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活血化瘀序贯疗法治疗类风湿关节炎30例临床观察
引用本文:苏励,田雨,薛轶燕,茅建春,顾军花.活血化瘀序贯疗法治疗类风湿关节炎30例临床观察[J].中医杂志,2009,50(10).
作者姓名:苏励  田雨  薛轶燕  茅建春  顾军花
摘    要:目的 观察活血化瘀序贯疗法治疗类风湿关节炎(RA)的临床疗效,及对RA患者瘀的状态的改善.方法 将60例RA患者随机分为对照组(30例)与治疗组(30例),分别予西药常规治疗、西药常规治疗加活血化瘀序贯疗法,疗程6个月.观察两组患者治疗前后晨僵、关节疼痛、肿胀、局部皮色、皮下结节、舌、脉等症状、体征变化,检测血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、纤维蛋白原(Fg)、血管内皮生长因子(VEGF)等实验室指标.结果 治疗组与对照组临床疗效相当;中医证候疗效治疗组优于对照组(P<0.05);在晨僵的改善,降低ESR、CRP、RF、Fg、VEGF方面治疗组优于对照组(P<0.05).结论 活血化瘀序贯疗法能有效且较迅速地改善RA患者体内存在的瘀的状态,并可降低患者血浆VEGF水平,故临床运用活血化瘀序贯疗法可能对阻止RA病情进展起到一定作用.

关 键 词:类风湿关节炎  活血化瘀  序贯疗法  血管翳  纤维蛋白原  血管内皮生长因子

Clinical Observation on 30 Rheumatoid Arthritis Patients Treated by Sequential Therapy of Activiting Blood Circulation to Dissolve Blood Stasis
Abstract:Objective To observe the therapeutic effect of sequential therapy of activating blood circulation to dissolve blood stasis on rheumatoid arthritis(RA)patients and the improvement of blood stasis after treatment.Methods Sixty RA patients were randomized into control group and treatment group with 30 ones in each.The control group was treated by the routine way of western medicine and the treatment group by the sequential therapy in addition to western medicine.The course of treatment was 6 months in total.Changes in the symptoms of morning stiffness,arthralgia,swelling,skin color,subcutaneous nodule,tongue and pulse before and after treatment were observed and the experimental indices including erythrocyte sedimentation rate(ESR),C reaction protein (CRP),rheumatoid factor(RF),Fibrinogen(Fg)and vascular endothelial growth factor(VEGF)were evaluated.Results Although the therapeutic effect of two groups turned out to be the same,the syndrome relief of the treatment group showed a betteroutcome(P<0.05).The treatment group also showed better results on improvement of morning stiffness and down-regulation of ESR,CRP,RF,Fg and VEGF level(P<0.05).Conclusion The sequential therapy can effectively improve the blood stasis state of RA patients and down-regulate the serum level of VEGF.Using sequential therapy of activating blood circulation to dissolve blood stasis might prevent RA aggravation.
Keywords:Rheumatoid arthritis  Activating blood circulation to dissolve blood stasis  Sequential therapy  Pannus  Fibrinogen  Vascular Endothelial Growth Factor
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