桂枝芍药知母汤联合甲氨蝶呤治疗活动期类风湿关节炎的疗效及影响因素分析

目的:观察桂枝芍药知母汤联合甲氨蝶呤治疗活动期类风湿关节炎(rheumatoid arthritis,RA)的疗效,探讨影响疗效的相关因素.方法:选取2016年12月至2019年12月中国人民解放军东部战区总医院收治的活动期RA患者126例,采用随机数表法分为观察组、对照组,每组63例.对照组患者给予甲氨蝶呤片治疗,观...

Efficacy and Influencing Factors of Guizhi Shaoyao Zhimu Decoction Combined with Methotrexate in the Treatment of Rheumatoid Arthritis in Active Phase

OBJECTIVE:To observe the efficacy of Guizhi Shaoyao Zhimu decoction combined with methotrexate in the treatment of rheumatoid arthritis(RA)in active phase,and to analyze efficacy-related factor.METHODS:Totally 126 patients with RA in active phase admitted into General Hospital of Eastern theater of PLA from Dec.2016 to Dec.2019 were selected and divided into observation group and control group via random number table,with 63 cases in each group.The control group was treated with methotrexate,while the observation group was given Guizhi Shaoyao Zhimu decoction based on the control group,the courses of treatment of both groups were 12 weeks.Serum rheumatoid factor(RF),C reactive protein(CRP)and erythrocyte sedimentation rate(ESR)levels were detected,and the efficacy was evaluated by RA patient’s condition evaluation(DAS28 score);the number of tender joints,swollen joints and other clinical data were recorded.RESULTS:After 6 weeks and 12 weeks of treatment,the serum CRP and ESR levels of both groups had been significantly decreased,the serum CRP and ESR levels after 12 weeks of treatment were significantly lower than after 6 weeks of treatment,and those of observation group were significantly lower than the control group during the same period,with statistically significant differences(P<0.05).After 6 weeks and 12 weeks of treatment,the serum RF level of observation group were significantly lower than those of before treatment,the serum RF level after 12 weeks of treatment were significantly lower than after 6 weeks of treatment,and that of observation group was significantly lower than the control group during the same period,with statistically significant differences(P<0.05).After12 weeks of treatment,the total effective rate of observation group was 92.07%(58/63),which was significantly higher than that of the control group(79.37%,50/63),with statistically significant difference(P<0.05).After 6 weeks and 12 weeks of treatment,the TCM syndrome integral of both groups were significantly lower than those of before treatment,the TCM syndrome integral after 12 weeks of treatment were significantly lower than after 6 weeks of treatment,and that of observation group was significantly lower than the control group during the same period,with statistically significant differences(P<0.05).The efficacy was related to patient’s gender,age,number of tender joints and swollen joints before treatment,course of disease,presence or absence of rheumatoid nodules and drug combination,serum RF,CRP and ESR levels before treatment;number of tender joints and swollen joints before treatment,course of disease,presence or absence of rheumatoid nodules and drug combination(Guizhi Shaoyao Zhimu decoction combined with methotrexate),serum RF and ESR levels before treatment were the independent factors that affect the efficacy.CONCLUSIONS:The efficacy of Guizhi Shaoyao Zhimu decoction combined with methotrexate in the treatment of RA in active phase is remarkable.Number of tender joints and swollen joints before treatment,course of disease,presence or absence of rheumatoid nodules and drug combination(Guizhi Shaoyao Zhimu decoction combined with methotrexate),serum RF and ESR levels before treatment were the independent factors that affect the efficacy.