加味宣痹汤内服外洗结合免疫抑制剂治疗湿热痹阻证类风湿性关节炎患者的疗效观察  

Clinical Efficacy of Modified Xuanbi Decoction by Oral Administration and External Washing Combined with Immunosuppressants in Treatment of Rheumatoid Arthritis Patients with Dampness-heat Obstruction Syndrome

作　　者：王旭[1] 吴金友[1] 戎蓉[1] 连博[1] 郝芬丽 乔银银 范兴刚[1] WANG Xu;WU Jin-you;RONG Rong;LIAN Bo;HAO Fen-li;QIAO Yin-yin;FAN Xing-gang(Traditional Chinese Medicine Department,Fuyang Fifth People′s Hospital,Fuyang Anhui 236000)

机构地区：[1]阜阳市第五人民医院中医科,安徽阜阳236000

出　　处：《世界中西医结合杂志》2024年第6期1222-1226,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：2020年安徽中医药管理局(2020zcyb17)。

摘　　要：目的探讨加味宣痹汤内服外洗结合免疫抑制剂治疗湿热痹阻证类风湿性关节炎(Rheumatoid arthritis,RA)患者的临床疗效。方法选取2018年12月—2022年12月期间阜阳市第五人民医院中医科收治的湿热痹阻证RA患者102例作为研究对象,按随机单双数法分为对照组和试验组,每组各51例。对照组予为期3个月的免疫抑制剂治疗,试验组在对照组基础上联合加味宣痹汤内服外洗治疗。观察比较两组患者治疗前后中医证候积分、28处关节疾病活动度分数(Disease activity score of 28 joints,DAS28)、骨性关节炎指数(Western ontario and mcmaster universities osteoarthritis index,WOMAC)、类风湿因子(Rheumatoid factor,RF)、血沉(Erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)水平,并评估临床疗效及不良反应情况。结果治疗后两组患者屈伸不利、肿胀、疼痛、压痛积分均较治疗前降低,差异有统计学意义(P<0.05);且试验组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者DAS28、WOMAC评分均较治疗前降低,差异有统计学意义(P<0.05);且试验组DAS28、WOMAC评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者RF、ESR、CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且试验组RF、ESR、CRP水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后试验组临床总有效率97.78%(44/45)明显高于对照组82.98%(39/47),差异有统计学意义(P<0.05)。治疗期间,试验组不良反应率4.44%(2/45)明显低于对照组19.15%(9/47),差异有统计学意义(P<0.05)。结论加味宣痹汤内服外洗结合免疫抑制剂应用于RA湿热痹阻证具有增效减毒、缓解症状、减轻疾病活动度、调节炎症及血沉的作用。Objective To investigate the clinical efficacy of modified Xuanbi Decoction by oral administration and external washing combined with immunosuppressants in treating patients with rheumatoid arthritis(RA)of dampness-heat obstruction syndrome.Methods From December 2018 to December 2022,102 RA patients with dampness-heat obstruction syndrome treated at the Traditional Chinese Medicine Department of the Fuyang Fifth People's Hospital were selected and randomly divided into a control group and an experimental group according to a random single and even number method,with 51 patients in each group.The control group received immunosuppressant treatment for 3 months,while the experimental group received modified Xuanbi Decoction for oral administration and external washing in addition to the immunosuppressants.The traditional Chinese medicine(TCM)symptom scores,Disease Activity Score of 28 joints(DAS28),Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)levels,clinical efficacy,and incidence of adverse reactions were compared between the two groups before and after treatment.Results After treatment,the scores for limited flexion and extension,swelling,pain,and tenderness significantly decreased in both groups compared to those before treatment(P<0.05),with the experimental group showing significantly lower TCM symptom scores than the control group(P<0.05).DAS28 and WOMAC scores also significantly decreased in both groups compared to those before treatment(P<0.05),with the experimental group scoring significantly lower than the control group(P<0.05).RF,ESR,and CRP levels significantly decreased in both groups compared to those before treatment(P<0.05),with the experimental group showing significantly lower levels than the control group(P<0.05).The total clinical efficacy rate in the experimental group was 97.78%(44/45),significantly higher than 82.98%(39/47)in the control group(P<0.05).During the treatment period,the advers

关 键 词：类风湿性关节炎 免疫抑制剂 加味宣痹汤 内服外洗 湿热痹阻证 

分 类 号：R593.22[医药卫生—内科学]