基于肌骨超声技术评价清毒伸筋汤治疗类风湿关节炎的临床效果  

The clinical effect of the Qingdu Shenjin decoction on rheumatoid arthritis based on musculoskeletal ultrasonography

作　　者：陈敏华 舒建龙 韦诗韵 黎烨 李凤珍 CHEN Minhua

机构地区：[1]广西国际壮医医院,广西南宁530021

出　　处：《中医临床研究》2025年第2期117-122,共6页Clinical Journal Of Chinese Medicine

基　　金：广西国际壮医医院科研启动基金(GZ2021RC003);广西国际壮医医院优势学科项目(医学影像学)(院字[2021]33号);广西壮族自治区中医药局自筹经费科研项目(GZZC2020142);广西卫生适宜技术开发与推广应用项目(S2020004)。

摘　　要：目的:运用肌骨超声技术观察并客观评价清毒伸筋汤治疗类风湿关节炎的临床效果。方法:选取2021年1月—2022年6月就诊于广西国际壮医医院风湿病科的类风湿关节炎患者100例,采用随机数字表法分为对照组与治疗组,每组50例。对照组采用西医常规治疗,治疗组在对照组的治疗基础上加用清毒伸筋汤治疗,疗程12周。运用肌骨超声技术观察两组患者治疗前后滑膜厚度、滑膜内血流信号、骨侵蚀情况,比较关节压痛数、肿胀关节数、28个关节的疾病活动度(Disease Activity Score 28,DAS28)评分情况及血清学指标[红细胞沉降率(Erythrocyte Sedimentation Rate,ESR)、类风湿因子、抗环瓜氨酸肽(Cyclic Citrullinated Peptide,CCP)抗体、抗环瓜氨酸肽抗体(Anti–Citrullinated Protein Antibody,ACPA)]水平。结果:治疗后,治疗组滑膜厚度、滑膜内血流信号、骨侵蚀分级均低于同期对照组,关节压痛数、肿胀关节数、DAS28评分及血清学指标(ESR、类风湿因子、抗CCP抗体、ACPA)水平均明显低于同期对照组(P<0.05)。结论:在肌骨超声技术支持下,清毒伸筋汤治疗类风湿关节炎的临床疗效显著,可显著缓解患者关节疼痛、肿胀,减轻炎症反应,值得借鉴。Objective:To observe and objectively evaluate the clinical effect of the Qingdu Shenjin decoction(清毒伸筋汤)on rheumatoid arthritis by musculoskeletal ultrasonography.Methods:A total of 100 patients with rheumatoid arthritis admitted from January 2021 to June 2022 were selected and divided into the control group and the treatment group by the random number table method,with 50 patients in each group.The control group was treated with conventional Western medicine,while the treatment group was treated with the Qingdu Shenjin decoction on the basis of the treatment in the control group.The course of treatment was 12 weeks.Musculoskeletal ultrasonography was used to observe the synovial thickness,blood flow signal in synovial membrane and bone erosion in the two groups before treatment and after treatment.The number of joint tenderness,number of swollen joints,DAS28 score and serological indexes(ESR,rheumatoid factor,anti-CCP antibody,and ACPA)before treatment and after treatment were compared within each group and between the groups.Results:After treatment,the synovial thickness,blood flow signal and bone erosion grade in the treatment group were lower than those in the control group,and the number of joint tenderness,number of swollen joints,DAS28 score and serological indexes(ESR,rheumatoid factor,anti-CCP antibody,and ACPA)in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion:With the support of musculoskeletal ultrasonography,the clinical efficacy of the Qingdu Shenjin decoction in the treatment of rheumatoid arthritis is significant,which can significantly relieve the joint pain and swelling of patients,and relieve the inflammatory response of patients,is worth learning.

关 键 词：类风湿关节炎 肌骨超声 清毒伸筋汤 临床效果 

分 类 号：R593.22[医药卫生—内科学]