补肾蠲痹汤联合甲氨蝶呤治疗老年类风湿关节炎的临床效果  

Clinical Effect on Bushen Juanbi Decoction Combined with Methotrexate in the Treatment of Elderly Rheumatoid Arthritis

作　　者：胡刚明[1] 高杰元 吴正刚 曾进军 贾天 王勇[1] HU Gangming;GAO Jieyuan;WU Zhenggang;ZENG Jinjun;JIA Tian;WANG Yong(Hanchuan Hospital of Wuhan University People's Hospital/Hanchuan People's Hospital,Hanchuan 431600,Hubei,China)

机构地区：[1]武汉大学人民医院汉川医院/汉川市人民医院,湖北汉川431600

出　　处：《世界复合医学》2024年第6期1-4,33,共5页World Journal of Complex Medicine

基　　金：孝感市自然科学计划立项(孝科技发[2022]8号,编号XGKJ2022010068);第五批湖北省中医药“三堂一室”项目:湖北省贺朝雄知名中医工作室(鄂卫通[2017]9号)。

摘　　要：目的研究补肾蠲痹汤与甲氨蝶呤联合使用对老年类风湿关节炎的治疗效果。方法回顾性选取2019年10月—2022年10月汉川市人民医院收治的118例老年类风湿关节炎患者的临床资料,以不同治疗方式分为两组,对照组(58例)给予口服甲氨蝶呤片治疗,观察组(60例)采用口服甲氨蝶呤片+补肾蠲痹汤治疗。比较两组晨僵时间及中医证候积分、视觉模拟评分法、类风湿性关节炎28个关节疾病活动评分、健康评估问卷评分、炎症因子水平、不良反应、治疗有效率。结果治疗后,观察组晨僵时间短于对照组,中医证候积分、视觉模拟评分法评分、类风湿性关节炎28个关节疾病活动评分及健康评估问卷评分低于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组红细胞沉降率、类风湿因子、C反应蛋白、肿瘤坏死因子-α、白细胞介素-1β、白细胞介素-6水平低于对照组,差异有统计学意义(P均<0.05)。治疗后,两组不良反应发生率比较,差异无统计学意义(P>0.05)。观察组治疗有效率为95.00%(57/60),高于对照组的82.76%(48/58),差异有统计学意义(χ^(2)=4.505,P<0.05)。结论与单独使用甲氨蝶呤相比,补肾蠲痹汤与甲氨蝶呤联合使用在改善老年类风湿关节炎的临床症状方面具有更显著的优势,还能有效降低炎症因子水平,同时不增加不良反应的发生风险。Objective To study the therapeutic effect of Bushen Juanbi Decoction combined with methotrexate on elderly patients with rheumatoid arthritis.Methods Clinical data of 118 elderly patients with rheumatoid arthritis treated in Hanchuan People's Hospital from October 2019 to October 2022 were retrospectively selected,and divided into two groups based on different treatment methods.The control group(58 cases)was treated with oral methotrexate tablets,and the observation group(60 cases)was treated with oral methotrexate tablets plus Bushen Juanbi Decoction.The time of morning stiffness,traditional Chinese medicine syndrome score,Visual Analog Scale,Disease Activity Score in 28 Joints,Health Assessment Questionnaire,levels of inflammatory factors,adverse reactions and treatment effectiveness were compared between the two groups.Results After treatment,the morning stiffness time of the observation group was shorter than that of the control group,and the traditional Chinses medicine syndrome score,Visual Analog Scale score,Disease Activity Score in 28 Jaints and Health Assessment Questionnaire score were lower than those of the control group,and the differences were statistically significant(all P<0.05).After treatment,the levels of erythrocyte sedimentation rate,rheumatoid factor,C-reactive protein,tumor necrosis factor-α,interleukin-1β,interleukin-6 levels in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).After treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The effective rate of the observation group was 95.00%(57/60),which was higher than 82.76%(48/58)of the control group,the difference was statistically significant(χ^(2)=4.505,P<0.05).Conclusion Compared with methotrexate alone,the combined treatment of Bushen Juanbi Decoction and methotrexate has more significant advantages in improving the clinical symptoms of elderly rheumatoid arthritis,and can effectively reduce

关 键 词：补肾蠲痹汤 甲氨蝶呤 老年类风湿关节炎 联合治疗 临床效果 

分 类 号：R259[医药卫生—中西医结合]