健脾活血补肾汤治疗脾肾亏虚、痰瘀阻络型老年类风湿关节炎临床观察  

Clinical Observation of Spleen-Invigorating and Blood-Activating and Kidney-Tonifying Decoction in the Treatment of Rheumatoid Arthritis with Spleen-Kidney Deficiency and Phlegm-Blood Stasis Blocking Collaterals Syndrome in the Elderly

作　　者：傅慧 胡林飞 FU Hui;HU Linfei(Xinyu Hospital of Traditional Chinese Medicine,Xinyu,Jiangxi,China,338025)

机构地区：[1]新余市中医院,江西新余338025

出　　处：《河南中医》2024年第11期1740-1744,共5页Henan Traditional Chinese Medicine

基　　金：新余市科技计划项目(20233090946)。

摘　　要：目的:观察健脾活血补肾汤对脾肾亏虚、痰瘀阻络型老年类风湿关节炎(rheumatoid arthritis,RA)患者白细胞介素(interleukin,IL)-6、血清淀粉样蛋白A(serum amyloid A,SAA)、肿瘤坏死因子(tumor necrosis factor,TNF)-α的影响。方法:选取2021年12月至2023年12月在新余市中医院就诊的脾肾亏虚、痰瘀阻络型RA患者80例,按照随机数字表法分为对照组和观察组,每组各40例。对照组给予氨甲蝶呤片、叶酸片、塞来昔布胶囊口服治疗,观察组在对照组治疗的基础上加用健脾活血补肾汤。观察两组患者治疗前后中医证候积分、生活质量评分、RA相关指标[类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸肽抗体(anti cyclic citrullinated peptide antibody,CCP-AB)、血浆红细胞沉降率(erythrocyte sedimentation rate,ESR)]、炎症细胞因子(IL-6、SAA及TNF-α)变化情况。结果:观察组治疗后关节痛、关节肿胀、关节屈伸不利、晨僵时间等中医证候积分均低于对照组,差异有统计学意义(P<0.05);观察组治疗后生活质量评分高于对照组,差异有统计学意义(P<0.05);观察组治疗后RF、CCP-AB、ESR低于对照组,差异有统计学意义(P<0.05);观察组治疗后IL-6、SAA及TNF-α低于对照组,差异有统计学意义(P<0.05)。结论:健脾活血补肾汤能减轻脾肾亏虚、痰瘀阻络型老年RA患者的临床症状,降低IL-6、SAA及TNF-α,提高患者生活质量。Objective:To observe the effect of Spleen-Invigorating and Blood-Activating and Kidney-Tonifying Decoction on interleukin(IL)-6,serum amyloid A(SAA),and tumor necrosis factor(TNF)-αin elderly patients with rheumatoid arthritis(RA)of the spleen-kidney deficiency and phlegm-blood stasis blocking collaterals syndrome type.Methods:A total of 80 RA patients with spleen-kidney deficiency and phlegm-blood stasis blocking collaterals syndrome treated at Xinyu Hospital of Traditional Chinese Medicine between December 2021 and December 2023 were selected,and randomly divided into the control group and the observation group,with 40 cases in each group.The control group received Methotrexate Tablets,Folic Acid Tablets,and Celecoxib Capsules for oral administration,while the observation group was additionally treated with Spleen-Invigorating and Blood-Activating and Kidney-Tonifying Decoction.The changes in TCM syndrome scores,quality of life scores,RA-related indicators[including rheumatoid factor(RF),anti-cyclic citrullinated peptide antibody(CCP-AB),erythrocyte sedimentation rate(ESR)],and inflammatory cytokines(including IL-6,SAA,and TNF-α)before and after treatment were observed in both groups.Results:After treatment,the TCM syndrome scores such as joint pain,joint swelling,difficulty in joint flexion and extension,and morning stiffness,etc.were significantly lower in the observation group than those in the control group,and the differences were statistically significant(P<0.05);The quality of life scores in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05);RF,CCP-AB,and ESR levels were significantly lower in the observation group than those in the control group,and the differences were statistically significant(P<0.05).Additionally,IL-6,SAA,and TNF-αlevels were significantly reduced in the observation group compared to the control group,and the differences were statistically significant(P<0.05).Conclusion:Spleen-Invigorating and Bl

关 键 词：老年类风湿关节炎 健脾活血补肾汤 白细胞介素-6 血清淀粉样蛋白A 肿瘤坏死因子-α 脾肾亏虚 痰瘀阻络证 

分 类 号：R274.984.3[医药卫生—中西医结合]