活血通络汤辨治类风湿关节炎合并肺间质纤维化临床研究

目的:探讨活血通络汤治疗类风湿关节炎合并肺间质纤维化患者的临床症状和体征、实验室检查以及肺功能指标的改善情况,分析其作用机制和应用前景。方法:选取类风湿关节炎合并肺间质纤维化患者60例,分为治疗组和对照组,每组患者各30例。对照组给予口服强的松0.5~0.6mg/(kg·d),治疗组在对照组基础上给予活血通络汤。结果:治疗组中患者的总有效率达到86.7%,经组间比较显示治疗组疗效显著高于对照组(P<0.05)。两组患者治疗后无论临床症状和体征均较治疗前明显改善(P<0.05);临床研究发现治疗组患者临床症状和体征改善幅度较对照组明显(P<0.05)。两组患者治疗后ESR、CRP、IgG水平及对照组患者IgA水平均较治疗前下降(P<0.05);治疗组患者ESR、CRP、IgG水平下降幅度均大于对照组(P<0.05)。两组患者肺功能各项指标治疗后差异无统计学意义(P>0.05);两组患者各肺功能指标在治疗后明显上升(P<0.05);治疗组患者各项肺功能上升幅度明显大于对照组(P<0.05)。结论:活血通络汤联合西药治疗类风湿关节炎肺间质纤维化可提高临床疗效,改善生存质量。

Brief analysis of Huoxue Tongluo decoction on differentiation and treatment of rheumatoid arthritis with pulmonary interstitial fibrosis

Objective:In this paper,the clinical symptoms and signs,laboratory examinations and improvement of pulmonary function indexes of rheumatoid arthritis patients with pulmonary interstitial fibrosis treated with huoxue tongluo decoction were discussed.Methods:60 patients with rheumatoid arthritis combined with pulmonary interstitial fibrosis were selected and divided into treatment group and control group,with 30 patients in each group.The control group was given oral prednisone 0.5~0.6 mg/(kg·d),and the treatment group was given Huoxue Tongluo decoction on the basis of the control group.The study included comparison and analysis of clinical efficacy,clinical symptoms and signs before and after treatment,ESR,CRP,immunoglobulin levels and lung function indicators between the two groups.Results:The total effective rate of the patients in the treatment group reached 86.7%.Both clinical symptoms and signs were significantly improved after treatment in both groups ( P <0.05).Clinical study found that the clinical symptoms and signs of patients in the treatment group improved significantly compared with the control group ( P <0. 05).After treatment,the ESR,CRP,IgG levels of the patients in the two groups and the IgA levels of the patients in the control group were all lower than before treatment ( P <0. 05).The decrease of ESR,CRP and IgG in the treatment group was greater than that in the control group ( P <0. 05).There was no significant difference in pulmonary function between the two groups after treatment ( P >0.05).The lung function indexes of the two groups increased significantly after treatment ( P <0. 05).The increase of pulmonary function in the treatment group was significantly greater than that in the control group ( P <0.05).Conclusion:Huoxue Tongluo decoction combined with western medicine in the treatment of rheumatoid arthritis pulmonary interstitial fibrosis can further improve the clinical efficacy and quality of life.