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解毒通络利湿汤治疗反应性类风湿关节炎的临床观察

[Clinical obervation of Jiedu Tongluo Lishi decoction on treating reactive rheumatoid arthritis].

作者信息

Wen Cheng-pin, Jin Chen-yu, Xu Zhi-liang, Cao Lin-yong

机构信息

Zhejiang Traditional Chinese Medical and Medicine University, Hangzhou 310006, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2007 Jul;32(13):1306-10.

Abstract

OBJECTIVE

To explore the clinical curative effect and safety of Jiedu Tongluo Lishi decoction on treating active rheumatoid arthritis (RA).

METHOD

106 cases of RA in active period were randomly divided into the integrated Chinese and western medicine group (n=54) and western medicine contrast group (n=52). The former group were treated by Jiedu Tongluo Lishi decoction combined with SASP, the latter by MTX combined with SASP. The arthritis morning stiffness time, ache indexes, tumidness indexes, function indexes, hands grip, 20-m walking time and experimental indexes including ESR, RF, CRP, C3, immune globin of both groups were observed and compared.

RESULT

The obviously clinical effective ratio and the total clinical effective ratio in the former group were 77.78% and 90.74% respectively, which are better than those in the latter group (59.62% and 71.15% respectively) (P < 0.01). The arthritis morning stiffness time, ache indexes, tumidness indexes, function indexes, hands grip and 20-m walking time in both groups were obviously released after treatment (P < 0.01). The clinical release in the former group was better than that in the latter group (P < 0.05). ESR, RF and CRP in both groups were markedly improved (P < 0.05). The improvement of ESR, RF, CRP, C3 and IgA in the former group were better than those in the latter group (P < 0.05). The side effect includes gastroenteric tract reaction, decrease of leucocyte, abnormity of liver function, tetter and catamenia maladjustment. The occurent ratio in the former group was 7.41%, which was obviously lower than that in the latter group (15.38%) (P < 0.01).

CONCLUSION

The compositively clinical curative effect of Jiedu Tongluo Lishi decoction combined with MTX on treating RA is obviously better than that of western medicine only such as MTX and SASP, with less side effect and higher safety, which is worth applying in clinics extensively.

摘要

目的

探讨解毒通络利湿汤治疗活动期类风湿关节炎(RA)的临床疗效及安全性。

方法

将106例活动期RA患者随机分为中西医结合组(n = 54)和西药对照组(n = 52)。前者采用解毒通络利湿汤联合柳氮磺胺吡啶治疗,后者采用甲氨蝶呤联合柳氮磺胺吡啶治疗。观察并比较两组患者的关节炎晨僵时间、疼痛指数、肿胀指数、功能指数、握力、20米步行时间以及血沉(ESR)、类风湿因子(RF)、C反应蛋白(CRP)、补体C3、免疫球蛋白等实验指标。

结果

前者组的显效率和总有效率分别为77.78%和90.74%,均优于后者组(分别为59.62%和71.15%)(P < 0.01)。两组患者治疗后关节炎晨僵时间、疼痛指数、肿胀指数、功能指数、握力及20米步行时间均明显改善(P < 0.01)。前者组的临床改善情况优于后者组(P < 0.05)。两组患者的ESR、RF和CRP均显著改善(P < 0.05)。前者组ESR、RF、CRP、C3及免疫球蛋白A(IgA)的改善情况优于后者组(P < 0.05)。副作用包括胃肠道反应、白细胞减少、肝功能异常、皮疹及月经失调。前者组的发生率为7.41%,明显低于后者组(15.38%)(P < 0.01)。

结论

解毒通络利湿汤联合甲氨蝶呤治疗RA的综合临床疗效明显优于单纯使用甲氨蝶呤和柳氮磺胺吡啶等西药,副作用少,安全性高,值得临床广泛应用。

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