本文選題：類風濕關(guān)節(jié)炎 + 溫陽通絡(luò)方��； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:1.為中醫(yī)溫陽通絡(luò)方治療類風濕關(guān)節(jié)炎提供臨床依據(jù);2.評價溫陽通絡(luò)方治療類風濕關(guān)節(jié)炎的療效及其安全性。方法:將云南省中醫(yī)醫(yī)院風濕門診64例符合納入標準的低活動度的類風濕關(guān)節(jié)炎患者按隨機的原則(采用SPSS19.0進行隨機,隨機碼20151228)分為治療組和對照組,兩組均予甲氨蝶呤片10mg/周,口服;治療組在口服甲氨蝶呤片的基礎(chǔ)上加服溫陽通絡(luò)方中藥免煎劑,2次/日,飯后溫服。分別在治療前、治療第4周、第8周記錄患者癥狀體征、各項評分、療效性指標及安全性指標:各癥狀體征、ESR、CRP、RF因子、PGA值、MDGA值、DAS28評分、中醫(yī)證候評分、CDAI、三大常規(guī)、肝腎功能、心電圖,對所得數(shù)據(jù)進行統(tǒng)計分析,以中醫(yī)證候改善率、疾病改善率分別評價患者全身癥狀體征、主要癥狀體征的改善情況,以ACR20達標率綜合評價溫陽通絡(luò)方的臨床療效,初步評估溫陽通絡(luò)方的安全性。結(jié)果:兩組治療方法均能有效改善患者癥狀、體征,降低疾病活動度指標(ESR、CRP、DAS28、CDAI值),治療組改善以上各指標均優(yōu)于對照組(P0.05)。兩組患者的RF因子在治療前后無差異(P0.05)。中醫(yī)證候改善方面,治療組總有效率為93.3%;對照組總有效率為78.2%;疾病療效方面,治療組總有效率為80.0%;對照組總有效率為40.6%;ACR20達標治療方面,治療組總達標率為80.0%,對照組總達標率為34.3%。兩組患者均未出現(xiàn)血尿便常規(guī)、肝腎功、心電圖的異常;治療組不良反應(yīng)發(fā)生率為3.0%,對照組不良反應(yīng)發(fā)生率為9.4%。結(jié)論:1溫陽通絡(luò)方聯(lián)合甲氨蝶呤片治療寒濕痹阻型RA能進一步改善患者臨床癥狀及體征、VAS評分、中醫(yī)證候積分;降低RA的活動性指標;能提高ACR20達標治療。2溫陽通絡(luò)方聯(lián)合MTX治療RA尚無毒副作用發(fā)生,治療期內(nèi)溫陽通絡(luò)方是安全有效的。
[Abstract]:Purpose 1. To provide a clinical basis for the treatment of rheumatoid arthritis with traditional Chinese medicine Wenyang Tongluo prescription. To evaluate the efficacy and safety of Wenyang Tongluo recipe in the treatment of rheumatoid arthritis. Methods: a total of 64 rheumatoid arthritis patients in rheumatoid clinic of Yunnan traditional Chinese Medicine Hospital were randomly divided into treatment group and control group according to the principle of randomization (randomized with SPSS19.0, random code 20151228). Both groups were given methotrexate tablets for 10mg/ week, and the treatment group took Wenyang Tongluo prescription for 2 times a day on the basis of oral methotrexate tablets. Before treatment, 4 weeks and 8 weeks of treatment, the symptoms and signs, scores, efficacy and safety indexes of patients were recorded respectively: every symptom and sign: ESR-CRPPU RF factor and MDGA value and DAS28 score, TCM syndrome score, CDAI3 routine, liver and kidney function, liver and kidney function. Electrocardiogram, statistical analysis of the obtained data, the improvement rate of TCM syndromes and diseases were used to evaluate the improvement of patients' systemic symptoms and signs, the improvement of main symptoms and signs, and the clinical efficacy of Wenyang Tongluo recipe (WYTL) were comprehensively evaluated by ACR20 standard rate. To evaluate the safety of Wenyang Tongluo recipe. Results: the two treatment methods could effectively improve the symptoms and signs of the patients, and reduce the disease activity index and the CDAI value of the CRPAS28 and CDAI. The improvement of the above indexes in the treatment group was better than that in the control group (P 0.05). There was no difference in RF factor between the two groups before and after treatment (P 0.05). In the improvement of TCM syndrome, the total effective rate of the treatment group was 93.3; the total effective rate of the control group was 78.2; the total effective rate of the treatment group was 80.0; the total effective rate of the control group was 40.6 ACR20; the total effective rate of the treatment group was 80.0; the total effective rate of the control group was 34.3. The incidence of adverse reactions was 3.0 in the treatment group and 9.4 in the control group. Conclusion the treatment of wenyangtongluo decoction combined with methotrexate tablet can further improve the clinical symptoms and signs of RA patients with VAS score, TCM syndromes score, reduce the activity index of RA. It was safe and effective to improve the standard of ACR20 in the treatment of RA with the combination of Wenyang Tongluo recipe and MTX. There were no side effects in the treatment of RA, and the Wenyang Tongluo recipe was safe and effective in the treatment period.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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本文編號：1899473