CAJ | 학술논문

目的：观察补益气血、祛湿通络法治疗气血不足、寒湿痹阻型类风湿关节炎的临床疗效。方法将50例气血不足、寒湿痹阻型类风湿关节炎患者随机分为治疗组25例、对照组25例。对照组口服来氟米特片、正清风痛宁片；治疗组口服来氟米特片，同时口服补益气血、祛湿通络中药。2组均以4周为1个疗程。比较2组疾病疗效，症状体征评分变化，血沉（ESR）、C-反应蛋白（CRP）、类风湿因子（RF）、血小板（PLT）等实验室指标的变化，生活质量评分变化。结果治疗组25例中，显效3例（12%），进步10例（40%），有效8例（32%），无效4例（16%），总有效率为84%；对照组25例中，显效1例（4%），进步6例（24%），有效10例（40%），无效8例（32%），总有效率为68%。经Ridit分析，U=-2.086，P＝0.043，P＜0.05，说明治疗组的疾病疗效优于对照组。治疗后治疗组关节疼痛、关节肿胀、关节压痛、晨僵时间、恶寒喜温、乏力气短、面色、肌肉麻木、多梦健忘评分均较本组治疗前降低（P＜0.05）。对照组关节疼痛、关节肿胀、关节压痛、晨僵时间、恶寒喜温、乏力气短、面色评分均较本组治疗前降低（P＜0.05），肌肉麻木、多梦健忘评分与本组治疗前比较差异均无统计学意义（P＞0.05）。治疗组关节疼痛、关节肿胀、关节压痛、晨僵时间、恶寒喜温、乏力气短、面色、肌肉麻木、多梦健忘治疗前后评分差值与对照组比较差异均有统计学意义（P＜0.05），治疗组优于对照组。治疗后2组ESR，CRP，RF，PLT较本组治疗前均降低（P＜0.05），治疗组治疗前后各差值与对照组比较差异均有统计学意义（P＜0.05），治疗组优于对照组。治疗后2组生活质量评分较本组治疗前均降低（P＜0.05），生活质量均有改善，治疗组治疗前后评分差值与对照组比较差异有统计学意义（P＜0.05），治疗组优于对照组。结论补益气血、祛湿通络法治疗气血不足、寒湿痹阻型类风湿关节炎具有较好的临床疗效。目的：觀察補益氣血、祛濕通絡法治療氣血不足、寒濕痺阻型類風濕關節炎的臨床療效。方法將50例氣血不足、寒濕痺阻型類風濕關節炎患者隨機分為治療組25例、對照組25例。對照組口服來氟米特片、正清風痛寧片；治療組口服來氟米特片，同時口服補益氣血、祛濕通絡中藥。2組均以4週為1箇療程。比較2組疾病療效，癥狀體徵評分變化，血沉（ESR）、C-反應蛋白（CRP）、類風濕因子（RF）、血小闆（PLT）等實驗室指標的變化，生活質量評分變化。結果治療組25例中，顯效3例（12%），進步10例（40%），有效8例（32%），無效4例（16%），總有效率為84%；對照組25例中，顯效1例（4%），進步6例（24%），有效10例（40%），無效8例（32%），總有效率為68%。經Ridit分析，U=-2.086，P＝0.043，P＜0.05，說明治療組的疾病療效優于對照組。治療後治療組關節疼痛、關節腫脹、關節壓痛、晨僵時間、噁寒喜溫、乏力氣短、麵色、肌肉痳木、多夢健忘評分均較本組治療前降低（P＜0.05）。對照組關節疼痛、關節腫脹、關節壓痛、晨僵時間、噁寒喜溫、乏力氣短、麵色評分均較本組治療前降低（P＜0.05），肌肉痳木、多夢健忘評分與本組治療前比較差異均無統計學意義（P＞0.05）。治療組關節疼痛、關節腫脹、關節壓痛、晨僵時間、噁寒喜溫、乏力氣短、麵色、肌肉痳木、多夢健忘治療前後評分差值與對照組比較差異均有統計學意義（P＜0.05），治療組優于對照組。治療後2組ESR，CRP，RF，PLT較本組治療前均降低（P＜0.05），治療組治療前後各差值與對照組比較差異均有統計學意義（P＜0.05），治療組優于對照組。治療後2組生活質量評分較本組治療前均降低（P＜0.05），生活質量均有改善，治療組治療前後評分差值與對照組比較差異有統計學意義（P＜0.05），治療組優于對照組。結論補益氣血、祛濕通絡法治療氣血不足、寒濕痺阻型類風濕關節炎具有較好的臨床療效。
목적：관찰보익기혈、거습통락법치료기혈불족、한습비조형류풍습관절염적림상료효。방법장50례기혈불족、한습비조형류풍습관절염환자수궤분위치료조25례、대조조25례。대조조구복래불미특편、정청풍통저편；치료조구복래불미특편，동시구복보익기혈、거습통락중약。2조균이4주위1개료정。비교2조질병료효，증상체정평분변화，혈침（ESR）、C-반응단백（CRP）、류풍습인자（RF）、혈소판（PLT）등실험실지표적변화，생활질량평분변화。결과치료조25례중，현효3례（12%），진보10례（40%），유효8례（32%），무효4례（16%），총유효솔위84%；대조조25례중，현효1례（4%），진보6례（24%），유효10례（40%），무효8례（32%），총유효솔위68%。경Ridit분석，U=-2.086，P＝0.043，P＜0.05，설명치료조적질병료효우우대조조。치료후치료조관절동통、관절종창、관절압통、신강시간、악한희온、핍력기단、면색、기육마목、다몽건망평분균교본조치료전강저（P＜0.05）。대조조관절동통、관절종창、관절압통、신강시간、악한희온、핍력기단、면색평분균교본조치료전강저（P＜0.05），기육마목、다몽건망평분여본조치료전비교차이균무통계학의의（P＞0.05）。치료조관절동통、관절종창、관절압통、신강시간、악한희온、핍력기단、면색、기육마목、다몽건망치료전후평분차치여대조조비교차이균유통계학의의（P＜0.05），치료조우우대조조。치료후2조ESR，CRP，RF，PLT교본조치료전균강저（P＜0.05），치료조치료전후각차치여대조조비교차이균유통계학의의（P＜0.05），치료조우우대조조。치료후2조생활질량평분교본조치료전균강저（P＜0.05），생활질량균유개선，치료조치료전후평분차치여대조조비교차이유통계학의의（P＜0.05），치료조우우대조조。결론보익기혈、거습통락법치료기혈불족、한습비조형류풍습관절염구유교호적림상료효。
Objective To observe the curative effect of the therapies of tonifying qi and replenishing blood, and dispelling dampness and freeing collateral vessels on rheumatoid arthritis (RA, type of deficiency of qi and blood and type of cold-dampness obstruction). Methods The patients (n=50) with RA (type of deficiency of qi and blood and type of cold-dampness obstruction) were randomly divided into treatment group and control group (each n=25). The control group was orally given leflunomide pills and Zhengqingfeng Tongning Pian, and treatment group was orally given leflunomide pills and Chinese medicinal with the actions of tonifying qi and replenishing blood, and dispelling dampness and freeing collateral vessels. A therapeutic course was 4 weeks. The curative effect, integral changes of symptom and signs, ESR, CRP, RF and PLT, and quality of life were compared between two groups. Results In treatment group, there were 3 cases (12%) with significant effect, 10 (40%) with advanced effect, 8 (32%) with effect and 4 (16%) without effect, and the total effective rate was 84%. In control group, there was 1 case (4%) with significant effect, 6 (24%) with advanced effect, 10 (40%) with effect and 8 (32%) without effect, and the total effective rate was 68%. The result of Ridit analysis showed that U=-2.086, P=0.043 and P<0.05. After treatment, the scores of symptoms, including arthralgia, arthroncus, joint tenderness, morning stiffness time, aversion to cold, preferring warmth, lack of strength, short of breath, complexion, muscle numbness, dreaminess and forgetfulness, were lower in treatment group than those before treatment (P<0.05). The scores of arthralgia, arthroncus, joint tenderness, morning stiffness time, aversion to cold, preferring warmth, lack of strength, short of breath and complexion were lower (P<0.05), and those of muscle numbness, dreaminess and forgetfulness had no statistical significance (P>0.05) in control group compared with those before treatment. The D-value of symptom scores before and after treatment had statistical significance (P<0.05) between two groups. After treatment, the levels of ESR, CRP, RF and PLT decreased in two groups (P<0.05), and D-value of laboratory indexes before and after treatment had statistical significance (P<0.05) between two groups. The scores of quality of life decreased (P<0.05) in two groups than those before treatment, and D-value of scores of quality of life before and after treatment had statistical significance (P<0.05) between two groups. Conclusion The therapies of tonifying qi and replenishing blood, and dispelling dampness and freeing collateral vessels have good curative effect on RA (type of deficiency of qi and blood and type of cold-dampness obstruction).