风湿病与关节炎
風濕病與關節炎
풍습병여관절염
Rheumatism and Arthritis
2014年
11期
15-19
,共5页
郭燕芬%吴宽裕%赵钟文%吴方真
郭燕芬%吳寬裕%趙鐘文%吳方真
곽연분%오관유%조종문%오방진
关节炎,类风湿%湿热痹阻型%中医药优化方案%雷公藤合剂%不良反应%血常规%肝肾功能%性激素
關節炎,類風濕%濕熱痺阻型%中醫藥優化方案%雷公籐閤劑%不良反應%血常規%肝腎功能%性激素
관절염,류풍습%습열비조형%중의약우화방안%뢰공등합제%불량반응%혈상규%간신공능%성격소
arthritis,rheumatoid%dampness-heat-blockage type%optimized scheme of TCM%Tripterygium Wilfordii Mixture%adverse reaction%routine blood test%liver and kidney function%sex hormone
目的:观察中医药优化方案治疗湿热痹阻型活动期类风湿关节炎出现的不良反应及性激素变化对病情的影响。方法:将60例类风湿关节炎患者随机分为优化方案组(治疗组)和对照组,每组30例。对照组给予西药甲氨蝶呤+来氟米特,中药宣痹汤合二妙散加减;治疗组在对照组治疗的基础上给予雷公藤合剂,并配合关节操。两组均以3个月为1个疗程。比较两组治疗前及治疗4,8,12周血常规、肝肾功能、性激素水平及不良反应的差异。结果:两组白细胞计数(WBC)、谷丙转氨酶(ALT)、性激素(包括促卵泡生成素、促黄体生成素、雌二醇、睾酮、垂体泌乳素)水平与治疗前比较,差异有统计学意义(P<0.05);血肌酐(SCr)与治疗前比较,差异无统计学意义(P>0.05);两组间WBC、ALT、SCr、性激素水平比较,差异无统计学意义(P>0.05)。两组均有轻微的不良反应,对症处理后恢复正常,不影响治疗。治疗组WBC下降2例,消化道反应2例,肝功能损害1例,月经量减少1例,不良反应发生率为20.00%;对照组WBC下降1例,消化道反应1例,肝功能损害2例,皮肤过敏1例,不良反应发生率为16.66%。两组比较,差异无统计学意义(P>0.05)。结论:中医药优化方案治疗湿热痹阻型活动期类风湿关节炎未出现严重不良反应,临床应用安全性好。
目的:觀察中醫藥優化方案治療濕熱痺阻型活動期類風濕關節炎齣現的不良反應及性激素變化對病情的影響。方法:將60例類風濕關節炎患者隨機分為優化方案組(治療組)和對照組,每組30例。對照組給予西藥甲氨蝶呤+來氟米特,中藥宣痺湯閤二妙散加減;治療組在對照組治療的基礎上給予雷公籐閤劑,併配閤關節操。兩組均以3箇月為1箇療程。比較兩組治療前及治療4,8,12週血常規、肝腎功能、性激素水平及不良反應的差異。結果:兩組白細胞計數(WBC)、穀丙轉氨酶(ALT)、性激素(包括促卵泡生成素、促黃體生成素、雌二醇、睪酮、垂體泌乳素)水平與治療前比較,差異有統計學意義(P<0.05);血肌酐(SCr)與治療前比較,差異無統計學意義(P>0.05);兩組間WBC、ALT、SCr、性激素水平比較,差異無統計學意義(P>0.05)。兩組均有輕微的不良反應,對癥處理後恢複正常,不影響治療。治療組WBC下降2例,消化道反應2例,肝功能損害1例,月經量減少1例,不良反應髮生率為20.00%;對照組WBC下降1例,消化道反應1例,肝功能損害2例,皮膚過敏1例,不良反應髮生率為16.66%。兩組比較,差異無統計學意義(P>0.05)。結論:中醫藥優化方案治療濕熱痺阻型活動期類風濕關節炎未齣現嚴重不良反應,臨床應用安全性好。
목적:관찰중의약우화방안치료습열비조형활동기류풍습관절염출현적불량반응급성격소변화대병정적영향。방법:장60례류풍습관절염환자수궤분위우화방안조(치료조)화대조조,매조30례。대조조급여서약갑안접령+래불미특,중약선비탕합이묘산가감;치료조재대조조치료적기출상급여뢰공등합제,병배합관절조。량조균이3개월위1개료정。비교량조치료전급치료4,8,12주혈상규、간신공능、성격소수평급불량반응적차이。결과:량조백세포계수(WBC)、곡병전안매(ALT)、성격소(포괄촉란포생성소、촉황체생성소、자이순、고동、수체비유소)수평여치료전비교,차이유통계학의의(P<0.05);혈기항(SCr)여치료전비교,차이무통계학의의(P>0.05);량조간WBC、ALT、SCr、성격소수평비교,차이무통계학의의(P>0.05)。량조균유경미적불량반응,대증처리후회복정상,불영향치료。치료조WBC하강2례,소화도반응2례,간공능손해1례,월경량감소1례,불량반응발생솔위20.00%;대조조WBC하강1례,소화도반응1례,간공능손해2례,피부과민1례,불량반응발생솔위16.66%。량조비교,차이무통계학의의(P>0.05)。결론:중의약우화방안치료습열비조형활동기류풍습관절염미출현엄중불량반응,림상응용안전성호。
Objective:To observe the adverse reaction in the treatment of dampness-heat-blockage-type rheumatoid arthritis with optimized scheme of traditional Chinese medicine to probe the impact of changes of sex hormones on patient’s condition.Methods:60 cases with rheumatoid arthritis were randomly divided into a treatment group and a control group,30 cases in each.The control group were given methotrexate,lelfunomide,and the combination of modiifed Xuanbi Decoction and Ermiao San;while the treatment group,based on the treatment of the control group,were given Tripterygium Wilfordii Mixture combined with joint exercise.Two groups were treated for 1 course(3 months).Comparisons were made on the aspects of blood routine,liver and kidney functions,sex hormone levels and adverse reaction of the two groups before and 4,8,12 weeks after the treatment. Results:After 12 weeks,comparing the blood cell count(WBC),alanine transarninase(ALT),and sex hormone (including follicle stimulating hormone,luteinizing hormone,estradiol,testosterone,prolactin level) of the two groups with those before the treatment,the differences were statistically significant (P < 0.05);the difference of serum creatinine (SCr) before and after the treatment was not significant(P > 0.05);the difference between the levels of WBC,ALT,SCr and sex hormone between the two groups had no significant difference(P > 0.05).There are mild adverse reactions of the two groups,returning to normal after proper treatment and having no effects on the treatment.In the treatment group, 2 cases had leukopenia,2 cases had gastrointestinal reaction,1 case had liver function damage,and the menstrual blood volume reduced in 1 case,the incidence rate of adverse reaction being 20%;while in the control group, 1 case had leukopenia,1 case had gastrointestinal reaction,2 cases had liver function damage,and 1 case had skin allergy,the rate of adverse reaction being 16.66%.The difference between the two groups was not significant (P > 0.05).Conclusion:There were no serious adverse reactions in the treatment of dampness-heat-blockagetype rheumatoid arthritis with optimized scheme of traditional Chinese medicine,safe in clinical application.