清痹洗方熏洗对类风湿性关节炎热痹证临床疗效的影响

目的]观察中药清痹洗方（由稀莶草、黄柏、赤芍、生地、汉防己、苍术、旱莲草、蜂房、乳香、没药、徐长卿、红花、牛膝、威灵仙、冰片、薄荷等药物组成）熏洗对类风湿性关节炎（RA）疗效的影响.方法]将60例RA患者随机分为治疗组（30例）和对照组（30例）.治疗组给予清痹洗方熏洗,并口服通痹灵片和尼美舒利;对照组只服用通痹灵片和尼美舒利,不用清痹洗方熏洗.两组的疗程均为1个月.观察两组治疗前后晨僵时间、握力、压痛关节数、压痛指数、关节休息痛、肿胀关节数、肿胀指数、病人和医生评价等临床症状、体征的变化情况;观察两组患者治疗前后血中类风湿因子（RF）、C-反应蛋白（CRP）、血沉（ESR）、白细胞计数（WBC）和血小板计数（PLT）等指标的变化情况.结果]治疗组的总有效率为90.0%,对照组为66.7%,治疗组的疗效优于对照组（P＜0.01）.治疗1个月后,两组患者的晨僵时间、双手平均握力、关节压痛和关节肿胀均有明显改善（与治疗前比较,P＜0.01）,且治疗组优于对照组（P＜0.01）.两组治疗后血中RF、CRP、ESR、WBC和PLT等指标均有下降（与治疗前比较,P＜0.01）,且治疗组血中CRP、ESR、PLT的下降较对照组明显（P＜0.01）.结论]清痹洗方熏洗对类风湿性关节炎热痹证患者的临床疗效有一定的促进作用.

Synergistic Action of Fuming-Washing Therapy with Qingbixifang on Rheumatoid Arthritis with Heat Retention

Objective] To investigate the synergistic action of fuming-washing therapy with Qingbixifang ( a herbal lotion mainly composed of Herba Siegesbeckiae, Cortex Phellodendri, Radix Paeoniae Rubra, Radix Rehmanniae, Radix Stephaniae Tetrandrae, Rhizoma Atractylodis, Herba Ecliptae, Nidus Vespae, Olibanum, Myrrha, etc.) on rheumatoid arthritis (RA) with heat retention. Methods] Sixty patients of RA with heat retention were randomized into groups A and B. Group A ( n = 30) was treated by fuming and washing the affected part with Qingbixifang, and taking Tongbiling Tablets and nimesulide; group B (n = 30) was treated by taking Tongbiling Tablets and nimesulide only. The treatment course of the two groups lasted one month. The time of morning stiffness, grip strength, the number of joints with tenderness, tenderness index, resting pain in joints, the number of swelling joints, swelling index, evaluation by patients themselves and by the doctor were compared before and after treatment. Laboratory parameters such as blood rheumatoid factor (RF), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count and platelet (PLT) count were also observed before and after treatment. Results] The total effective rate was 90.0% in group A and 66.7% in group B, the difference being significant (P < 0.01). After treatment, the time of morning stiffness, mean grip strength, tenderness and swelling in joints were much improved in the two groups (P < 0.01 as compared with those before treatment), and the therapeutic effect in group A was better than that in group B ( P < 0.01). Blood RF, CRP, ESR, WBC and PLT decreased in the two groups ( P < 0.01 as compared with those before treatment), and the decrease of CRP, ESR and PLT in group A was obvious as compared with group B (P <0.01). Conclusion] Fuming-washing therapy with Qingbixifang has a synergistic action on routine drugs for the treatment of RA with heat retention.