【摘要】：目的:討論、總結(jié)加味桂枝芍藥知母湯治療寒熱錯雜型類風濕關(guān)節(jié)炎的理論依據(jù),并評估其臨床療效及安全性,為臨床治療中應用此方藥治療類風濕關(guān)節(jié)炎提供理論依據(jù)及數(shù)據(jù)支持。方法:1.理論研究:查閱相關(guān)文獻,剖析加味桂枝芍藥知母湯治療寒熱錯雜型類風濕關(guān)節(jié)炎的理論依據(jù)及其方藥配伍關(guān)系;2.臨床研究:將72例寒熱錯雜型RA患者,采取隨機、開放、平行對照的研究方法,分為治療組(包含患者36例)和對照組(包含患者36例),分別采用加味桂枝芍藥知母湯配合甲氨蝶呤片、白芍總苷膠囊配合甲氨蝶呤片治療,8周后,記錄兩組患者治療前后的相關(guān)疾病臨床癥狀及體征(如晨僵時間、關(guān)節(jié)壓痛數(shù)、關(guān)節(jié)腫脹數(shù)、雙手平均握力)及相關(guān)化驗指標,進行分析比較后對兩組藥物療效做出對比和評價。結(jié)果:兩組總療效進行對比,加味桂枝芍藥知母湯組優(yōu)于對照組,差異明顯(P0.05)。治療前后比較,兩組患者晨僵持續(xù)時間、關(guān)節(jié)壓痛數(shù)、關(guān)節(jié)腫脹數(shù)、雙手平均握力、血沉、C-反應蛋白及相關(guān)臨床癥狀均有顯著改善,差異有顯著統(tǒng)計學意義(P0.01)。比較兩組患者治療后相關(guān)臨床癥狀和實驗室指標,加味桂枝芍藥知母湯組優(yōu)于對照組(P0.05或P0.01)。結(jié)論:比較臨床觀察結(jié)果后可得出結(jié)論,加味桂枝芍藥知母湯治療寒熱錯雜型類風濕性關(guān)節(jié)炎療效顯著,優(yōu)于白芍總苷膠囊;在降低相關(guān)實驗室炎性指標方面,其也有確切療效;同時,加味桂枝芍藥知母湯安全性良好,無明顯毒副作用。
[Abstract]:Objective: to discuss and summarize the theoretical basis of Jiawei Guizhi Shaoyao Anemarrhena decoction in the treatment of rheumatoid arthritis with cold and heat disorder, and to evaluate its clinical efficacy and safety. To provide theoretical basis and data support for the treatment of rheumatoid arthritis. Methods: 1. Theoretical study: refer to relevant literature, analyze the modified Guizhi Shaoyao Anemarrhena decoction for the treatment of cold and heat complex rheumatoid arthritis theoretical basis and prescription compatibility; 2. Clinical study: 72 patients with RA with cold and heat disorder were divided into two groups: the treatment group (including 36 patients) and the control group (including 36 patients). After 8 weeks of treatment, the clinical symptoms and signs of related diseases (such as morning stiffness time, joint tenderness and joint tenderness) were recorded after 8 weeks of treatment with modified Guizhi-Shaoyaozhengmu decoction combined with methotrexate tablet, total paeony glucoside capsule and methotrexate tablet respectively. The number of joint swelling, the average grip strength of both hands) and the related test indexes were compared and evaluated after the analysis and comparison between the two groups. Results: the total curative effect of the two groups was compared, the modified Guizhi Shaoyao Anemarrhena decoction group was superior to the control group, the difference was significant (P0.05). Before and after treatment, the duration of morning stiffness, the number of joint tenderness, the number of joint swelling, the mean grip strength, erythrocyte sedimentation rate, C-reactive protein and related clinical symptoms of the two groups were significantly improved (P0.01). Compared the two groups of patients after treatment related clinical symptoms and laboratory indicators, Jiawei Guizhi Shaoyao Anemarrhena decoction group was better than the control group (P0.05 or P0.01). Conclusion: after comparing the clinical observation results, it can be concluded that the modified Guizhi Shaoyao Anemarrhena decoction is more effective than the total paeony glucoside capsule in the treatment of rheumatoid arthritis of the type of cold and heat disorder. At the same time, the modified Guizhi Shaoyao Anemarrhena decoction is safe and has no obvious side effects.
【學位授予單位】：云南中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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