【摘要】：評價散痹湯加減治療類風(fēng)濕關(guān)節(jié)炎腎虛寒濕證的療效及安全性。該試驗將168例符合條件的受試者隨機(jī)分為中藥組、西藥組和中西藥組,每組各56例。分別給予散痹湯加減,甲氨蝶呤,散痹湯加減+甲氨蝶呤,療程均為16周。觀察各組治療前后健康狀況(HAQ)、疾病活動指數(shù)(DAS28)、視覺模擬評分(VAS)、中醫(yī)證候、血沉(ESR)、C反應(yīng)蛋白(CRP)、抗環(huán)瓜氨酸肽(CCP)和類風(fēng)濕因子(RF)的變化。治療后中西藥組總有效率92.7%,優(yōu)于中藥組79.2%和西藥組的82.4%(P0.05);中藥組和西藥組比較無明顯差異,表明散痹湯加減治療類風(fēng)濕關(guān)節(jié)炎腎虛寒濕證具有有效性;中西藥組和中藥組中醫(yī)證候評分較西藥組改善更為明顯(P0.05);其他癥狀中西藥組改善均優(yōu)于中藥組和西藥組(P0.05),中藥組和西藥組比較無明顯差異,表明散痹湯加減可有效改善類風(fēng)濕關(guān)節(jié)炎腎虛寒濕證的臨床癥狀;不良反應(yīng)的發(fā)生率中藥組(3.8%,2/53)中西藥組(16.4%,9/55)西藥組(33.9%,18/53)(P0.05)。綜合以上研究散痹湯加減治療類風(fēng)濕關(guān)節(jié)炎腎虛寒濕證的療效與甲氨蝶呤無明顯差異,具有有效性,且不良反應(yīng)的發(fā)生率較甲氨蝶呤低;散痹湯加減結(jié)合甲氨蝶呤片治療類風(fēng)濕關(guān)節(jié)炎腎虛寒濕證具有協(xié)同增效的作用,且可降低甲氨蝶呤的不良反應(yīng)。
[Abstract]:To evaluate the efficacy and safety of Sanbi decoction in treating rheumatoid arthritis with kidney deficiency and cold dampness syndrome. 168 eligible subjects were randomly divided into Chinese medicine group, western medicine group and western medicine group with 56 cases in each group. Sangbi decoction, methotrexate and Sangbi decoction were given methotrexate for 16 weeks. (HAQ), disease activity index (DAS28), visual analogue score (VAS), (ESR), C reactive protein (CRP), (ESR) and TCM syndromes were observed before and after treatment. Changes of anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF). After treatment, the total effective rate of the Chinese and western medicine group was 92.7%, which was better than that of the traditional Chinese medicine group (79.2%) and the western medicine group (82.4%) (P0.05). There was no significant difference between the traditional Chinese medicine group and the western medicine group, which indicated that Sangbi decoction was effective in treating rheumatoid arthritis with kidney deficiency and cold dampness syndrome, and the TCM syndrome score of the traditional Chinese medicine group and the traditional Chinese medicine group was more improved than that of the western medicine group (P0.05). The improvement of other symptoms in traditional Chinese medicine group and western medicine group were better than that in traditional Chinese medicine group and western medicine group (P0.05). There was no significant difference between traditional Chinese medicine group and western medicine group, which indicated that Sangbi decoction could effectively improve the clinical symptoms of rheumatoid arthritis with kidney deficiency and cold dampness syndrome. The incidence of adverse drug reactions in the Chinese medicine group (3.8 / 53), the traditional Chinese medicine group (16.4 / 55) and the western medicine group (33.9 / 18 / 53) (P0.05). According to the above study, the curative effect of Sanbi decoction in treating rheumatoid arthritis with deficiency of kidney and cold and dampness was not significantly different from that of methotrexate, and the incidence of adverse reactions was lower than that of methotrexate. Sangbi decoction combined with methotrexate tablet has synergistic effect in treating rheumatoid arthritis with deficiency of kidney and cold and dampness, and can reduce the adverse reaction of methotrexate.
【作者單位】： 河南省中醫(yī)院;鄭州大學(xué)第二附屬醫(yī)院;
【基金】：河南省科技攻關(guān)項目(172102310322)
【分類號】：R259
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本文編號：2420036