Huang Yi-Min, Zhuang Yu, Tan Zhi-Ming
Department of Rheumatology and Immunology, Huizhou Central People's Hospital, Huizhou 516001, Guangdong Province, China.
World J Clin Cases. 2022 Jan 7;10(1):35-42. doi: 10.12998/wjcc.v10.i1.35.
Rheumatoid arthritis (RA) is a prevalent clinical autoimmune disease that is commonly treated with diclofenac and methotrexate. In recent years, the application of traditional Chinese medicine in RA has received widespread attention; it promotes blood circulation, strengthens the immune system, and eliminates evil. The sinomenine preparation of Zhingqeng Fengtongning is studied as a possible treatment for patients with RA.
To explore the value of sinomenine injection into the articular cavity for the treatment of RA.
A total of 94 patients with RA treated from January 2019 to January 2021 were selected and divided into the study and control groups with 47 patients each using a simple random number table method. Both groups received conventional treatment with diclofenac sodium and methotrexate tablets. The control group received diproxone and lidocaine by intra-articular administration while the study group received an intra-articular administration of the sinomenine preparation of Zhengqing Fengning and lidocaine. test was used to evaluate the therapeutic effect and synovial thickness, degree of pain through the visual analog scale (VAS), blood flow grade, arthroinflammatory indexes [rheumatoid factor (RF), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR)] before and after treatment in the two groups.
The total effective rate of the study group (93.62%) was higher than that of the control group (78.72%) ( < 0.05). Before treatment, there were no significant differences between the two groups in terms of synovial thickness, VAS score, blood flow grading, levels of RF, and ESR ( > 0.05). After treatment, the synovial thickness and VAS score were significantly lower ( < 0.05) in the study group than in the control group (2.05 ± 0.59 mm 2.87 ± 0.64 mm and 2.11 ± 0.62 2.90 ± 0.79 scores, respectively). The rate of blood flow at grade 0 in the study group (76.60%) was higher than that in the control group (57.45%), and the rate of blood flow at grade I (10.64%) was lower than that in the control group (31.91%) ( < 0.05). Furthermore, the levels of RF (55.61 ± 6.13 U/mL), CRP (11.43 ± 3.59 mg/L), and ESR (29.60 ± 5.56 mm/h) in the study group were lower than those in the control group (73.04 ± 9.23 U/mL, 15.07 ± 4.06 mg/L, 36.64 ± 6.10 mm/h, respectively) ( < 0.05).
Sinomenine administration of Zhengqing Fengtongning in the articular cavity with conventional treatment of RA can improve ultrasonographic blood flow and synovial thickness, reduce pain, regulate inflammation, and enhance therapeutic effect.
类风湿关节炎（RA）是一种常见的临床自身免疫性疾病，通常用双氯芬酸和甲氨蝶呤治疗。近年来，中药在RA中的应用受到广泛关注；其具有促进血液循环、增强免疫系统和祛邪的作用。研究正清风痛宁的青藤碱制剂作为RA患者的一种可能治疗方法。
探讨关节腔内注射青藤碱治疗RA的价值。
选取2019年1月至2021年1月治疗的94例RA患者，采用简单随机数字表法分为研究组和对照组，每组47例。两组均接受双氯芬酸钠和甲氨蝶呤片常规治疗。对照组关节腔内注射得宝松和利多卡因，研究组关节腔内注射正清风宁青藤碱制剂和利多卡因。采用检验评估两组治疗前后的治疗效果、滑膜厚度、通过视觉模拟评分法（VAS）评估的疼痛程度、血流分级、关节炎症指标[类风湿因子（RF）、C反应蛋白（CRP）和红细胞沉降率（ESR）]。
研究组总有效率（93.62%）高于对照组（78.72%）（P<0.05）。治疗前，两组在滑膜厚度、VAS评分、血流分级、RF水平和ESR方面无显著差异（P>0.05）。治疗后，研究组的滑膜厚度和VAS评分显著低于对照组（P<0.05）（分别为2.05±0.59mm对2.87±0.64mm和2.11±0.62对2.90±0.79分）。研究组0级血流率（76.60%）高于对照组（57.45%），I级血流率（10.64%）低于对照组（31.91%）（P<0.05）。此外，研究组的RF（55.61±6.13U/mL）、CRP（11.43±3.59mg/L）和ESR（29.60±5.56mm/h）水平低于对照组（分别为73.04±9.23U/mL、15.07±4.06mg/L、36.64±6.10mm/h）（P<0.05）。
正清风痛宁青藤碱制剂关节腔内给药联合RA常规治疗可改善超声血流和滑膜厚度，减轻疼痛，调节炎症，提高治疗效果。
