敦煌消定汤联合甲氨喋呤对类风湿关节炎滑膜炎患者滑膜和炎症指标的影响

目的:探讨敦煌消定汤联合甲氨喋呤治疗类风湿关节炎滑膜炎的临床疗效及安全性。方法:收集2018年3月-2019年3月甘肃中医药大学附属医院风湿科患者120例,根据随机数字表法分为:治疗组60例,给予敦煌消定汤联合甲氨喋呤治疗;对照组60例,给予雷公藤多甙片和甲氨蝶呤治疗,均治疗12周,观察两组治疗前后炎症指标血沉(ESR)、C-反应蛋白(CRP)]变化情况以及滑膜指标(包括膝关节的滑膜厚度、髌上囊积液深度、滑膜血流信号)。结果:两组患者炎症指标(ESR、CRP)均较治疗前显著改善(P<0.05)。两组患者滑膜指标(滑膜厚度评分、髌上囊积液、血流信号评分)均较治疗前显著改善(P<0.05)。结论:敦煌消定汤联合甲氨喋呤治疗类风湿关节炎滑膜炎疗效显著,值得临床应用,且安全性高,胃肠道不良反应少。

Effects of Dunhuang Xiaoding Decoction combined with Methotrexate on synovium and inflammatory indexes of rheumatoid arthritis synovitis

Objective: To investigate the clinical efficacy and safety of Dunhuang Xiaoding Decoction combined with Methotrexate in the treatment of rheumatoid arthritis synovitis. Methods: A total of 120 patients who met the standard were collected in the Department of Rheumatism of Affiliated Hospital of Gansu University of Chinese Medicine from March, 2018 to March, 2019. They were randomly divided into 2 groups, 60 cases in the treatment group were given Dunhuang Xiaoding Decoction combined with Methotrexate, and 60 cases in the control group. The control group was treated with Tripterygium Glycosides and Methotrexate. The two groups were treated for 12 weeks. The changes of inflammatory markers(ESR, CRP) before and after treatment, and synovial index(including synovial thickness of knee joint, depth of suprapatellar bursa effusion, synovial blood flow signal) were observed in two groups of patients, respectively. Results: Inflammatiory markers(ESR, CRP) of the two groups were improved compared with those before treatment(P<0.05). The synovial indexes(synovial thickness score, suprapatellar effusion, blood flow signal score) of the two groups were improved compared with those before treatment(P<0.05). Conclusion: Dunhuang Xiaoding Decoction combined with Methotrexate is effective in treating rheumatoid arthritis synovitis. It is worthy of clinical application, and it has high safety and little side effects in gastrointestinal tract.