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91.
目的探讨小剂量雷公藤总苷联合甲氨蝶呤对类风湿关节炎患者临床症状、炎性因子及关节功能的影响。方法选取2017年10月—2018年2月收治的类风湿关节炎68例,根据治疗方法的不同,分为对照组与观察组,每组各34例。对照组予甲氨蝶呤及常规治疗,观察组采用小剂量雷公藤总苷联合甲氨蝶呤及常规治疗。两组均治疗3个月。比较两组治疗前、治疗后临床症状(晨僵时间、关节疼痛程度、双手平均握力、关节压痛数及关节肿胀数)、炎性因子相关指标[白细胞介素-6(interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)、类风湿因子(rheumatoid factors,RF)、红细胞沉降率(erythrocyte sedimentation rate,ESR)]、关节功能变化,记录不良反应发生情况。结果与对照组比较,观察组治疗后晨僵时间、关节压痛数、关节肿胀数减少,关节疼痛程度降低,双手平均握力升高,IL-6、ESR、CRP、RF水平降低,差异有统计学意义(P<0.05或P<0.01);与本组治疗前比较,两组治疗后晨僵时间、关节压痛数、关节肿胀数显著减少,关节疼痛程度明显降低,双手平均握力显著升高,IL-6、ESR、CRP、RF水平降低,且观察组治疗后关节功能障碍分级Ⅰ级比例升高及Ⅱ级比例降低,差异有统计学意义(P<0.05或P<0.01)。两组不良反应总发生率比较差异无统计学意义(χ2=1.308,P=0.253),且治疗过程中均未出现严重不良反应,给予对症处理后症状好转。结论小剂量雷公藤总苷联合甲氨蝶呤能更有效改善类风湿关节炎患者的临床症状、炎性因子水平及关节功能,且不良反应发生率低。 相似文献
92.
目的 比较全牙弓垫(ADRCOS)和后牙区垫(PTCOS)治疗颞下颌关节紊乱病(TMD)的临床疗效,探讨PT-COS治疗TMD的应用价值.方法 选取安徽医科大学附属口腔医院2017年7~9月收治的TMD患者60例,所有患者符合垫治疗适应证.按治疗方法不同,60例患者分为ADRCOS组和PTCOS组,每组30例.临床治疗2周后复诊,检查两组患者颞下颌关节弹响、关节疼痛和下颌运动异常症状的改善情况.结果 ADRCOS组和PTCOS组患者的TMD症状都明显改善,其中关节弹响的治愈率分别为23.33%和50.00%,差异有统计学意义(P<0.05);而两组患者治疗有效率的差异无统计学意义(P>0.05).结论 ADRCOS和PTCOS治疗TMD临床疗效都很明显,PTCOS对TMD关节弹响症状的疗效优于ADRCOS. 相似文献
93.
Serum matrix metalloproteinase-3 in systemic sclerosis 总被引:1,自引:0,他引:1
Jinnin M Ihn H Asano Y Yamane K Yazawa N Tamaki K 《Archives of dermatological research》2004,296(1):25-29
To determine the serum levels of matrix metalloproteinase-3 (MMP-3) in patients with systemic sclerosis (SSc) and investigate their clinical significance in this disease, serum samples from 83 patients with SSc and 30 healthy volunteers were examined by a specific enzyme-linked immunosorbent assay (ELISA). There was no significant difference in serum levels of MMP-3 between SSc patients and healthy controls. However, in female patients, there was a significant difference in serum MMP-3 levels between patients subsequently developing accompanying rheumatoid arthritis (RA) and those not developing RA, and patients with increased levels of MMP-3 were more likely to develop RA than those with normal MMP-3 levels. Additionally, arthralgia, elevated CRP, and elevated rheumatoid factor were seen significantly more frequently in patients with increased MMP-3 levels than in those with normal MMP-3 levels. These results suggest that increased serum MMP-3 is a marker for developing RA in SSc patients. SSc patients with increased serum MMP-3 levels need to be followed up carefully because of the risk of developing overlapping RA. 相似文献
94.
Nicola Walsh Fiona Cramp Shea Palmer Jon Pollock Lisa Hampson Rachael Gooberman-Hill Colin Green Louise Jones Sonia Phillips Liz Johnson Mike Hurley 《Physiotherapy》2013
Objectives
Chronic musculoskeletal pain and osteoarthritis can significantly limit the functional independence of individuals, and given that 25% of the population experience these problems, the socioeconomic impact is immense. Exercise and self-management have proven benefits for these conditions, but most trials tailor interventions for specific joints. Epidemiological data demonstrates that many older people with degenerative joint problems experience pain and functional difficulty in other joints, seeking further healthcare input when these present. Managing multiple joint presentations simultaneously could potentially reduce the need for repeat visits to healthcare professionals as advice is frequently the same for differing site presentations. This single-blind cluster randomised controlled trial will determine the clinical and cost-effectiveness of an exercise and self-management intervention delivered to people over-50 with either hip, knee or lower back pain, compared to ‘standard’ GP care. A qualitative analysis will also establish the acceptability of the intervention.Methods
352 people with chronic degenerative musculoskeletal pain of the hip, knee or lower back will be recruited from primary care. GP surgeries will be randomised to either the intervention or control arms. Participants in the intervention arm will receive a 6-week group exercise and self-management programme facilitated by a physiotherapist in primary care. Participants allocated to the control arm will continue under ‘standard’ GP care. The primary outcome measure is the Dysfunction Index of the Short Musculoskeletal Functional Assessment (SMFA).Analysis
Individual patient responses will be modelled using a mixed effects linear regression, allowing for the clustering effects. Resource use and related intervention costs will be estimated and broader resource use data will be collected using a version of the Client Service Receipt Inventory adapted for musculoskeletal relevance. In addition, a cost-utility analysis will be undertaken to present an estimate of the incremental cost per QALY. A qualitative analysis investigating the acceptability of the intervention to participants and healthcare professionals will also be undertaken and thematically analysed.Ethics and dissemination
Ethical approval was received from South West 4 REC, identification number 11/SW/0053. Study findings will be disseminated via conference and journal presentation; via arthritis charitable organisations; and through local GP consortia. 相似文献95.
96.
[目的]观察艾叶散熏洗治疗踝关节骨性关节炎疗效。[方法]使用前瞻性设计方法,对46例门诊患者使用艾叶散(艾叶、黄连、木香各50g,当归20g,干姜10g,龙骨20g,羌活、威灵仙各60g,狗脊、续断、透骨草、草乌、乳香各30g),75g/次,30min/次,2次/d,患处熏洗。连续治疗3个月为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]优33例,良8例,差5例,优良率89.10%。[结论]艾叶散熏洗治疗踝关节骨性关节炎,疗效满意,无副作用,值得推广。 相似文献
97.
中医时间医学是利用中医学理论研究时间因素对人体影响的一门科学,从自然界节律变化角度来阐述人生理、病理节律变化,用以诊断疾病,选择有利时间进行治疗和预防。春分、秋分节气作为昼夜时间相等及春秋平分的节气,是自然界阴阳平衡的最佳时机及阴阳对比由量变到质变之期,天人相应,自然界阴阳转化剧烈之时恰是机体的阴阳转化剧烈之时,风湿病阴阳失调的患者,最易在此时节复发加重及传变。结合痹证病因、病机、病理及春分、秋分的节气特点,选择于春分、秋分两个时节进行"春·秋分贴敷"防治痹证。 相似文献
98.
聂爱迪 《实用中医内科杂志》2014,(10):66-69
中医辨证治疗痹症历史悠久,疗效确切,包含未病先防-三因制宜、痹证论治-突出辨证、百法归一-标本同治、病证结合-古法今方、经方活用-尊古不拘、局部整体-综合治疗、中西结合-内外兼治、善用乌头-安全高效、调理情志-身心同治、医患协作-以人为本等十个方面,治未病思想贯穿始终,突出辨证,标本同治,活用经方、古方(善用乌头),强调局部与整体结合,与现代医学结合,同时注重与患者沟通协作,调节情志。 相似文献
99.
《Joint, bone, spine : revue du rhumatisme》2022,89(4):105403
ObjectivesWe aimed to analyze rheumatic immune-related (ir) and nonimmune-related adverse events (AEs) due to immune-checkpoint inhibitors (ICIs) targeting programmed cell death-1 or its ligand PD-(L)1 in lung cancer patients from the available literature.MethodsWe performed a systematic review and meta-analysis of phase III randomized clinical trials (RCTs) assessing PD-(L)1-ICIs in lung cancer patients, from inception until January 12th, 2021. We extracted data of each trial to estimate odds ratio (OR) for rheumatic ir or non-irAE as classified in RCTs safety data. Sensitivity analyses (by ICI, treatment group and histology) were performed.ResultsEighteen RCTs met the inclusion criteria (n = 12172 subjects). The OR [95%IC] for rheumatic irAE in ICIs versus controls (either placebo or chemotherapy) was 2.20 [0.85,5.72]. Among rheumatic non-irAEs, both overall and severe (grade≥3) back pain were significantly more frequent in ICIs versus controls, 2.01 [1.09;3.73] and 2.90 [1.18;7.08], respectively. The overall frequency of arthralgia was similar between ICIs and controls; by sensitivity analysis RCTs assessing ICIs in combination with chemotherapy showed a significant association with arthralgia (1.55 [1.15;2.10]). Similarly, the frequency of myalgia was significantly lower in RCTs assessing ICIs alone versus chemotherapy (OR 0.32 [0.24;0.42]). Muscular pain was not significantly increased with ICI.ConclusionRheumatic irAEs are not increased in RCTs assessing PD-(L)1 inhibitors, not reflecting the real-life incidence, therefore likely underreported or misclassified. Back pain is significantly associated with them regardless its severity, while arthralgia only when ICIs are added on conventional chemotherapy. 相似文献
100.