清热利湿通络中药外用联合西药对湿热痹阻型类风湿关节炎炎症指标的影响  

Effect of External Application of Chinese Medicine of Clearing Heat,Eliminating Dampness and Removing the Obstruction in Mmeridians Combined with Western Medicine on Inflammatory Factors in Patients with Dampness-heat Blockage tType of Rheumatoid Aarthritis

作　　者：于文宁[1] 刘新艳[2] 杨露梅[1] 周卉芸 张葆花[1] 苗柳 YU Wen-ning;LIU Xin-yan;YANG Lu-mei;ZHOU Hui-yun;ZHANG Bao-hua;MIAO Liu(Department of Rheumatism,Shijiazhuang Traditional Chinese Medicine Hospital,Shijiazhuang Hebei 050051;Department of Respiration,Shijiazhuang Traditional Chinese Medicine Hospital,Shijiazhuang Hebei 050051)

机构地区：[1]石家庄市中医院风湿科,河北石家庄050051 [2]石家庄市中医院呼吸科,河北石家庄050051

出　　处：《世界中西医结合杂志》2020年第5期946-950,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2019434)。

摘　　要：目的探讨清热利湿通络中药外用与西药联合治疗对湿热痹阻型类风湿关节炎患者炎症指标的改善效果。方法回顾性分析2018年1月—2019年6月期间在石家庄市中医院接受治疗的107例湿热痹阻型类风湿关节炎患者的临床资料,依据临床治疗方案的差异性按照随机数字表法进行分组,分为对照组与治疗组。对照组53例给予甲氨蝶呤和塞来昔布治疗,治疗组54例在对照组治疗的基础上给予清热利湿通络中药外用。比较两组治疗前后C反应蛋白(CRP)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、血沉(ESR)、临床症状体征积分及类风湿因子(RF)变化情况。结果治疗后,观察组患者治疗总有效率高于对照组(P<0.05),差异有统计学意义;治疗21 d后,两组患者CRP、IL-1、TNF-α、ESR水平均较本组治疗前降低(P<0.05),且治疗组CRP、IL-1、TNF-α与ESR水平均低于对照组(P<0.05);两组患者关节肿胀度、关节压痛、关节发热度、晨僵时间积分均较本组治疗前降低(P<0.05),且治疗组关节肿胀度、关节压痛、关节发热度、晨僵时间积分均低于对照组;两组患者RF水平均较本组治疗前降低(P<0.05),且治疗组RF水平低于对照组(P<0.05),差异有统计学意义。结论湿热痹阻型类风湿关节炎患者通过清热利湿通络中药外用与西药联合治疗,可有效缓解临床症状、体征,减轻炎症反应,控制RF水平。Objective To investigate the effect of external application of Chinese medicine of clearing heat,eliminating dampness and removing the obstruction in meridians combined with Western medicine on inflammatory factors in patients with dampness-heat blockage type of rheumatoid arthritis.Methods The clinical data of patients with dampness-heat blockage type of rheumatoid arthritis who treated in Shijiazhuang City Traditional Chinese Medicine Hospital hospital from 2018.01 to 2019.06 were retrospectively analyzed.They were divided into control group(methotrexate+celecoxib,53 cases)and treatment group(external application of Chinese medicine of clearing heat,eliminating dampness and removing the obstruction with meridians+methotrexate+celecoxib,54 cases)according to the random number table method.Before and after treatment,the inflammatory factors[C-reactive protein(CRP),interleukin 1(IL-1),tumor necrosis factor-α(TNF-α),erythrocyte sedimentation rate(ESR)],clinical symptoms and signs,rheumatoid factor(RF)were compared between two groups.Results After treatment,the total effective rate of the observation group was higher than that of the control group(P<0.05);After treatment for 21 d,the scores of joint swelling,joint tenderness,joint heat and morning stiffness time in the treatment group were lower than those in the control group(P<0.05);After treatment for 21 d,the level of RF in the treatment group was lower than that in the control group(P<0.05).Conclusions External application of Chinese medicine of clearing heat,eliminating dampness and removing the obstruction in meridians combined with Western medicine in the treatment of patients with dampness-heat blockage type of rheumatoid arthritis can relieve clinical symptoms and signs,reduce inflammatory response,and control the level of RF.

关 键 词：类风湿关节炎 湿热痹阻型 中药外用 清热利湿通络 血沉 C反应蛋白 类风湿因子 白细胞介素-1 肿瘤坏死因子-α 

分 类 号：R289[医药卫生—方剂学]