蠲痹胶囊联合西药治疗类风湿关节炎临床观察

目的：观察甲氨喋呤（MTX）联合蠲痹胶囊治疗类风湿关节炎（Ka）的临床疗效及安全性。方法：符合纳入标准的60例RA患者随机分成2组。对照纽30例采用蠲痹胶囊治疗，综合组30例采用蠲痹胶囊联合MTX治疗，疗程均为6月。观察治疗前后疼痛视觉模拟评分法（VAS）评分、关节压痛指数、关节肿胀指数及晨僵时间，并检查红细胞沉降率（ESR）、C-反应蛋白（CRP）、类风湿因子（RF）水平、血常规、肝功能、肾功能。随时观察治疗过程中的不良反应。结果：2组治疗后晨僵时间比较，差异有显著性意义（P〈0．05）。2组治疗后ESR、CRP、RF等实验室检查指标比较，差异均有显著性意义（P〈0．05）。总有效率综合组为90％，对照组为60％，2组比较，差异有显著性意义（P〈0．05）。对照组出现药物不良反应10例，综合组1例。主要表现为消化道症状、疲劳、乏力、嗜睡、下肢轻度浮肿、转氨酶升高，未发现末梢神经病变和深静脉血栓形成，所有患者能耐受，经观察和对症处理后均能完成治疗。结论：蠲痹胶囊联合西药MTX治疗RA疗效、安全性较好，联合应用有协同作用。

Clinical Observation of Juanbi Capsule Combined with Western Medicine for Treatment of Rheumatoid Arthritis

Objective:To observe the clinical efficacy and safety of methotrexate(MTX)combined with Juanbi Capsule for the treatment of rheumatoid arthritis(RA).Methods:Sixty RA patients were equally randomized into two groups,MTX group (control group)and combination group(MTX combined with Juanbi capsule).The treatment covered 6 months.The pain score evaluated by visual analog scale(VAS),joint tenderness index,joint swelling index,and time for morning stiffness were observed.Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid factor(RF),blood routine indexes,and hepatic and renal function were examined.Meanwhile,the side effect was monitored during the treatment.Results:The difference of time for morning stiffness was significant between the two groups after treatment(P<0.05).After treatment,ESR,CRP and RF in the combination group differed from those in the control group(P<0.05).The total effective rate was 90% in the combination group,and was 60%in the control group,the difference being significant(P<0.05).Adverse action occurred in 10 patients of the control group and in one patient of the combination group,mainly manifested as digestive tractsymptoms,lassitude,weakness,drowsiness,slight edema of the lower extremity,increase of aminotransferases.All ofthe patients finished the treatment without peripheral neuropathy or deep venous thrombosis.Conclusion:Juanbi capsule combined with western medicine is effective and safe for the treatment of rheumatoid arthritis,showing good synergisticaction.