[清热活血汤治疗类风湿关节炎患者影像学进展的一年评估]

[One-year evaluation of radiographic progress in patients with rheumatoid arthritis treated by Qingre Huoxue decoction].

作者信息

Zhou Xin-Yao, Wang Lei, Yu Wei, Jiang Quan, Wang Ping, Tang Xiao-Po

机构信息

Department of Rheumatology, Guang'an Men Hospital, China Academy of Chinese Medical Science, Beijing 100053, China.

出版信息

Zhongguo Gu Shang. 2011 Dec;24(12):992-6.

PMID:22276506

Abstract

OBJECTIVE

To investigate the effect of Qingre Huoxue decoction, (QRHX) on radiographic progression in patients with rheumatoid arthritis (RA) with X-ray imaging.

METHODS

From July 2007 to March 2009, 86 patients with active RA who were diagnosed as damp-heat and blood stasis syndrome were randomly divided into QRHX group and QRHX plus methotrexate (MTX) group, 43 cases in each group. Patients in the QRHX group were treated with QRHX decoction [composed of Huangbai, Chishao, Bixie, Danshen, Ezhu, Qingfengteng, raw Huangqi, Jinyinhua, Tufuling, Wugong, Fengfang, raw Yiyiren, which was cooked with water as 400 ml liquid); while patients in the other group were treated with QRHX decoction plus MTX. After one-year observation, 21 patients in each group (42 in total) were evaluated,with 19 females in QRHX group, average age of (43.0 +/- 11.3) years, and the course of the disease was 2 (1,3) years; and 18 females in QRHX+MTX group, average age of (44.5 +/- 14.0) years, and the course of the disease was 3 (1.7, 5) years. Radiographs of hands were obtained at baseline and 12 months after treatment. Images were evaluated by investigators blinded to chronology and clinical data, and assessed according to Sharp/van der Heijde methods.

RESULTS

High intrareader agreements were reached (mean intraobserver intraclass coefficients: 0.95). No significant change in any imaging parameters of joint destruction was observed at 12 months after treatment in both groups; and there were no statistical differences between the two groups (P > 0.05). The severity of progress in two groups was also similar (P = 0.46), 7 patients without radiographic progress in QRHX group and 8 patients in QRHX+MTX group,3 patients with obvious radiographic progress in QRHX group and 1 patient in QRHX+MTX group.

CONCLUSION

Radiographic progress of RA patients in two groups is similar, indicating QRHX decoction has a potential role in preventing bone destruction.

摘要

目的

采用X线成像研究清热活血汤（QRHX）对类风湿关节炎（RA）患者影像学进展的影响。

方法

2007年7月至2009年3月，将86例诊断为湿热血瘀证的活动期RA患者随机分为清热活血汤组和清热活血汤联合甲氨蝶呤（MTX）组，每组43例。清热活血汤组患者服用清热活血汤（由黄柏、赤芍、萆薢、丹参、莪术、青风藤、生黄芪、金银花、土茯苓、蜈蚣、蜂房、生薏苡仁组成，水煎取汁400 ml）；另一组患者服用清热活血汤加MTX。经过一年的观察，对每组21例患者（共42例）进行评估，清热活血汤组19例女性，平均年龄（43.0±11.3）岁，病程为2（1，3）年；清热活血汤+MTX组18例女性，平均年龄（44.5±14.0）岁，病程为3（1.7，5）年。在基线和治疗12个月后获取手部X线片。由对时间顺序和临床资料不知情的研究者对图像进行评估，并根据Sharp/van der Heijde方法进行评定。

结果

阅片者间一致性较高（平均观察者内组内相关系数：0.95）。两组在治疗12个月后关节破坏的任何影像学参数均未观察到显著变化；两组间无统计学差异（P>0.05）。两组进展的严重程度也相似（P = 0.46），清热活血汤组7例无影像学进展，清热活血汤+MTX组8例；清热活血汤组3例有明显影像学进展，清热活血汤+MTX组1例。