三联法治疗中晚期类风湿性关节炎95例临床研究

目的：探讨三联疗法辨证治疗中晚期类风湿性关节炎（RA）的疗效及安全性，方法：以扶正蠲痹，化痰祛瘀为基本治则，以痹得治片口服，中药汽疗仪配寒湿痹浴舒雾化透皮法，正清风痛宁针关节腔注射（三联甲组）治疗阳虚寒凝，痰瘀互结中晚期RA50例，痹得清饮口服，中药汽疗仪配寒热痹浴安雾化透皮法，正清风痛宁针关节腔注射（三联乙组）治疗阴虚热郁，痰瘀互结中晚期RA45例，并以消炎痛内服加肌注甲氨喋呤（MTX）治疗中晚期RA43例作对照研究。结果：三联甲组对中晚期RA中医主症控显率，有效率分别为74％，26％和86％，14％，三联乙组对中晚期RA，中医主症控显率，有效率分别为73．34％，26．66％和86．67％，13．33％；对照组对中晚期RA，中医主症控显率，有效率分别为27．91，46．51％和23．26％37．21％。三联甲、乙组分别与对照组比较，按Ridit检验，有非常显著性差异（P＜0．01），且三联甲组，乙组临床症状，体征，炎症指数，血沉（ESR），C反应蛋白（CRP），类风湿因子（RF）滴度，免疫球蛋白G（IgG)，免疫球蛋白M（IgM)，血清补体C3（C3），血红蛋白（Hb)治疗前后分别比较，差异有非常显著性（P＜0．01），与对照组比较差异有显著性（P＜0．05或P＜0．01）。结论：三联疗法对RA中期病情控制尤为突出，对晚期RA患者提高生活质量较为明显，且较安全。

Clinical Study on Treatment of 95 Cases of Intermediate and Late Rheumatoid Arthritis with Tri-combination Method

Objective: In order to approach to the therapeutic effect and safety of tri - combination method in treatment of intermediate and late rheumatoid arthritis .(RA).Method: Oral administration of Bi De Zhi Tabelets, Chinese drug steam therapeutic instrument combined with Han Shi Bi Yu Shu spray skin - permeating method, and injection of Zheng Qing Feng Tong Ning into articular cavity were used for treatment of 50 cases of intermediate and late rheumatoid arthritis with Yang - deficiency and accumulation of pathogenic cold and phlegm as tri - combination group A; and oral administration of Bi De Qing Yin decoctinon, Chinese drug stem therapeutic instrument combined with Han Re Bi Yu An spray skin -permeating method, and injection of Zheng Qing Feng Tong Ning into articular cavity were used to treat 45 cases of rheumatoid arthritis with Yin - deficiency, retention of pathogenic heat, and accumulation of phlegm as tri -combination group B, and 43 cases treated with oral medication of indomethacin plus intermuscular injection of MTX ascontrol group. Results: The control and markedly effective rate and the effective rate for TCM main symptoms were respectively 74%,26% and 86%, 14% in group A; 73%, 27% and 87%, 13% in the group B; 28%, 47% and 23%, 37% in the control group. There was very significantly difference as the group A, and the group B compared with the control group respectively (P<0. 01). There was a very significant difference (P<0. 01) before and after treatment in the group A and the group B in clinical symptoms, signs, inflammation index, and blood sedimenation, reactive protein,titer of rheumatoid factor, IgG, IgM, C3 and hemoglobin. And there was . a significantly difference (P < 0. 01 orP < 0. 05) as they compared with the control group. It is indicated that the tri -combination method has an obvious therapeutic effect on rheumatoid arthritis at metaphase and can increase life quality of the patient at late stage with safety.