补肾祛寒治尪汤联合甲氨蝶呤治疗类风湿关节炎临床研究

目的观察补肾祛寒治尪汤联合甲氨蝶呤治疗类风湿关节炎的临床疗效。方法将180例类风湿关节炎患者随机分为2组,对照组90例予甲氨蝶呤治疗,治疗组90例在对照组治疗基础上加补肾祛寒治尪汤治疗,2组均治疗6个月后统计临床疗效。比较2组治疗前后临床症状和体征、类风湿关节炎患者的健康评估问卷(HAQ)、疾病活动指数(DAS28)评分及红细胞沉降率(ESR)、C反应蛋白(CRP)水平变化。结果治疗组总有效率81.1%,对照组66.7%,2组总有效率比较差异有统计学意义(P0.05),治疗组临床疗效优于对照组。治疗后2组压痛关节数、肿胀关节数均较本组治疗前减少,晨僵时间缩短,双手握力增加,休息痛评分、HAQ各项评分及DAS28评分降低(P0.05),且治疗组治疗后压痛关节数、肿胀关节数及HAQ各项评分、DAS28评分低于对照组,比较差异有统计学意义(P0.05)。治疗后2组ESR及CRP水平均较本组治疗前下降(P0.05),但2组组间比较差异无统计学意义(P0.05)。结论补肾祛寒治尪汤联合甲氨蝶呤治疗类风湿关节炎具有较好的临床疗效,能显著改善临床症状。

Clinical observation of Bushen - quhan - zhiwang decoction combined with methotrexate on the treatment of rheumatoid arthritis

Objective To observe the clinical effects of Bushen - quhan - zhiwang decoction combined with methotrexate on the treatment of rheumatoid arthritis. Methods 180 patients with rheumatoid arthritis were random-ly divided into two groups. 90 cases in control group were treated by methotrexate,and 90 cases in treatment group were treated by Bushen - quhan - zhiwang decoction on the basis of control group treatment. The curative effect was evaluated after 6 months. The clinical symptoms and signs,Health Assessment Questionnaire(HAQ),Disease Ac-tivity Index(DAS28),erythrocyte sedimentation rate(ESR)and C - reactive protein(CRP)before and after treat-ment were observed in two groups. Results There were statistical differences on the total effective rate between treatment and control group(P < 0. 05). The curative effects in treatment group were superior to control group. The counts of tender joint and swelling joint after treatment were decreased in two groups,the morning stiffness duration was shortened,handgrip strength was increased,and the score of rest pain,HAQ and DAS28 was decreased(P <0. 05). The counts of tender joint,swelling joint,and the items of HAQ and DAS28 after treatment in treatment group were lower than those in control group,with statistical differences(P < 0. 05). The ESR and CRP after treatment were decreased in two groups(P < 0. 05),but there were no statistical differences between two groups(P < 0. 05). Conclusion Bushen - quhan - zhiwang decoction combined with methotrexate has a better effect on the treatment of rheumatoid arthritis,can significantly improve the clinical symptoms.