Clinical and experimental study of RA mixture in treatment of rheumatoid arthritis

The RA mixture is composed of Tripterygium wilfordii (TW) and other Chinese medicinal herbs with effect of expelling Wind, activating blood circulation, invigorating the Kidney and Qi. The authors treated rheumatoid arthritis (RA) patients with RA mixture and compared it with D-Penicillamine as ocntrol. The two group’s therapeutical effect is similar (P >0.05), but side effect occuring ratio in treatment group was obviously lower than that of control group (P <0.01). After treatment with RA mixture, the patient’s human lymphocytic antigen-degenerative reaction (HLA-DR⁺) cell, CD4/CD8 ratio were reduced and automixed lymphocytic reaction (AMLR) level enhanced (P <0.05). The results of animal experiment showed that swelling of rheumatoid arthritis model mouse’s joint could be reduced by both RA mixture and TW. Comparing with TW, RA mixture had stronger effect in controlling the inflammation of synovial cell and fibroid degeneration of fibrocytes. At the same time, RA mixture had stronger effect in protecting immune organ from atrophy and maintaining functions of cellular immunity. All these suggest that RA mixture can reduce the syndroms of RA by improving distribution of T lymphocyte subsets and functions of cellular immunity. The Chinese medicinal herbs for reinforcing Kidney, supplementing Qi, activating blood circulation and expelling evil wind in the RA mixture could enhance TW’s therapeutical effect and reduce it’s side effect.     

Clinical study on treatment of chemotherapy or radiotherapy induced leukopenia with Fuzheng Compound ())

The therapeutic effect of Fuzheng Compound, a Chinese herbal medicine, on leukocyte count in 59 patients with cancer of advanced stage after chemotherapy or radiotherapy were observed. Among the 41 cases of leukopenia, leukocyte of 37 cases were normalized after treatment, the count pre- and post-treatment were (2.8±0.6)×10⁹/L and (5.9 ×1.5)×10⁹/L respectively (P<0.01). In the 18 patients with normal leukocyte count before treatment, the counts of 17 cases remained normal after treatment. The time for leukocyte recovering was 8.0 days in average, while that of 23 patients who did not take Fuzheng Compound was 20.6 × 1.8 days. The results indicated that Fuzheng Compound could alleviate the inhibition of chemo- or radiotherapy on hemopoietic function of bone marrow and has leukocytogenic effect.     

云克联合来氟米特治疗类风湿关节炎的临床研究

目的观察云克（^99Tc—MDP）联合来氟米特治疗类风湿关节炎（RA）的临床疗效。方法将54例RA患者随机分为治疗组与对照组各27例,治疗组采用云克联合来氟米特治疗;对照组给予来氟米特加甲氨堞呤治疗,疗程均为12周。结果经12周治疗后,治疗组显效率70．37％,总有效率92．59％;对照组显效率55．56％,总有效率81．48％,两组差异有显著性（P〈0．05）;治疗后治疗组在各项观察指标改善方面均优于对照组,差异有统计学意义（P〈0．05）,两组均无严重不良反应发生。结论云克联合来氟米特治疗可明显改善类风湿关节炎患者的临床症状和实验室指标,疗效确切。     

TACE联合超声聚焦刀治疗中晚期肝癌的临床研究

目的 探讨TACE联合超声聚焦刀治疗中晚期肝癌的方法及疗效.方法 将68例中晚期肝癌患者随机分成两组,对照组34例单纯行TACE治疗,联合组34例行TACE联合超声聚焦刀治疗;比较两组6、12、18及24个月生存率、肿瘤缩小情况及临床疗效与有效率以及肝功能变化等.结果 对照组6、12、18及24个月生存率分别为:91.12％、76.47％、58.82％和35.29％,平均生存期14个月;联合组分别为:100％、94.12％、79.41％和52.94％,平均生存期22个月;6个月内联合组CT、MRI提示联合组病灶完全坏死者占29.41％,病灶明显缩小者占61.77％;6个月内对照组CT和MRI提示对照组病灶完全坏死者占17.65％,病灶明显缩小者占38.24％;两组间差异均有显著性(P值均＜0.05).两组临床疗效相比较,差异无显著性(P＞0.05);但有效率相比较,差异有显著性(P＜0.05);两组术后肝功能变化相比较,差异无显著性(P＞0.05).结论 TACE联合超声聚焦刀治疗中晚期肝癌是一种有效的联合治疗方法,近期疗效显著,明显优于单纯TACE治疗.     

尿G1细胞形成机制及临床意义

探讨尿Ｇ１细胞的形成机制及其在血尿定位诊断中的意义。方法 系统观察尿液不同渗透压，ｐＨ值及模拟肾小管渗透压动态变化在Ｇ１细胞形成过程中作用。结果 正常红细胞经历模拟肾小管的渗压动态变化过程且终末尿渗透压达６４０ｍｍｏｌ．Ｌ＾－１出现Ｇ１细胞，终末尿渗透压愈高，Ｇ１细胞所占的比例愈大；而当渗透压或ｐＨ值固定不变时，则无论其值如何，均不会出现Ｇ１细胞。     

合并肾脏病变的类风湿关节炎临床表现分析

[目的]探讨类风湿性关节炎(RA)中肾脏受累患者临床特点。[方法]回顾性分析2006—2008年RA合并肾脏病变(肾病组)患者35例及同期住院的未合并肾损害且无重要合并症的89例RA患者(非肾病组)的临床资料,比较两组的临床资料包括首发症状、病程中临床特点、化验室检查以及肾脏组织活检等情况。[结果](1)肾脏病变组首发症状以发热乏力者多于非肾脏病变组(P<0.05);在病程中肾脏病变组关节肿痛总数较非肾病组多见(P<0.05);两组患者入院时的ESR、CRP、WBC、IgG、IgM、IgA以及RF分别为(85±32)mm/h和(75±36)mm/h;(59±34)mg/L和(48±25)mg/L;(10.3±2.9)×109/L和(9.3±3.0)×109/L;(11.1±3.0)g/L和(10±2.1)g/L;(2.1±1.00)g/L和(1.6±0.98)g/L;(32±2.10)g/L和(29±0.98)g/L;(35±15)U/mL和(41±21)U/mL,两组中除ESR、WBC和IgG以及RF以外,IgM、IgA以及CRP比较差异有显著性意义(P<0.05)。(2)肾病组在停用疑似对肾脏有损害药物或使用肾毒性小的药物治疗2个月后分别有5例血尿8例蛋白尿患者转阴,与非肾脏病组相比差异无显著性意义(P>0.05);肾病组24 h尿蛋白治疗前后分别为(2.54±0.56)g/24 h和(1.63±0.21)g/24 h,两组比较差异有显著性意义(P<0.05)。肾病组ESR、CRP、WBC、IgM、IgA在治疗前后相比差异有显著性意义(P<0.05)。(3)选取其中5例持续性肾损害患者肾组织活检发现,2例系膜增生性肾小球肾炎,1例膜性肾病,1例新月体肾炎,1例膜增生性肾炎。[结论]合并肾脏病变的RA患者在首发症状和病程中的临床表现与未合并肾脏病变RA患者有所不同;肾脏病变者大多有用药史,临床肾脏损害以药物性和免疫炎症引起为主,排除药物因素后诊断不明者应尽早行肾穿刺明确病理诊断。     

地藤痹痛颗粒联合中药熏蒸治疗类风湿关节炎(寒痹)的临床观察

目的观察地藤痹痛颗粒联合中药熏蒸对类风湿性关节炎(寒痹)的疗效及血清炎性因子的影响。方法纳入2016年1月—2018年1月类风湿性关节炎(寒痹)患者165例,随机分为治疗组和对照组,治疗组83例,对照组82例,两组均给予常规药物治疗,对照组在此基础上给予地藤痹痛颗粒,治疗组在对照组基础上联合中药熏蒸法,连续治疗30 d,观察治疗后两组有效率,治疗前后中医证候量表评分、血清核因子(NF-κB)、肿瘤坏死因子(TNF-α)、血清类风湿因子(RF)、C反应蛋白(CRP)、血沉(ESR)、白介素1β(IL-1β)及不良反应。结果两组治疗后,治疗组痊愈率为48.1%,有效率43.3%,总有效率91.5%;对照组痊愈率为34.1%,有效率45.1%,总有效率79.2%,两组痊愈率和有效率比较,差异具有统计学意义(P<0.05);两组治疗前后临床症状指标(关节肿胀度、压痛程度、关节疼痛数目、晨僵持续时间)与中医证候量表评分比较差异具有统计学意义,且治疗组优于对照组(P<0.05);两组治疗前后TNF-α、NF-kB、IL-1β、RF、CRP、ESR比较差异有统计学意义,且治疗组优于对照组(P<0.05)。结论地藤痹痛颗粒联合中药熏蒸治疗类风湿性关节炎(寒痹)确有良好的效果,值得临床应用推广。     

类风湿关节炎与动脉粥样硬化的相关性研究

目的 利用高频超声探讨类风湿关节炎(RA)与亚临床型动脉粥样硬化病变之间的相关性.方法 超声测量45例RA患者及25例正常对照组颈动脉内-中膜厚度(IMT)及肱动脉血流介导的血管舒张(FMD),并进行对比分析.结果 RA患者颈动脉IMT较正常对照组明显增厚(P＜0.01);RA组FMD较正常对照组明显降低(P＜0.01).结论 RA与动脉粥样硬化的发生有明显相关性,高频超声可作为早期预测RA患者亚临床型动脉粥样硬化有效的、敏感且无创的手段.     

淋巴细胞去除与血浆置换治疗类风湿性关节炎的初步研究

利用CS-3000 plus血细胞分离机,应用淋巴细胞单采术和血浆置换术治疗类风湿性关节炎18例,取得良好的治疗效果,其临床症状,体征明显改善.血液学指标(Hb、WBC、淋巴细胞绝对值、UA)、免疫学指标(RF、ANA、IgG、IgM、IgA、C_3)检测恢复接近正常,复发率低.外周血中T淋巴细胞亚群分析结果表明,类风湿性关节炎患者辅助T淋巴细胞(OKT_4)以及辅助T淋巴细胞与抑制T淋巴细胞(OKT_8)的比值OKT_4./OKT_8.明显增高.经治疗后OKT_4;的量与OKT_4./OKT_8的比值明显降低.说明该疗法对治疗类风湿性关节炎具可探讨性,OKT_4;/OKT_8的比值变化是评价其疗效的较好指标.     

桂枝芍药知母汤加味治疗类风湿性关节炎临床疗效观察

目的观察桂枝芍药知母汤加味治疗类风湿性关节炎(RA)的临床疗效.方法将57例RA患者随机分治疗和对照组,对照组以金诺匹林口服,治疗组用桂枝芍药知母汤加味及复方丹参注射液30 ml静脉滴注,观察两组治疗前后症状、体征及ESR、RF、CRP的改善情况.结果治疗组治愈率35.29%,总有效率97.06%;对照组治愈率13.04%,总有效率86.95%.两组总有效率比较,差异有非常显著性意义(P＜0.01).结论桂枝芍药知母汤加味具有通阳行痹,祛风除湿,和营通络之功效;复方丹参注射液行气散瘀止痛,用于治疗RA近期疗效满意,值得进一步研究.     

Clinical Study on treatment of mid-late stage gastric carcinoma by compound Xiansu capsule () combined with chemotherapy) combined with chemotherapy

Objective: To assess the effect and mechanism of compound Xiansu capsule ( ), (XSC) combined with chemotherapy in treating gastric carcinoma of mid-late stage.Methods: Sixty-one patients of the test group were treated by XSC combined with chemotherapy and 30 patients of the control group treated with chemotherapy alone. The effect of treatment and cell mediated immunity of patients were observed.Results: The effective rate of the test group and the control group was 32.8% and 13.3% respectively (P < 0.05), the toxic reaction occurrence caused by chemotherapy was less in the former than that in the latter group (P < 0.01). The CD₈ level of patients in the test group decreased, and CD₄/CD₈ level was raised obviously, which suggested that XSC had immuno-regulating effect on T-cell.Conclusion: XSC could enhance the efficacy and reduce the toxic and side-effect of chemotherapy. To regulate the cell mediated immunity of patients is possibly its mechanism.     

糖皮质激素治疗类风湿关节炎的临床分析

目的　分析糖皮质激素治疗类风湿关节炎(RA)的临床效果及对类风湿关节炎转归的影响,提高对糖皮质激素治疗类风湿关节炎的认识。方法　回顾性分析了1999年1月至2003年3月北京协和医院门诊有随访记录的300例类风湿关节炎患者的临床资料,将治疗初期即使用改善病情抗风湿药的227例患者分为糖皮质激素治疗组(89例)和非糖皮质激素治疗组(138例),比较两组患者疾病临床缓解和远期关节X线变化的差异,比较糖皮质激素治疗组中不同剂量间的近期、远期疗效及不同疗程的远期疗效。结果　两组近期疗效总有效率分别为86 .5%、66 .0% (P<0. 05),起效时间分别为(3 5±1 6)、(5 4±1 9)周(P<0 .05);糖皮质激素治疗组中不同剂量间的近期疗效、远期疗效及不同疗程的远期疗效差异均无统计学意义(P>0 .05)。结论　糖皮质激素对于活动性类风湿关节炎患者能较快、明显地改善疾病活动程度,但未见对类风湿关节炎骨侵蚀有控制作用。不同初始治疗剂量及疗程对近期改善类风湿关节炎疾病活动度和控制其骨破坏未见差异。     

类风湿关节炎患者血清抗EB病毒抗体的临床研究

目的研究ＥＢ病毒感染与类风湿关节炎的临床关系。方法以Ｂ９５－８细胞为抗原底物,用间接免疫荧光法检测血清中抗ＩｇＡＥＢ病毒壳抗原抗体（抗ＩｇＡ／ＶＣＡ抗体）。以免疫印迹法检测血清中抗ＩｇＧＥＢ病毒Ｚ蛋白抗体（抗ＩｇＧ／Ｚ抗体）。结果类风湿关节炎患者血清中抗ＩｇＧ／ＶＣＡ抗体阳性率２１．９％,明显高于正常人及其他风湿病患者。抗ＩｇＧ／Ｚ抗体仅在抗ＩｇＡ／ＶＣＡ抗体阳性时出现。结论抗ＩｇＡ／ＶＣＡ抗体的检测对类风湿关节炎的诊断有一定临床意义。类风湿关节炎患者体内的ＥＢ病毒可能处于激活状态。     

清络饮治疗类风湿性关节炎的实验研究

目的观察清络饮对完全弗氏佐剂(CFA)类风湿性关节炎(RA)大鼠模型的一般状态及炎症指标的影响。方法选择普通雌性大鼠30只,随机分为空白对照组、模型对照组、治疗组,各10只。采用RA造模成功1周后,灌注清络饮汤药,1次/d,共21 d。1记录每组大鼠脚掌的疼痛、肿胀指数;221天后断尾采血,用ELISA法做IL-1定量测定。最后用方差分析和SNK-q检验分析组间差异。结果和模型对照组比较,治疗组关节肿胀度下降速度明显,痛阈值明显提高(P<0.05);治疗组CFA大鼠血清IL-1水平低于模型对照组,差异有统计学意义(P<0.05)。结论清络饮可以改善RA的部分临床症状。     

应用膝关节镜滑膜切除术对早期类风湿关节炎的诊断及治疗效果

目的探讨应用膝关节镜滑膜切除术诊断及治疗早期类风湿关节炎(RA)的临床效果。方法选取我院于2015年7月至2017年7月收治的60例具有明确关节炎表现的患者,入选患者年龄均>16岁并且病程<1年,所有入选患者均行膝关节镜滑膜切除术,根据患者术后的滑膜形态改变和病理、生化免疫学检查以及影像学磁共振成像(MRI)检查等对RA进行明确诊断。分别在患者术后3个月和术后1年时进行随访,比较患者治疗前后的C反应蛋白(CRP)和红细胞沉降率(ESR)以及Lysholm评分和健康问卷评分(HAQ)。结果早期RA分类标准对于RA诊断的特异性为91%(21/23)、敏感度为81%(30/37)。在37例RA患者中,20例慢性滑膜炎,17例病变滑膜组织病理切片经苏木精-伊红(HE)染色结果诊断为RA。2组患者在术后3个月和术后1年时的HAQ评分、Lysholm评分、CRP水平、ESR等指标均优于术前(均P<0.05);RA组患者在术后1年时的HAQ评分、Lysholm评分、CRP水平、ESR等指标均优于本组术后3个月(均P<0.05)。结论早期RA分类标准具有简便和实用的优势,有助于临床上RA的早期诊断;在明确诊断RA后在早期及时应用膝关节镜滑膜切除术能够显著改善患者的生活质量和全身健康状况,大大缓解了患者的患膝症状。     

甲氨蝶呤治疗类风湿关节炎疗效观察

目的　观察甲氨蝶呤 (MTX)治疗类风湿关节炎 (RA)的临床疗效。方法　 78例RA患者随机分两组 ,观察组40例 ,静脉注射MTX 7 5～ 15mg/周和口服美洛昔康 15mg/d治疗 ;对照组 3 8例患者口服美洛昔康 15mg/d治疗 ,观察 12周。结果　观察组临床缓解及显效率 75 % ,对照组为 42 % ,两者差异有显著性 (P <0 0 1) ;观察组与对照组药物副作用的发生率分别为 2 8%和 18% ,两者比较无统计学意义 (P >0 0 5 )。结论　小剂量MTX合用NSAIDs治疗RA ,临床疗效优于单用NSAIDs治疗 ,且副反应并不增加     

寒湿透骨散治疗寒湿痹阻证类风湿关节炎随机对照多中心临床研究

目的 观察寒湿透骨散治疗寒湿痹阻证类风湿关节炎的临床疗效和安全性.方法 应用随机平行、双肓和双模拟对照的多中心临床研究方案,试验组入选360例,对照组入选120例,试验组采用寒湿透骨散外敷,对照组采用模拟药物外敷,敷用1次,观察3d.观察两组患者关节疼痛、关节肿胀、关节压痛、关节屈伸不利和晨僵评分,比较其疗效并得出结论.结果 两组除关节屈伸不利外,关节疼痛、关节肿胀、关节压痛、晨僵评分比较差异均有显著性(P<0.05).两组安全性指标、不良事件发生率差异无显著性(P>0.05).结论 ①寒湿透骨散能改善寒湿痹阻证类风湿关节炎关节疼痛、关节肿胀、关节压痛、晨僵等症状.②寒湿透骨散未发现存在明显的安全性问题.     

来氟米特联合甲氨蝶呤治疗类风湿性关节炎的疗效观察

目的：观察来氟米特联合甲氨蝶呤治疗类风湿性关节炎的疗效。方法：选取我院于2009年10月～2010年1月所收治的98例类风湿关节炎患者,随机分为两组。对照组49例,采用甲氨蝶呤与柳氮磺胺吡啶治疗类风湿性关节炎。治疗组49例,采用来氟米特与甲氨蝶呤进行治疗。结果：采用甲氨蝶呤与柳氮磺胺吡啶治疗6个月总有效率为71.4%。采用来氟米特与甲氨蝶呤治疗6个月,总有效率为89.8%。结论：采用来氟米特与甲氨蝶呤可以安全有效地治疗类风湿性关节炎。     

Comparative study on methotrexate and hydroxychloroquine in the treatment of rheumatoid arthritis

This study was done to see the efficacy and tolerability of methotrexate and hydroxychloroquine in the Treatment of Rheumatoid Arthritis. It was an open label controlled clinical trial, done in Mymensingh Medical college hospital. Fifty six patients were selected by random sampling method, 28 were included in methotrexate group and another 28 for hydroxychloroquine group using inclusion & exclusion criteria. Primary efficacy variables (DAS28, daily naproxen), secondary efficacy variables, and safety measurement variables studied both clinically & laboratory investigations. The data were analyzed by computer with the help of SPSS. The student's t test was used as test of significant. The mean age of the patients at diagnosis was almost identically distributed between methotrexate and hydroxychloroquine group (41.7±12.2 vs. 42.9±9.2 years, p=0.659). Disease activity at baseline was found to be almost homogeneous to each group except CRP which was observed to be significantly higher in methotrexate group than hydroxychloroquine group (p<0.001). Disease activity at 1 month of treatment reduced in the methotrexate group than those in hydroxychloroquine group (p<0.05 in each case). After 3 and 6 months of treatment, disease activity decreased significantly in both groups (p<0.001 and p<0.05 respectively). The average daily dose of NSAID (Naproxen) decreased significantly (p<0.001). Safety variables at 6 month were within normal physiological ranges and did not differ in groups (p>0.05) indicating that both methotrexate and hydroxychloroquine were effective and safe to use in rheumatoid arthritis. The difference in the incidence of adverse effects, total or individual, was almost nil.