利湿活血通络方联合阿达木单抗治疗湿热瘀阻型类风湿性关节炎临床研究  

Clinical Study on Lishi Huoxue Tongluo Prescription Combined with Adamumab forRheumatoid Arthritis of Damp-Heat Stasis Obstruction Type

作　　者：李玉[1] 戚徐斌 朱亚琴[1] LI Yu;QI Xubin;ZHU Yaqin(Department of Chinese Medicine,Haining People's Hospital,Haining Zhejiang 314400,China)

机构地区：[1]海宁市人民医院中医科,浙江海宁314400

出　　处：《新中医》2023年第15期90-94,共5页New Chinese Medicine

基　　金：海宁市科技计划项目(2018075)。

摘　　要：目的:观察利湿活血通络方联合阿达木单抗治疗湿热瘀阻型类风湿性关节炎的临床疗效。方法:采用随机数字表法将124例湿热瘀阻型类风湿性关节炎分为对照组、观察组各62例。对照组予阿达木单抗治疗,观察组在对照组基础上联用利湿活血通络方治疗。比较2组治疗前后中医证候积分、炎症指标、血液流变学指标、临床疾病活动指数(CDAI)、视觉模拟评分法(VAS)评分、Lysholm膝关节量表评分,评估2组临床疗效及不良反应发生情况。结果:观察组总有效率91.94%,高于对照组77.42%(P<0.05)。2组治疗后中医证候积分、CDAI、VAS评分均较治疗前降低(P<0.05),Lysholm膝关节量表评分升高(P<0.05);观察组治疗后中医证候积分、CDAI、VAS评分低于对照组(P<0.05),Lysholm膝关节量表评分高于对照组(P<0.05)。2组治疗后抗环瓜氨酸肽(CCP)、人附睾蛋白4 (HE4)、Nod样受体蛋白3 (NLRP3)、全血黏度(WBV)、D-二聚体(D-D)、纤维蛋白原(FIB)、红细胞聚集指数(EAI)均低于治疗前(P<0.05),观察组治疗后上述炎症指标与血液流变学指标均低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:利湿活血通络方联合阿达木单抗治疗湿热瘀阻性类风湿性关节炎疗效确切,能降低患者炎症因子水平,改善血液流变学指标,安全性较高。Objective:To observe the clinical effect of the therapy of Lishi Huoxue Tongluo Prescription combined with Adamumab on rheumatoid arthritis of damp-heat stasis obstruction type.Methods:A total of 124 cases with rheumatoid arthritis of damp-heat stasis obstruction type were divided into the control group and the observation group according to random number table method,with 62 cases in each group.The control group was treated with Adamumab,and the observation group was additionally treated with Lishi Huoxue Tongluo Prescription based on the treatment of the control group.The traditional Chinese medicine(TCM)syndrome scores,inflammation indexes,hemorheology indexes,Clinical Disease Activity Index(CDAI),Visual Analogue Scale(VAS),Lysholm knee scale score were compared before and after treatment between the two groups.The clinical effect and the occurrence of adverse reactions were evaluated in both groups.Results:The total effective rate was 91.94%in the observation group,higher than that of 77.42% in the control group (P<0.05). After treatment, the TCM syndrome scores and thescores of CDAI and VAS in the two groups were decreased when compared with those before treatment(P<0.05), and the Lysholm knee scale scores were increased (P<0.05);the TCM syndrome score andscores of CDAI and VAS in the observation group were lower than those in the control group (P<0.05),andthe Lysholm knee scale score was increased (P<0.05). After treatment, the cyclic citrullinated peptide(CCP), human epididymal protein 4 (HE4), Nod- like receptor protein 3 (NLRP3), whole blood viscosity(WBV),D-dimer (D-D),fibrinogen (FIB) and Erythrocyte Aggregation Index (EAI) in the two groups wereall decreased when compared with those before treatment (P<0.05), and the inflammation indexes andhemorheology indexes in the observation group were lower than those in the control group after treatment(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion:The therapy of Lishi Huoxue Tonglu

关 键 词：类风湿性关节炎 湿热瘀阻 利湿活血通络方 阿达木单抗 炎症因子 血液流变学 

分 类 号：R684[医药卫生—骨科学]