热痹膏外用联合西药口服治疗类风湿关节炎湿热痹阻证临床观察  

Clinical Observation on the Treatment of Rheumatoid Arthritis Dampness-Heat Obstruction Syndrome by External Application of Rebi Ointment Combined with Oral Western Medicine

作　　者：金芳梅[1] 杨会军 李伟青[1] 王海东[1] 田雪梅[1] JIN Fangmei;YANG Huijun;LI Weiqing;WANG Haidong;TIAN Xuemei(Rheumatic Bone Disease Center,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃省中医院风湿骨病中心,甘肃兰州730050

出　　处：《中国医药指南》2025年第10期147-150,共4页Guide of China Medicine

基　　金：甘肃省中医药管理局项目(GZKP-2021-12)。

摘　　要：目的观察湿热痹阻证类风湿关节炎(RA)患者治疗中应用常规西药联合热痹膏外用的可行性分析。方法于2022年1月至2024年10月,将甘肃省中医院收治的72例RA患者纳入研究,区组随机化分组。两组患者均接受甲氨蝶呤片、来氟米特口服治疗,治疗组给予热痹膏外用,对照组则采用热痹膏模拟剂外用。治疗后,观察两组临床疗效,对比主要体征指标、实验室血清指标,并统计不良反应发生情况。结果治疗组中医证候积分、疼痛评分均较对照组更低(均P<0.05);治疗组压痛关节数、肿胀关节数均较对照组更低(P<0.05)。治疗组两组滑膜增生、关节腔积液评分,以及C反应蛋白、红细胞沉降率水平均低于对照组(均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。治疗组美国风湿病学会20达标比高于对照组(P<0.05)。结论相比单纯口服西药治疗,联合外用热痹膏在改善患者关节临床症状及降低炎性指标方面疗效更佳,能够降低患者疼痛感。Objective To observe the feasibility analysis of external application of conventional western medicine combined with heat Bi ointment in the treatment of Rheumatoid Arthritis(RA).Methods From January 2022 to October 2024,72 patients with rheumatoid arthritis admitted to Gansu Provincial Hospital of Traditional Chinese Medicine were included in the study and randomized,block randomization grouping.Both groups were treated with Methotrexate tablet and leflunomide orally.The treatment group was treated with Rebi ointment for external use,while the control group was treated with Rebi ointment for external use.After treatment,the clinical treatment effect of both groups was observed,the main serosigns and laboratory indicators were compared,and the incidence of side effects was statistically recorded.Results TCM syndrome scores and pain scores in the treatment group were lower than those in the control group(all P<0.05).The number of tender joints and swollen joints in the treatment group were lower than those in the control group(P<0.05).The scores of synovial hyperplasia,articular effusion,C-reactive protein and erythrocyte sedimentation rate in the treatment group were lower than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The American College of Rheumatology 20 standard ratio in the treatment group was higher than that in the control group(P<0.05).Conclusions Compared with simple oral western medicine treatment,combined with topical Rebi ointment has better efficacy in improving joint clinical symptoms and reducing inflammatory indexes,can reduce the patient’s pain.

关 键 词：类风湿关节炎 湿热痹阻证 热痹膏 外治法 

分 类 号：R287[医药卫生—中药学] R593.22[医药卫生—中医学]