当归四逆汤联合甲氨蝶呤 洛索洛芬钠治疗类风湿关节炎疗效分析

目的探讨当归四逆汤联合甲氨蝶呤、洛索洛芬钠治疗类风湿关节炎患者的临床效果.方法将243例娄风湿关节炎患者按简单随机化分组法分为3组,每组81例,西药组口服甲氨蝶呤、洛索洛芬钠治疗,中药组口服当归四逆汤治疗,联合组予以当归四逆汤联合甲氨蝶呤及洛索洛芬钠治疗,观察1个月.比较3组治疗1个月后总有效率,曼彻斯特大学骨性关节炎指数评分、中医症候积分、实验室指标(血沉、C反应蛋白、娄风湿因子、抗环瓜氨酸肽抗体)、Wnt/β-catenin信号通路(Wnt3α、β-catenin)表达水平及不良反应发生率.结果(1)联合组治疗1个月后总有效率(90.1%)显著高于西药组(75.3%)、中药组(72.8%)(P<0.05),西药组与中药组比较差异无统计学意义(P>0.05);(2)联合组治疗1个月后曼彻斯特大学骨性关节炎指数评分、中医症候积分显著低于西药组、中药组(P<0.01),西药组与中药组比较差异均无统计学意义(P>0.05)(3);联合组治疗1个月后血沉、C反应蛋白、类风湿因子、抗环瓜氨酸肽抗体水平及Wnt3α、β-catenin表达水平均显著低于西药组、中药组(P<0.01),西药组与中药组各项指标比较差异均无统计学意义(P>0.05);(4)联合组、中药组不良反应发生率(2.5%、1.2%)显著低于西药组(13.6%)(P<0.01),中药组、联合组不良反应发生率比较差异无统计学意义(P>0.05).结论当归四逆汤联合甲氨蝶呤及洛索洛芬钠治疗类风湿关节炎患者具有协同增效作用,能有效改善患者疼痛、晨僵等临床症状,缓解炎症反应,控制患者病情,且安全性高.

Therapeutic effect of Danggui Sini Decoction combined with methotrexate and loxoprofen on rheumatoid arthritis

Objective To investigate the clinical effects of Danggui Sini Decoction combined with methotrexate and loxoprofen in the treatment of rheumatoid arthritis.Methods A total of 243 patients with rheumatoid arthritis were divided into 3 groups according to simple randomized grouping method,81 cases each.Oral methotrexate and loxoprofena in the western medicine group,and Danggui Sini decoction in the traditional Chinese medicine group.The combination group was treated with Danggui Sini Decoction combined with methotrexate and loxoprofena,patients were observed for 1 month.Compare the total effective rate after 1 months of treatment,WOMAC score,TCM syndrome score,laboratory indicators(ESR,Creactive protein,rheumatoid factor,anti-cyclic citrullinated peptide antibody),Wnt/The expression level of β-catenin signaling pathway(Wnt3α,β-catenin)and the incidence of adverse reactions.Results(1)The total effective rate was significantly higher in the combined group(90.1%)than in the western medicine group(75.3%)and the Chinese medicine group(72.8%)(P<0.05).There was no significant difference between the western medicine group and the traditional Chinese medicine group(P>0.05).(2)After 1 month of treatment,the scores of Osteoarthritis Index and TCM syndrome of Manchester University were significantly lower than those of western medicine group and Chinese medicine group(P<0.01).The difference between western medicine group and Chinese medicine group was compared.There was no statistical significance(P>0.05).(3)After 1 month of treatment,the levels of erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor,anti-cyclic citrullinated peptide antibody and Wnt3α and β-catenin were significantly lowerthan those of western medicine group and Chinese medicine group(P<0.01).There were no significant differences between the western medicine group and the traditional Chinese medicine group(P>0.05).(4)The incidence of adverse reactions in the combined group and the traditional Chinese medicine group(2.5%,1.2%)was significantly lower than that of the western medicine group(13.6%)(P<0.01).There was no significant difference in the incidence of adverse reactions between the Chinese medicine group and the combined group(P>0.05).Conclusions Danggui Sini Decoction combined with methotrexate and loxoprofen in the treatment of rheumatoid arthritis patients have synergistic effects,which can effectively improve the clinical symptoms and signs such as pain and morning stiffness,relieve inflammation and control the patient's condition and have high security.