

关 键 词：类风湿关节炎 骨质疏松患者 桂枝附子汤加味 西药 临床疗效 

分 类 号：R593.22[医药卫生—内科学]