二十八味风湿骨痛汤加减在高海拔地区类风湿性关节炎治疗中的作用  

The Role of Modified Fengshi Gutong Decoction(二十八味风湿骨痛汤加减)in Treatment of Rheumatoid Arthritis in High-altitude areas

作　　者：王森林[1] 张永刚[1] 张英 沈括[1] 郑桂萍 WANG Senlin;ZHANG Yonggang;ZHANG Ying;SHEN Kuo;ZHENG Guiping(Qinghai Provincial People's Hospital,Xining 810000,Qinghai,China)

机构地区：[1]青海省人民医院,青海西宁810000

出　　处：《中华中医药学刊》2024年第12期215-218,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：青海省中藏医药科研创新项目(J2020020)。

摘　　要：目的观察二十八味风湿骨痛汤加减结合西药治疗高海拔地区类风湿性关节炎的疗效及对血清中胰岛素样生长因子结合蛋白-6(insulin-like growth factor binding protein-6,IGFBP-6)水平影响。方法研究纳入医院收治的高海拔地区类风湿性关节炎患者合计81例(2020年1月—2023年1月收治)以随机数字表法分为西药组与观察组,西药组患者(40例)采取单纯西药治疗,观察组患者(41例)采取西药结合二十八味风湿骨痛汤加减方治疗,观察各组患者临床数据:疗效、中医症候总积分变化及晨僵时间、关节压痛数及关节肿胀数变化、C反应蛋白(C-reactive protein,CRP)及类风湿因子(rheumatoid factor,RF)、血沉指标变化、IGFBP-6水平变化、血浆D-二聚体(plasmaD-dimer,D-D)与纤维蛋白原(fibrinogen,FIB)水平变化、免疫球蛋白A、G、M(ImmunoglobulinA,IgA、ImmunoglobulinG,IgG、ImmunoglobulinM,IgM)指标变化、不良反应。结果观察组患者治疗效果优于西药组,P<0.05;治疗前两组患者中医症候总积分、晨僵时间、关节压痛数及关节肿胀数、CRP及RF、血沉、IGFBP-6水平、D-D、FIB、IgA、IgG、IgM等指标比较,P>0.05,治疗后各组患者中医症候总积分、晨僵时间、关节压痛数及关节肿胀数、CRP及RF、血沉、IGFBP-6水平、D-D、FIB、IgA、IgG、IgM等指标均改善,且观察组治疗后中医症候总积分、晨僵时间、关节压痛数及关节肿胀数、CRP及RF、血沉、IGFBP-6水平、D-D、FIB、IgA、IgG、IgM等指标均优于西药组,P<0.05;观察组患者治疗不良反应率与西药组相当,P>0.05。结论二十八味风湿骨痛汤加减结合西药治疗高海拔地区类风湿性关节炎的疗效显著,可较好提升患者IGFBP-6水平,改善患者病症及凝血功能、免疫功能,治疗不良反应较少,值得应用。Objective To observe the curative effect of Modified Ershibawei Fengshi Gutong Decoction(二十八味风湿骨痛汤加减)combined with Western medicine in the treatment of rheumatoid arthritis in plateau area and the influence of serum insulin-like growth factor binding protein-6(IGFBP-6)level.Methods A total of 81 patients with rheumatoid arthritis in plateau areas admitted into the hospital(from January 2020 to January 2023)were divided into western medicine group and observation group by random number table method.The patients in the western medicine group(40 cases)were treated with Western medicine alone,and those in the observation group(41 cases)were treated with Western medicine combined with Ershibawei Fengshi Gutong Decoction.The therapeutic effect,changes in total scores of TCM symptoms and morning stiffness time,changes in joint tenderness and joint swelling,C-reactive protein(CRP)and rheumatoid factor(RF),changes in erythrocyte sink index,changes in IGFBP-6 levels,changes in plasma D-dimer(D-D)and fibrinogen(FIB),immunoglobulin index changes(IgA,IgG,IgM)and adverse reactions of two groups were observed.Results The therapeutic effect of the observation group was better than that of the western medicine group(P<0.05).The total scores of TCM symptoms,morning stiffness time,number of joint tenderness and swelling,the levels of CRP and RF,erythrocyte sink,the levels of IGFBP-6,D-D,FIB,IgA,IgG and IgM and other indexes were not significant between the two groups before treatment(P>0.05).After treatment,the total scores of TCM symptoms,morning stiffness time,joint tenderness number and joint swelling number,the levels of CRP and RF,erythrocyte sedimentation rate,the levels of IGFBP-6,D-D,FIB,IgA,IgG and IgM and other indexes were improved in both groups.And the scores and the indexes above in the observation group were better than those in the western medicine group(P<0.05).The adverse reaction rate of the observation group was similar to that of the western medicine group(P>0.05).Conclusion Ershibawei Fen

关 键 词：高海拔地区 类风湿性关节炎 二十八味风湿骨痛汤加减 西药 免疫功能 IGFBP-6水平 

分 类 号：R255.6[医药卫生—中医内科学]