清热除湿通络方治疗类风湿关节炎湿热痹阻证临床研究  

Clinical study on treatment of rheumatoid arthritis with damp-heat obstruction syndrome using Qingre Chushi Tongluo formula

作　　者：金鹤[1] 张帆 周胜利[1] JIN He;ZHANG Fan;ZHOU Shengli(The Second People’s Hospital of Hefei,Hefei 230011,China)

机构地区：[1]合肥市第二人民医院,安徽合肥230011

出　　处：《陕西中医》2025年第3期350-353,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：安徽省中医药传承创新科研项目[皖中药秘(2024)6号2024CCCX039];“十四五”合肥市中医优势专科(专病)建设项目[合卫中医(2021)167]。

摘　　要：目的:观察清热除湿通络方治疗类风湿关节炎湿热痹阻证的临床疗效。方法:对74例类风湿关节炎湿热痹阻证患者的临床资料进行回顾性分析,根据治疗方案分为对照组、治疗组,每组37例。对照组予甲氨蝶呤片、塞来昔布胶囊口服,治疗组在此基础上加用清热除湿通络方,疗程1个月。观察两组患者临床疗效、关节功能恢复情况(关节肿胀数、关节压痛数、晨僵时间)以及类风湿相关血液指标(PLT、ESR、CRP、RF、CCP-AB)变化情况。结果:治疗组总有效率高于对照组(P<0.05)。治疗后,两组患者的关节肿胀数、关节压痛数及晨僵时间减少,且治疗组效果更为显著,差异有统计学意义(均P<0.05)。两组患者血清PLT、ESR、CRP、RF、CCP-AB均在治疗后明显降低,其中治疗组降低幅度大于对照组,差异有统计学意义(均P<0.05)。结论:清热除湿通络方能有效改善类风湿关节炎湿热痹阻证临床症状,促进关节功能恢复,降低RA相关实验室指标,有较好疗效和较高安全性。Objective:To observe clinical effect of Qingre Chushi Tongluo prescription on rheumatoid arthritis dampness-heat obstruction syndrome.Methods:The clinical data of 74 patients with rheumatoid arthritis damp-heat obstruction syndrome were retrospectively analyzed.According to the treatment plan,the patients were divided into control group and treatment group,37 cases in each group.The control group were given methotrexate tablets and celecoxib capsules orally,and the treatment group given Qingre Chushi Tongluo prescription on the basis of this.The course of treatment was one month.The clinical efficacy,recovery of joint function(number of joint swelling,number of joint tenderness,morning stiffness time)and changes of rheumatoid related blood indexes(PLT,ESR,CRP,RF,CCP-AB)of the two groups were observed.Results:The total effective rate of treatment group was higher than that in the control group(P<0.05).After treatment,the number of joint swelling,joint tenderness and morning stiffness time of the two groups were reduced,and effect of the treatment group was more significant,difference statistically significant(all P<0.05).Serum PLT,ESR,CRP,RF and CCP-AB in both groups were significantly reduced after treatment,and reduction in the treatment group was greater than that in the control group,statistical significance(all P<0.05).Conclusion:Qingre Chushi Tongluo can effectively improve clinical symptoms of rheumatoid arthritis damp-heat obstruction syndrome,promote joint function recovery,reduce RA related laboratory indexes,and have better efficacy and high safety.

关 键 词：类风湿关节炎 清热除湿通络方 二妙散 湿热痹阻 甲氨蝶呤 C反应蛋白 抗环瓜氨酸肽抗体 

分 类 号：R274[医药卫生—中医骨伤科学]