辛热燥湿方联合甲氨蝶呤治疗寒湿阻络证RA效果观察及对膝关节功能的影响  

Efficacy of pungent-heat-dampness-drying method combined with methotrexate in the treatment of rheumatoid arthritis with cold-dampness blocking syndrome and its effect on knee joint function

作　　者：程素丹 祝军峰 王臣大 Cheng Sudan;Zhu Junfeng;Wang Chenda(Department of Pharmacy,Quzhou Municipal Hospital of Traditional Chinese Medicine,Quzhou 324000,Zhejiang Province,China;Department of Orthopedics,Quzhou Municipal Hospital of Traditional Chinese Medicine,Quzhou 324000,Zhejiang Province,China;Department of Nephrology,Quzhou Municipal Hospital of Traditional Chinese Medicine,Quzhou 324000,Zhejiang Province,China)

机构地区：[1]衢州市中医医院药学部,衢州324000 [2]衢州市中医医院骨科,衢州324000 [3]衢州市中医医院肾内科,衢州324000

出　　处：《中国基层医药》2024年第5期662-667,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省中医药管理局科技计划(2021ZB326);浙江省衢州市科技计划(2022058)。

摘　　要：目的探讨辛热燥湿方联合甲氨蝶呤治疗寒湿阻络证类风湿关节炎(RA)患者的疗效及其对膝关节功能的影响。方法选取衢州市中医医院2020年7月至2022年10月收治的寒湿阻络证RA患者120例进行随机对照研究,按照随机数字表法分为对照组(n=60)和观察组(n=60)。对照组采用甲氨蝶呤片治疗,观察组采用辛热燥湿方联合甲氨蝶呤片治疗,两组疗程4周。比较两组临床指标改善情况、膝关节功能。结果治疗4周后,观察组活动疼痛时间(0.95±0.05)h、休息疼痛时间(0.62±0.08)h、晨僵持续时间(0.65±0.02)h、痛痹持续时间(0.52±0.03)h均短于对照组[(2.13±0.15)h、(1.36±0.14)h、(1.23±0.63)h、(1.02±0.52)h](t=57.81、35.55、7.13、7.44,均P<0.001);观察组美国膝关节协会(KSS)评分为(35.42±8.26)分,高于对照组的(20.23±5.75)分,差异有统计学意义(t=-11.69,P<0.001);观察组丙氨酸氨基转移酶、天冬氨酸氨基转移酶、红细胞沉降率、C反应蛋白水平均低于对照组(t=26.96、57.72、19.44、12.61、17.37,均P<0.05);观察组膝关节功能评分为(75.42±5.26)分,高于对照组的(62.23±5.65)分,差异有统计学意义(t=-13.24,P<0.05)。结论辛热燥湿方联合甲氨蝶呤能有效改善寒湿阻络证RA患者临床指标,缓解膝关节疼痛,改善膝关节功能。Objective To investigate the efficacy of pungent-heat-dampness-drying method combined with methotrexate in the treatment of rheumatoid arthritis with cold-dampness blockage syndrome and its effect on knee joint function.Methods A randomized controlled study was conducted on 120 patients with rheumatoid arthritis exhibiting cold-dampness blockage syndrome,who were admitted to the Quzhou Municipal Hospital of Traditional Chinese Medicine between July 2020 and October 2022.Using the random number table method,these patients were randomly assigned to either the control group(n=60)or the observation group(n=60).The control group received methotrexate tablets exclusively,while the observation group received a combined therapy of pungent-heat-dampness-drying method along with methotrexate.All patients were treated for 4 weeks.At the end of the treatment period,improvements in clinical indices and knee joint function were compared between the two groups.Results After 4 weeks of treatment,the activity pain time[(0.95±0.05)hours],rest pain time[(0.62±0.08)hours],morning stiffness duration[(0.65±0.02)hours],and pain paralysis duration[(0.52±0.083)hours]in the observation group were significantly lower than those in the control group[(2.13±0.15)hours,(1.36±0.14)hours,(1.23±0.63)hours and(1.02±0.52)hours,respectively](t=57.81,35.55,7.13,7.44;all P<0.001).The Knee Society Score in the observation group was(35.42±8.26)points,which was significantly higher than that in the control group[(20.23±5.75)points,t=-11.69,P<0.001].Additionally,levels of alanine aminotransferase,aspartate aminotransferase,erythrocyte sedimentation rate,and C-reactive protein were significantly lower in the observation group compared to the control group(t=26.96,57.72,19.44,12.61,17.37;all P<0.05).The knee joint function score in the observation group was(75.42±5.26)points,which was significantly higher than that in the control group[(62.23±5.65)points,t=-13.24,P<0.05].Conclusion The combination of the pungent-heat-dampness-drying method with

关 键 词：关节炎 类风湿 医学 中国传统 甲氨蝶呤 膝关节 丙氨酸转氨酶 天冬氨酸氨基转移酶类 血沉 C反应蛋白质 

分 类 号：R593.22[医药卫生—内科学]