本文關(guān)鍵詞：熱痹清治療類風(fēng)濕關(guān)節(jié)炎濕熱痹阻證臨床療效觀察及生活質(zhì)量的影響　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 類風(fēng)濕關(guān)節(jié)炎 濕熱痹阻證 熱痹清 VAS DAS28 HAQ

【摘要】：目的：評(píng)估熱痹清方在治療類風(fēng)濕關(guān)節(jié)炎濕熱痹阻證型上的臨床療效,以及對(duì)生活質(zhì)量的影響。方法：本次實(shí)驗(yàn)基于非盲平行對(duì)照的臨床試驗(yàn)原則。將總數(shù)40例類風(fēng)濕關(guān)節(jié)炎且符合中醫(yī)證型濕熱痹阻證的病人分為兩組,其中20例藥物干預(yù)為甲氨喋呤(MTX)+熱痹清(RBQ)方同用作治療組,另20例藥物干預(yù)僅甲氨喋呤作對(duì)照組。入組病例中DAS28評(píng)分屬于重度活動(dòng)以上(DAS28評(píng)分≥5.1)者,加用美洛昔康片治療。療程12周后觀察患者關(guān)節(jié)腫脹數(shù)、關(guān)節(jié)壓痛數(shù)、雙手握力、中醫(yī)證候積分、理化檢測(cè)上的變化。評(píng)估病情的整體變化程度采用DAS28評(píng)分及VAS評(píng)分,評(píng)估患者生存質(zhì)量采HAQ評(píng)分。安全監(jiān)測(cè)其肝腎功能、血常規(guī)的異常。結(jié)果：兩組中對(duì)于減輕患者疾病活動(dòng)度、中醫(yī)證候、臨床體征、生存質(zhì)量及理化檢測(cè)上均有明顯療效。對(duì)于中醫(yī)證候,治療組在關(guān)節(jié)疼痛度、關(guān)節(jié)發(fā)熱、疲乏無(wú)力等癥狀方面的緩解皆較對(duì)照組更佳。對(duì)于疾病活動(dòng)度,治療組較對(duì)照組在類風(fēng)濕關(guān)節(jié)炎疾病活動(dòng)度DAS28指數(shù)的改善更佳,而VAS評(píng)分改善更為明顯。對(duì)于生存質(zhì)量,治療組較對(duì)照組的HAQ評(píng)分改善明顯。對(duì)于理化檢測(cè)上,治療組較對(duì)照組無(wú)明顯變化差異。兩組均未出現(xiàn)重大不良反應(yīng)事件。RBQ與MTX聯(lián)合使用治療類風(fēng)濕關(guān)節(jié)炎濕熱痹阻證發(fā)現(xiàn)RA病人的臨床癥狀和實(shí)驗(yàn)指標(biāo)改善治療前與后對(duì)比經(jīng)統(tǒng)計(jì)學(xué)比較有差異(P0.05).另一面,RBQ聯(lián)合MTX能增強(qiáng)MTX治療類風(fēng)濕關(guān)節(jié)炎的臨床療效。結(jié)論：中藥熱痹清方結(jié)合西藥治療RA濕熱痹阻證在改善體征、癥狀及控制疾病活動(dòng)的炎性指標(biāo)方面皆有確切療效。相較于單純西藥干預(yù),配合熱痹清方在病情活動(dòng)度DAS28指數(shù)、生存質(zhì)量指數(shù)等方面改善更為明顯。
[Abstract]:Objective: to evaluate the clinical effect of Rebiqing recipe in treating rheumatoid arthritis syndrome of damp-heat arthralgia. Methods: 40 patients with rheumatoid arthritis were divided into two groups based on the principle of non-blind parallel control clinical trial. Among them, 20 cases were treated with methotrexate (MTX), heat Bi Qing (RBQ) prescription, and the same prescription was used in the treatment group. The other 20 cases were treated with methotrexate only as the control group. The DAS28 score of the patients was more than 5. 1 (the score of DAS28 鈮，

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