中西医结合治疗类风湿关节炎41例临床观察

目的：观察薏苡仁汤联合西药治疗类风湿关节炎的临床疗效和不良反应。方法：将82例类风湿关节炎患者随机分为对照组和治疗组各41例,分别应用单纯西药及在西药基础上加服薏苡仁汤,观察两组患者治疗前后晨僵时间、关节压痛数、关节肿胀数、类风湿因子、血沉、C-反应蛋白、血红蛋白和血管内皮生长因子水平;并对治疗3疗程后的两组患者行基本概念视觉模拟评分和关节疾病活动度评分;比较两组患者临床疗效。结果：两组患者治疗前后,晨僵时间、关节压痛数、关节肿胀数、类风湿因子、血沉、C-反应蛋白、血红蛋白水平及基本概念视觉模拟评分结果经比较,差异均有统计学意义（P〈0.05）;治疗组晨僵时间、关节压痛数、关节肿胀数、血沉、C-反应蛋白、血红蛋白和血管内皮生长因子水平治疗效果明显优于对照组（P〈0.05）,两组治疗后类风湿因子差异无统计学意义（P〉0.05）;治疗组基本概念视觉模拟评分和关节疾病活动度评分结果均明显高于对照组（P〈0.05）;但两组临床疗效经比较,差异无统计学意义（P〉0.05）。结论：薏苡仁汤联合甲氨蝶呤与沙利度胺治疗类风湿关节炎的临床疗效优于用甲氨蝶呤与沙利度胺。

Clinical Observation of 41 Cases of Integrative Medicine on Rheumatoid Arthritis

Objective： To observe the clinical effects and adverse reaction of coix decoction combined with western medicine in treating rheumatoid arthritis. Methods： The 82 patients with rheumatoid arthritis were randomly divided into control group and treatment group, 41 cases each. The control group was treated with western medicine only; while the treatment group was given coix decoction besides western medicine. Then some indexes in two groups were observed before and after the treatment, such as the time of morning stiffness, the number of joint tenderness and joint swelling, rheumatoid factors, erythrocyte sedimentation rate（ESR）, C-reactive protein, hemoglobin, and the level of vascular endothelial growth factor（VEGF）. And the scores of VAS and DAS were measured after 3 courses of treatment. The clinical effects of two groups were compared. Results： Before and after the treatment, these indexes above mentioned in two groups all changed, and the difference has statistical significance（P〈0.05）. Except rheumatoid factors, the changes of other indexes in the treatment group were significantly bigger than the control group（P〈0.05）; While the levels of rheumatoid factors in two groups after the treatment showed no difference（P〉0.05）. Compared with the control group, the scores of VAS and DAS in the treatment group were much higher（P〈0.05）. The clinical effects in two groups had no significant difference（P〉0.05）. Conclusion： The clinical curative effects of Coix decoction combined with methotrexate and thalidomide in the treatment of rheumatoid arthritis is better than that of methotrexate and thalidomide drugs.