中药痹通汤加减联合甲氨蝶呤治疗类风湿关节炎32例临床观察  

Clinical Observation on 32 Cases of Rheumatoid Arthritis Treated with Modified Bitong Tang(痹通汤)Combined with Methotrexate

作　　者：陈利民[1] 陆一兰[1] CHEN Li-min;LU Yi-lan

机构地区：[1]麻城市人民医院,湖北麻城438300

出　　处：《风湿病与关节炎》2020年第9期29-32,共4页Rheumatism and Arthritis

摘　　要：目的:观察中药痹通汤加减联合甲氨蝶呤治疗类风湿关节炎的临床疗效。方法:将61例类风湿关节炎患者随机分为治疗组32例和对照组29例,对照组予甲氨蝶呤片口服治疗,治疗组在对照组治疗基础上联合痹通汤加减口服。2组均以6个月为1个疗程。观察2组治疗前后类风湿因子(RF)、红细胞沉降率(ESR)、C-反应蛋白(CRP)、白细胞计数(WBC)及DAS28评分,评价疾病活动度及ACR20、ACR50、ACR70。结果:治疗后,2组达到ACR20的分别为78.13%(25/32)、51.72%(15/29),差异有统计学意义(P=0.030)。治疗组达到ACR50、ACR70的分别为50.00%、6.25%,均高于对照组(27.59%、6.90%),但差异无统计学意义(P>0.05)。治疗后,2组疾病活动度较治疗前均有改善(P=-0.001,P=-0.029),但2组间比较,差异无统计学意义(P>0.05)。治疗后,2组WBC较治疗前无明显改变(P>0.05),ESR、CRP、RF、DAS28评分较治疗前均有明显降低(P<0.05);且治疗组RF、DAS28评分较对照组下降更显著(P<0.05)。2组不良反应发生率分别为18.75%(6/32)、17.24%(5/29),组间比较,差异无统计学意义(P>0.05)。结论:中药痹通汤加减联合甲氨蝶呤治疗类风湿关节炎疗效较单用甲氨蝶呤有一定优势,可达到更高的ACR20,且RF、DAS28降低更明显。Objective:To observe the clinical efficacy of modified Bitong Tang(痹通汤)combinedwith methotrexate in the treatment of rheumatoid arthritis.Methods:Sixty-one patients with rheumatoid arthritis were randomly divided into a treatment group(32 cases)and a control group(29 cases).The control group was treated with methotrexate and the treatment group was treated with modified Bitong Tang based on the treatment for the control group.Both groups were treated for 6 months as a course.Rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),white blood cell count(WBC)and DAS28 score were observed and recorded before and after treatment.The disease activity,ACR20,ACR50 and ACR70 were evaluated.Results:After treatment,ACR20 were 78.13%(25/32)and 51.72%(15/29)in both groups,and the difference was statistically significant(P=0.030).ACR50 and ACR70 in the treatment group were 50.00%and 6.25%respectively,which were higher than those in the control group(27.59%and 6.90%),but the difference was not statistically significant(P>0.05).After treatment,the disease activity of the two groups was improved compared with that before treatment(P=-0.001,P=-0.029),but there was no significant difference between both groups(P>0.05).After treatment,WBC of the two groups did not change significantly,and ESR,CRP,RF and DAS28 scores were significantly lower than before treatment(P<0.05);and RF,DAS28 scores of the treatment group were significantly lower than those of the control group(P<0.05).The incidence of adverse reactions in the two groups were 18.75%(6/32)and 17.24%(5/29)respectively,with no significant difference(P>0.05).Conclusion:The curative effect of modified Bitong Tang combined with methotrexate in the treatment of rheumatoid arthritis has certain advantages over methotrexate alone,which can achieve higher ACR20,and reduce RF and DAS28 more obviously.

关 键 词：关节炎 类风湿 中药 痹通汤 临床疗效 

分 类 号：R593.22[医药卫生—内科学]