健脾补肾方治疗类风湿关节炎的临床观察  

Clinical Observation of Jianpi Bushen Formula in the Treatment of Rheumatoid Arthritis

作　　者：胡欣怡 荣晓凤[1] HU Xinyi;RONG Xiaofeng(The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院,重庆400016

出　　处：《中医药信息》2023年第12期58-64,共7页Information on Traditional Chinese Medicine

基　　金：国家中医药管理局中医药重点学科项目。

摘　　要：目的:观察健脾补肾方联合甲氨蝶呤治疗类风湿关节炎的临床疗效及对甲氨蝶呤相关不良反应的防治作用。方法:选取符合纳入标准的类风湿关节炎患者84例,按就诊单双号将患者随机分为对照组和治疗组,每组42例,治疗过程中对照组脱落3例,治疗组脱落2例。对照组给予口服甲氨蝶呤和叶酸治疗,治疗组在对照组基础上给予健脾补肾方治疗,疗程3个月。观察评估两组患者治疗前后类风湿DAS28评分、疼痛等级评分(VAS评分)、类风湿关节炎HAQ指数以及类风湿因子(RF)、红细胞沉降率(ESR)、C反应蛋白(CRP)、抗瓜氨酸蛋白抗体(ACPA)等指标的变化情况,并记录消化道症状、白细胞减少和贫血等不良反应的发生情况。结果:治疗后,对照组显效率为10.26%(4/39)、总有效率为84.62%(33/39),治疗组显效率为30%(12/40)、总有效率为87.5%(35/40),治疗组显效率显著高于对照组,差异有统计学意义(P<0.05),但总有效率比较没有统计学意义(P>0.05)。治疗后,两组患者DAS28评分、VAS评分、HAQ指数以及RF、ESR、CRP、ACPA水平均降低(P<0.05),且治疗组DAS28评分、VAS评分、HAQ指数以及ESR、CRP水平低于对照组(P<0.05)。治疗后,对照组中未发生不良反应的患者6例(15.38%,6/39),治疗组14例(35%,14/40),两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者消化道反应、失眠、脱发症状评分较治疗前均下降(P<0.05),且治疗组消化道反应和脱发评分低于对照组(P<0.05)。结论:运用健脾补肾方联合甲氨蝶呤治疗类风湿关节炎,可有效协同改善患者症状和体征,提高关节功能,降低炎症指标,减少甲氨蝶呤不良反应事件发生,提高患者生活质量。Objective:to observe the clinical efficacy of Jianpi Bushen Formula(JBF)combined with methotrexate in the treatment of rheumatoid arthritis and the prevention and treatment of methotrexate-related adverse reactions.Methods:A total of 84 patients with rheumatoid arthritis who met the inclusion criteria were selected and randomly divided into control group and treatment group according to the odd-even treatment number,with 42 patients in each group.During the treatment,3 patients dropped out in the control group and 2 patients dropped out in the treatment group.The control group was given oral methotrexate and folic acid treatment,and the treatment group was given the same in addition to JBF formula,and the course of treatment was 3 months.The changes before and after the treatment of DAS28 score,VAS score,HAQ index,RF,ESR,CRP and ACPA were observed,and adverse reactions such as gastrointestinal symptoms,leukopenia and anemia were recorded.Results:After treatment,the effective rate of the control group was 10.26%(4/39),and the total effective rate of the control group was 84.62%(33/39);the effective rate of the treatment group was 30%(12/40),and the total effective rate of the treatment group was 87.5%(35/40);the effective rate of the treatment group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).However,there was no statistical significance in total effective rate(P>0.05).After treatment,DAS28 score,VAS score,HAQ index,RF,ESR,CRP and ACPA levels in the two groups decreased(P<0.05);the DAS28 score,VAS score,HAQ index,as well as ESR and CRP levels in the treatment group were lower than those in the control group(P<0.05).After treatment,there were 6 patients(15.38%,6/39)in the control group and 14 patients(35%,14/40)in the treatment group without adverse reactions,the difference between the two groups was statistically significant(P<0.05).After treatment,the scores of digestive tract reaction,insomnia and alopecia in both groups were lower than before

关 键 词：健脾补肾方 甲氨蝶呤 类风湿关节炎 不良反应 

分 类 号：R259[医药卫生—中西医结合]