归脾汤加味联合来氟米特治疗类风湿关节炎疗效观察

目的:观察归脾汤加味联合来氟米特治疗气血亏虚型类风湿关节炎(Rheumatoid Arthritis,RA)的临床疗效及安全性。方法:将120例气血亏虚型RA患者随机分为治疗组(80例,归脾汤加味方联合来氟米特治疗,归脾汤每日1剂,分2次口服,连续治疗2个月)和对照组(40例,来氟米特治疗),两组来氟米特从10 mg逐渐加至20 mg,每日1次,疗程为2个月。观察两组ACR20改善率、28个关节数疾病活动度评分(DAS28)、红细胞沉降率(Erythrocyte Sedimentation Rate,ESR)、类风湿因子(Rheumatoid Factor,RF)、C反应蛋白(C-reactive Protein,CRP)、抗环瓜氨酸肽(Cychc Citrullinated Peptide,CCP)抗体和血红蛋白。结果:治疗组治疗后ACR20、ACR50、ACR70高于对照组(P<0.05)。与本组治疗前比较,两组治疗后DAS28评分、ESR、RF、CRP、CCP抗体均降低(P<0.01,P<0.05),血红蛋白均升高(P<0.01,P<0.05)。与对照组同期比较,治疗组干预后ACR20改善率升高,DAS28评分、ESR、RF、CRP降低,差异均有统计学意义(P<0.05)。治疗组2例出现肝功能异常;对照组3例白细胞减低,3例出现肝功能异常。结论:归脾汤联合来氟米特可有效改善气血亏虚型RA患者的关节及全身症状。

Observation on treating rheumatoid arthritis with the Guipi decoction plus leflunomide

Objective:To observe the clinical efficacy and safety of the Guipi decoction(归脾汤)plus leflunomide on rheumatoid arthritis of the Qixue Kuixu type(气血亏虚型).Methods:120 cases were randomly divided into two groups,80 cases in the treatment group were treated with the Guipi decoction plus leflunomide,and 40 cases in the control group were treated with leflunomide for 2 months.Leflunomide was gradually added from 10 mg to 20 mg once a day for 2 months in both groups.Efficacy of TCM syndrome,the improvement rate of ACR20,DAS28,ESR,rheumatoid factor(RF),C-reactive protein(CRP),anti-cyclic citrullinated peptide(CCP)antibody and hemoglobin were observed in the two groups.Results:The improvement rate of ACR20,ACR50,ACR70 in the treatment group were higher than those in the control group(P<0.05).Compared with those before treatment,DAS28 score,ESR,RF,CRP and CCP antibody were decreased(P<0.01,P<0.05),and hemoglobin were increased in both groups after treatment(P<0.01,P<0.05).Compared with the control group,the improvement rate of ACR20 in the treatment group was higher,and the DAS28 score,ESR,RF and CRP were lower in the treatment group after intervention,and the differences were statistically significant(P<0.05).There were 2 cases with abnormal liver function in the treatment group,and 3 cases with leukopenia and 3 cases with abnormal liver function in the control group.Conclusion:The Guipi decoction plus leflunomide can effectively improve the joint and systemic symptoms of RA of the Qixue Kuixu type.