文献类型：期刊文献

中文题名：身痛逐瘀汤联合西药治疗类风湿关节炎瘀血痹阻证的临床观察

英文题名：Clinical Observation on Effect of Shentong Zhuyutang Combined with Western Medicine in Treating Rheumatoid Arthritis with Blood Stasis Syndrome

作者：王佳[1];王钢[1];王涛[1];田杰祥[1];杨芳[1];王丽琴[1];刘海龙[1]

第一作者：王佳

机构：[1]甘肃中医药大学附属医院,兰州730020

第一机构：甘肃中医药大学第二附属医院

年份：2017

卷号：23

期号：24

起止页码：185

中文期刊名：中国实验方剂学杂志

外文期刊名：Chinese Journal of Experimental Traditional Medical Formulae

收录：CSTPCD;;北大核心:【北大核心2014】；CSCD:【CSCD_E2017_2018】；

基金：甘肃省第二批全省五级中医药师承教育工作项目(2014-123)

语种：中文

中文关键词：身痛逐瘀汤;联合用药;瘀血痹阻;类风湿关节炎

外文关键词：Shentong Zhuyutang; combined administration; blood stasis syndrome; rheumatoid arthritis

摘要：目的:探讨身痛逐瘀汤联合西药治疗类风湿关节炎的临床疗效及安全性。方法:将120例类风湿关炎患者根据随机数字表法分为治疗组和对照组,各60例。基础治疗给予甲氨喋呤10 mg/次,1次/周,口服,来氟米特20 mg/次,1次/d,口服,对照组在基础治疗上加用雷公藤多苷片,治疗组在基础治疗上加用身痛逐瘀汤。连续治疗12周后分析两组患者的临床疗效差异,并观察两组患者晨僵时间,关节压痛数,肿胀数,休息痛,双手握力,20 m步行时间及健康评价问卷评分以及实验室指标血沉(ESR),C-反应蛋白(CRP),类风湿因子(RF),瘤坏死因子-α(TNF-α),白细胞介素-1(IL^(-1))水平变化情况。结果:治疗组总有效率91.7%,高于对照组的83.3%(P<0.05);治疗后与对照组比较,治疗组DAS28评分,患者晨僵时间,休息痛,关节压痛个数,肿胀个数,20 m步行时间、和健康状况问卷(HAQ)评分均低于对照组,双手握力高于对照组(P<0.05);治疗组患者CRP,ESR,RF,TNF-α及IL^(-1)水平低于对照组(P<0.05)。结论:身痛逐瘀汤联合西药治疗类风湿关节炎在提高疗效、控制症状、改善实验室指标等方面均有较强的优势,且安全性较高,值得临床推广应用。
Objective： To explore the clinical efficacy and safety of Shentong Zhuyutang combined with western medicine in the treatment of rheumatoid arthritis. Method： A total of 120 patients with rheumatoid arthritis were randomly divided into treatment group and control group,with 60 cases in each group. The basic therapy included methotrexate 10 mg/time,1 time/week,Leflunomide,20 mg/time,1 time/d,for oral administration. In addition to the basic therapy,the control group was also given Tripterygium glycosides tablets,while the treatment group was also given Shentong Zhuyutang. After 12 weeks of continuous treatment,the differences in the clinical curative effect between two groups were analyzed. Morning stiffness time,tender joint count,swollen joint count,resting pain,20 m walking time,health evaluation questionnaire,as well as laboratory indexes C-reactive protein（ CRP）,rheumatoid factor（ RF）,tumor necrosis factor-α（ TNF-α） and interleukin-1（ IL^-1） were observed.Result： The total effective rate of the treatment group was 91. 7%,which was higher than 83. 3% of control group,with statistically significant differences between two groups（ P〈0. 05）. Compared with control group,DAS28 score,morning stiffness,rest pain,tender joint count,swollen joint count,20 m walking time and HAQ score of the treatment group were lower than those of the control group,but with handgrip strength higher than control group（ P〈0. 05）. CRP,ESR,RF,TNF-α and IL^-1 in treatment group were significantly lower than those in the control group（ P〈0. 05）. Conclusion： Shentong Zhuyutang combined with western medicine showed stronger advantages in improving efficacy,controlling symptoms,improving laboratory indexes in the treatment of rheumatoid arthritis,with a higher safety,and is worth clinical promotion and application.