Liu Shan-Xi, Jiang Lin, Liang Xin, Kong Wei-wei, Chen Jing, Liu Yi-guo, He Le-qin
Institute of Hematopathy, Shanxi Medical University, Xi'an, 710061, China.
Chin J Integr Med. 2007 Dec;13(4):301-5. doi: 10.1007/s11655-007-0301-8.
To study the effect and safety of graded therapy featuring integrative traditional Chinese and Western medicine for the treatment of hemophilic arthritis.
Forty patients with hemophilic arthritis were hospitalized randomly, with their blood coagulation factor activity determined by one-stage method and their arthritis classified into 4 stages. The treatment was applied according to the stage of arthritis and finding of intra-articular cavity puncture. For stage I, based on the principle of RICE (rest, ice, compression and elevation), 1.8 g of Xuefuda was medicated orally once per day, intravenous dripping of 250 mL of hemostasis mixture twice a day and 1.2 g of clindamycin per day were also given for hemostasis and anti-inflammation. For stage II-III, Kangyanling was additionally administered via intra-articular cavity injection twice a week, 2 mL every time, for 5-6 times in total. For stage IV, the drug for intra-articular cavity injection was replaced with 25 mg of sodium hyaluronate and the frequency of injection reduced to every two weeks, for 5-6 times in total. Coagulation factors III and IV as well as blood plasma were not given in the whole treatment course. Short-term therapeutic effects and adverse reaction in patients were evaluated, and the long-term effects were followed-up after patients left the hospital with 6-month consolidation therapy by Xuefuda.
After a 3-week treatment, 33 patients (82.5%) were completely remitted; 5 (12.5%) were partially remitted and 2 (5.0%) un-remitted, setting the short-term effective rate at 95.0% (38 cases). The 6-month follow-up showed that except for a relapse in 2 and 4 patients of stage III and IV respectively, long-term remission displayed in all the other 34 patients, with the remission sustaining rate being 85.0%. No complication such as an infection, bleeding or aggravating pain occurred in the 215 times intra-articular puncturing conducted in the 40 patients. Normal figures were shown in liver and kidney function, electrolytes, ECG, blood glucose and routine test of blood and urine throughout the course.
The graded treatment of integrative medicine for hemophilia with non-blood preparation has a favorable effect and is safe or without any adverse reaction, which opens a high efficacy and new safe path and thinking for the treatment of and deformity prevention in the hemophilic patients.
探讨中西医结合分级治疗对血友病性关节炎的疗效及安全性。
40例血友病性关节炎患者随机住院，采用一期法测定其凝血因子活性，并将其关节炎分为4期。根据关节炎分期及关节腔穿刺结果进行治疗。I期，依据RICE原则（休息、冰敷、加压和抬高），口服血府逐瘀达1.8g，每日1次，静脉滴注止血合剂250mL，每日2次，每日给予克林霉素1.2g以止血抗炎。II - III期，每周2次经关节腔注射康炎灵，每次2mL，共注射5 - 6次。IV期，关节腔注射药物换为透明质酸钠25mg，注射频率减为每两周1次，共注射5 - 6次。整个治疗过程未给予凝血因子III、IV及血浆。评估患者的短期治疗效果及不良反应，患者出院后用血府逐瘀进行6个月巩固治疗并随访长期疗效。
经过3周治疗，33例（82.5%）完全缓解；5例（12.5%）部分缓解，2例（5.0%）未缓解，短期有效率为95.0%（38例）。6个月随访显示，除III期和IV期分别有2例和4例复发外，其余34例均长期缓解，缓解维持率为85.0%。40例患者共进行215次关节穿刺，未发生感染、出血或疼痛加重等并发症。整个过程中肝肾功能、电解质、心电图、血糖及血尿常规均正常。
中西医结合非血液制品分级治疗血友病性关节炎疗效良好且安全，无不良反应，为血友病患者的治疗及畸形预防开辟了高效、安全的新途径及思路。
