三痹汤加减联合甲氨蝶呤治疗肝肾亏虚型类风湿关节炎的临床研究  

Clinical Efficacy of Modified Sanbi Decoction Combined with Methotrexate in the Treatment of Liver-Kidney Deficiency Type Rheumatoid Arthritis:A Randomized Controlled Trial

作　　者：杨婉晴 张春芳 师健 覃家超 张辰龙 王玉洁 郭凯航 李鹏飞 YANG Wan-qing;ZHANG Chun-fang;SHI Jian;QIN Jia-chao;ZHANG Chen-long;WANG Yu-jie;GUO Kai-hang;LI Peng-fei(School of Medicine,Xiamen University,Xiamen Fujian,361000,China;Department of Traditional Chinese Medicine,Xiang’an Hospital Affiliated with Xiamen University,Xiamen Fujian,361000,China)

机构地区：[1]厦门大学医学院,福建厦门361000 [2]厦门大学附属翔安医院中医科,福建厦门361000

出　　处：《中华养生保健》2025年第5期34-38,共5页CHINESE HEALTH CARE

基　　金：厦门市科技局厦门市医疗卫生指导性项目(350220224ZD1142)。

摘　　要：目的观察中药方剂三痹汤加减联合甲氨蝶呤治疗类风湿关节炎(RA)的临床疗效。方法选取2021年9月—2023年9月厦门大学附属翔安医院收治的63例类风湿关节炎患者作为研究对象,按照随机数表法分为两组,其中对照组31例予甲氨蝶呤片口服治疗,治疗组32例在三痹汤加减联合甲氨蝶呤口服进行干预。治疗组和对照组均以4周为1个疗程。比较两组治疗前后晨僵、关节疼痛、肿胀及握力水平,检测红细胞沉降率(ESR)、类风湿因子(RF)和C反应蛋白(CRP)水平,同时对T淋巴细胞辅助因子(OKT4)、T淋巴细胞抑制因子(OKT8)、OKT4/OKT8等安全性指标进行比较,评估两组治疗前后病情活动度。结果与治疗前比较,两组治疗后晨僵时间均缩短,关节疼痛评分及关节肿胀评分均降低(P<0.05),握力水平均升高(P<0.05),ESR、RF及CRP水平均降低(P<0.05),OKT4、OKT8均升高、OKT4/OKT8水平均降低(P<0.05);与对照组相比,治疗组晨僵时间、关节疼痛、关节肿胀及握力水平改善(P<0.05),ESR、RF及CRP水平更低(P<0.05),OKT4、OKT8更高、OKT4/OKT8水平更低(P<0.05)。结论三痹汤加减+甲氨蝶呤组治疗RA疗效确切,能够有效改善患者临床症状,抑制病情活动度,缓解病情,调节免疫系统的活性和平衡。Objective To observe the clinical efficacy of modified Sanbi decoction combined with methotrexate in the treatment of rheumatoid arthritis(RA).Methods A total of 63 patients with RA admitted between September 2021 and September 2023 were selected as the study subjects.They were randomly divided into two groups:the control group(n=31)received oral methotrexate tablets,and the treatment group(n=32)received modified Sanbi decoction in addition to oral methotrexate tablets.Both groups were treated for 4 weeks.Compare the levels of morning stiffness,joint pain,swelling,and grip strength before and after treatment between the two groups.Detect the erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),and C-reactive protein(CRP)levels.Additionally,compare the safety indicators such as T lymphocyte helper factor(OKT4),T lymphocyte suppressor factor(OKT8),and OKT4/OKT8 ratios to assess the disease activity before and after treatment in both groups.Results Compared with before treatment,both groups showed a significant reduction in morning stiffness duration,joint pain and swelling scores(P<0.05),and an increase in grip strength(P<0.05)after treatment.ESR,RF,and CRP levels were significantly decreased(P<0.05),while OKT4 levels,OKT8 levels increased,and OKT4/OKT8 ratio decreased significantly(P<0.05).Compared with the control group,the treatment group showed improvements in morning stiffness duration,joint pain,joint swelling,and grip strength levels(P<0.05).The levels of ESR,RF,and CRP were all lower(P<0.05).Additionally,the levels of OKT4 and OKT8 were higher,and the OKT4/OKT8 ratio was lower(P<0.05).Conclusion Modified Sanbi decoction combined with methotrexate is effective in treating RA,improving clinical symptoms,reducing inflammation,inhibiting disease activity,and preventing bone destruction.

关 键 词：类风湿性关节炎 临床研究 三痹汤 甲氨蝶呤 

分 类 号：R259[医药卫生—中西医结合]