国际中医中药杂志
國際中醫中藥雜誌
국제중의중약잡지
INTERNATIONAL JOURNAL OF TRIDITIONAL CHINESE MEDICINE
2014年
8期
685-688
,共4页
谢友明%冯颜杰%杜若晨%黄翰
謝友明%馮顏傑%杜若晨%黃翰
사우명%풍안걸%두약신%황한
类风湿性关节炎%独活寄生汤%临床研究
類風濕性關節炎%獨活寄生湯%臨床研究
류풍습성관절염%독활기생탕%림상연구
Rheumatoid arthritis%Duhuo-Jisheng decoction%Clinical study
目的:观察独活寄生汤加减配合西医常规疗法治疗类风湿性关节炎(rheumatoid arthritis, RA)的临床疗效。方法收集2010年1月至2013年8月湘雅博爱康复医院骨科门诊患者120例,均符合RA诊断标准,按病例尾号将患者随机分为两组各60例,对照组口服甲氨蝶呤(7.5 mg/次,1次/周),柳氮磺吡啶(2~3 g/d),美洛昔康片(7.5 mg/次,2次/d),有胃肠道反应时减量或停服,待症状缓解后续服。治疗组在对照组治疗基础上加服独活寄生汤。两组均治疗1个月为1个疗程,治疗3个疗程后观察并比较两组患者临床疗效,以及红细胞沉降率(ESR)、C 反应蛋白(CRP)、类风湿因子(RF)等指标变化。结果治疗后治疗组总有效率为90.0%(54/60);对照组为70.0%(42/60),两组总有效率比较,差异有统计学意义(χ2=4.193,P<0.05)。治疗后CRP、ESR、RF[治疗组分别为(22.06±10.31)mg/L、(25.18±17.80)mm/h、(28.19±4.17)IU/L,对照组分别为(14.11±7.32)mg/L、(24.16±22.09)mm/h、(36.08±5.24)IU/L]均较同组治疗前[治疗组分别为(82.16±21.37)mg/L、(68.84±9.71)mm/h、(84.92±15.31)IU/L,对照组分别为(52.46±22.26)mg/L、(62.72±33.31)mm/h、(85.17±14.23)IU/L]降低(P<0.01);治疗组的CRP 降低情况优于对照组(P<0.05)。治疗后关节压痛数、关节肿胀数、晨僵时间、双手握力、20 m步行时间[治疗组分别为(3.43±1.46)个、(2.95±1.35)个、(19.32±16.54)min、(79.35±22.14)mmHg、(19.32±4.81)s,对照组分别为(4.63±4.21)个、(3.55±2.47)个、(21.23±19.37)min、(77.81±16.22)mmHg、(25.15±5.81)s]均较同组治疗前[治疗组分别为(10.71±5.12)个、(7.95±3.97)个、(109.32±68.52)min、(47.12±18.22)mmHg、(36.21±6.62)s,对照组为(11.54±5.32)个、(7.64±4.01)个、(96.02±58.39)min、(49.67±16.48)mmHg、(36.33±7.23)s]改善(P<0.05),其中治疗组关节压痛数、关节肿胀数、20 m步行时间均优于对照组(P<0.05)。结论独活寄生汤加味配合常规疗法可有效减轻RA患者的临床症状,降低ESR、CRP、RF水平。
目的:觀察獨活寄生湯加減配閤西醫常規療法治療類風濕性關節炎(rheumatoid arthritis, RA)的臨床療效。方法收集2010年1月至2013年8月湘雅博愛康複醫院骨科門診患者120例,均符閤RA診斷標準,按病例尾號將患者隨機分為兩組各60例,對照組口服甲氨蝶呤(7.5 mg/次,1次/週),柳氮磺吡啶(2~3 g/d),美洛昔康片(7.5 mg/次,2次/d),有胃腸道反應時減量或停服,待癥狀緩解後續服。治療組在對照組治療基礎上加服獨活寄生湯。兩組均治療1箇月為1箇療程,治療3箇療程後觀察併比較兩組患者臨床療效,以及紅細胞沉降率(ESR)、C 反應蛋白(CRP)、類風濕因子(RF)等指標變化。結果治療後治療組總有效率為90.0%(54/60);對照組為70.0%(42/60),兩組總有效率比較,差異有統計學意義(χ2=4.193,P<0.05)。治療後CRP、ESR、RF[治療組分彆為(22.06±10.31)mg/L、(25.18±17.80)mm/h、(28.19±4.17)IU/L,對照組分彆為(14.11±7.32)mg/L、(24.16±22.09)mm/h、(36.08±5.24)IU/L]均較同組治療前[治療組分彆為(82.16±21.37)mg/L、(68.84±9.71)mm/h、(84.92±15.31)IU/L,對照組分彆為(52.46±22.26)mg/L、(62.72±33.31)mm/h、(85.17±14.23)IU/L]降低(P<0.01);治療組的CRP 降低情況優于對照組(P<0.05)。治療後關節壓痛數、關節腫脹數、晨僵時間、雙手握力、20 m步行時間[治療組分彆為(3.43±1.46)箇、(2.95±1.35)箇、(19.32±16.54)min、(79.35±22.14)mmHg、(19.32±4.81)s,對照組分彆為(4.63±4.21)箇、(3.55±2.47)箇、(21.23±19.37)min、(77.81±16.22)mmHg、(25.15±5.81)s]均較同組治療前[治療組分彆為(10.71±5.12)箇、(7.95±3.97)箇、(109.32±68.52)min、(47.12±18.22)mmHg、(36.21±6.62)s,對照組為(11.54±5.32)箇、(7.64±4.01)箇、(96.02±58.39)min、(49.67±16.48)mmHg、(36.33±7.23)s]改善(P<0.05),其中治療組關節壓痛數、關節腫脹數、20 m步行時間均優于對照組(P<0.05)。結論獨活寄生湯加味配閤常規療法可有效減輕RA患者的臨床癥狀,降低ESR、CRP、RF水平。
목적:관찰독활기생탕가감배합서의상규요법치료류풍습성관절염(rheumatoid arthritis, RA)적림상료효。방법수집2010년1월지2013년8월상아박애강복의원골과문진환자120례,균부합RA진단표준,안병례미호장환자수궤분위량조각60례,대조조구복갑안접령(7.5 mg/차,1차/주),류담광필정(2~3 g/d),미락석강편(7.5 mg/차,2차/d),유위장도반응시감량혹정복,대증상완해후속복。치료조재대조조치료기출상가복독활기생탕。량조균치료1개월위1개료정,치료3개료정후관찰병비교량조환자림상료효,이급홍세포침강솔(ESR)、C 반응단백(CRP)、류풍습인자(RF)등지표변화。결과치료후치료조총유효솔위90.0%(54/60);대조조위70.0%(42/60),량조총유효솔비교,차이유통계학의의(χ2=4.193,P<0.05)。치료후CRP、ESR、RF[치료조분별위(22.06±10.31)mg/L、(25.18±17.80)mm/h、(28.19±4.17)IU/L,대조조분별위(14.11±7.32)mg/L、(24.16±22.09)mm/h、(36.08±5.24)IU/L]균교동조치료전[치료조분별위(82.16±21.37)mg/L、(68.84±9.71)mm/h、(84.92±15.31)IU/L,대조조분별위(52.46±22.26)mg/L、(62.72±33.31)mm/h、(85.17±14.23)IU/L]강저(P<0.01);치료조적CRP 강저정황우우대조조(P<0.05)。치료후관절압통수、관절종창수、신강시간、쌍수악력、20 m보행시간[치료조분별위(3.43±1.46)개、(2.95±1.35)개、(19.32±16.54)min、(79.35±22.14)mmHg、(19.32±4.81)s,대조조분별위(4.63±4.21)개、(3.55±2.47)개、(21.23±19.37)min、(77.81±16.22)mmHg、(25.15±5.81)s]균교동조치료전[치료조분별위(10.71±5.12)개、(7.95±3.97)개、(109.32±68.52)min、(47.12±18.22)mmHg、(36.21±6.62)s,대조조위(11.54±5.32)개、(7.64±4.01)개、(96.02±58.39)min、(49.67±16.48)mmHg、(36.33±7.23)s]개선(P<0.05),기중치료조관절압통수、관절종창수、20 m보행시간균우우대조조(P<0.05)。결론독활기생탕가미배합상규요법가유효감경RA환자적림상증상,강저ESR、CRP、RF수평。
Objective To evaluate the effects of rheumatoid arthritis treated with modified Duhuo-Jisheng decoction and western conventional treatment. Methods 120 patients with heumatoid arthritis of our hospital from January 2010 to 2013 August were recruited and randomly divided into a treatment group and a control group, 60 patients in each group. The control group was treated with oral intake of Methotrexate, Sulfasalazine and Meloxicam in acute stage and oral intake of diclofenc in stable stage, while the treatment group was further added modified Duhuo-Jisheng decoction on the basis of the control group. TCM symptom score, arthritis symptom score, symptomatic relief time, ESR, CRP, RF were observed after 3 months’ treatment. Results After 3 mouths’ treatment, the total effective rate was 90.0%(54/60) in the study group and 70.0%(42/64) in the control group. There was no significant difference(χ2=4.193,P<0.05) between the two groups. CRP,ESR, RF[The treatment group respectively(22.06±10.31)mg/L, (25.18±17.80)mm/h, (28.19±4.17)IU/L,the control group respectively (14.11±7.32)mg/L, (24.16±22.09)mm/h, (36.08±5.24)IU/L]decreased after the treatment in both groups compared with the values before the treatment[The treatment group respectively (82.16± 21.37)mg/L, (68.84±9.71)mm/h, (84.92±15.31)IU/L,the control group respectively (52.46±22.26)mg/L, (62.72±33.31)mm/h, (85.17±14.23)IU/L, P<0.01],while the decrease of CRP in the treatment group was much obvious than the control group(P<0.05),but the change of ESR had no statistical significance between the two group after the treatment(P>0.05);Number of joint tenderness, The number of swollen joints, Time of morning stiffness, Dual hands grip strength , 20 m walking time decreased obviously in both groups after the treatment[After the treatment, the treatment group respectively (3.43 ± 1.46), (2.95 ± 1.35), (19.32 ± 16.54)min,(79.35±22.14)mmHg,(19.32±4.81)s,the control group respectively (4.63±4.21), (3.55±2.47), (21.23 ± 19.37)min,(77.81 ± 16.22)mmHg,(25.15 ± 5.81)s before the treatment, the treatment group respectively(10.71±5.12), (7.95±3.97), (109.32±68.52)min, (47.12±18.22)mmHg, (36.21±6.62)s, the control group respectively (11.54±5.32), (7.64±4.01), (96.02±58.39)min, (49.67±16.48)mmHg, (36.33± 7.23)s](P<0.05). Conclusion Duhuo-Jisheng decoction could effectively improve the clinical symptoms of aged patients with osteoporosis and reduce the levels of their ESR, CRP, and RF.