【摘要】：目的探討陳氏清肺方(太子參、麥冬、沙參,等)治療類風濕關節(jié)炎合并肺間質病變(RA-ILD)的臨床療效。方法均使用強的松用藥的RA-ILD患者,用區(qū)組隨機按數字表法分為對照組和觀察組(另加陳氏清肺方)。兩組療程均為3個月。治療前評價疾病活動度(DAS28),檢測紅細胞沉降率(ESR)、C反應蛋白(CRP)、類風濕因子(RF)、抗環(huán)瓜氨酸肽抗體(CCP抗體)。進行治療前后高分辨CT(HRCT)檢查并評分及觀察記錄中醫(yī)證候體征。結果治療后觀察組在咳嗽、咳痰和氣短等中醫(yī)證候積分有明顯改善,總有效率達71%,對照組改善的總有效率為23%。治療后觀察組HRCT肺部影像學改善總有效率68%,對照組總有效率13%。結論在治療RA用藥不變的基礎上,陳氏清肺方能明顯改善RA-ILD患者的咳嗽、咳痰和氣短等癥狀,HRCT影像學證實能明顯改善肺間質病變的面積和嚴重程度。
文內圖片：
圖片說明：觀察組治療前后HＲCT檢查對比
[Abstract]:Objective to investigate the clinical effect of Chen Shi Qingfei recipe (Panax quinquefolium, Ophiopogon japonicus, Panax quinquefolium, etc.) in the treatment of rheumatoid arthritis complicated with pulmonary stroma lesion (RA-ILD). Methods RA-ILD patients who were treated with prednisone were randomly divided into control group and observation group (plus Chen's Qingfei recipe) according to the method of digital table. The course of treatment in both groups was 3 months. The disease activity (DAS28) was evaluated before treatment, and the erythrocyte sedimentation rate (ESR), C) reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (CCP antibody) was detected. High resolution CT (HRCT) was performed before and after treatment, and the symptoms and signs of TCM syndromes were observed and recorded. Results after treatment, the scores of TCM syndromes such as cough, expectoration and shortness of breath were significantly improved in the observation group, and the total effective rate was 71% in the observation group and 23% in the control group. After treatment, the total effective rate of HRCT pulmonary imaging improvement was 68% in the observation group and 13% in the control group. Conclusion Chen's Qingfei recipe can obviously improve the symptoms of cough, expectoration and shortness of breath in RA-ILD patients on the basis of constant treatment of RA. HRCT imaging can significantly improve the area and severity of pulmonary stroma lesions.
【作者單位】： 揚州大學醫(yī)學院;上海市光華中西醫(yī)結合醫(yī)院;上海中醫(yī)藥大學關節(jié)病研究所;
【基金】：上海市長寧區(qū)衛(wèi)生和計劃生育委員會科研基金(CNKW2013J05)
【分類號】：R259

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