摘要
[目的]观察辨证分型联合西药治疗类风湿性关节炎疗效。[方法]使用随机平行对照方法,将100例门诊患者按随机数字表方法随机分为两组。对照组50例双氯芬酸,75mg/次,1次/d;甲氨蝶呤,5mg/次,1次/周;来氟米特,初始剂量20mg/次,1次/d,根据具体情况,增至50mg/次,1次/d。治疗组50例辨证分型,中药方剂水煎200m L,口服,2次/d,西药治疗同对照组;寒湿痹症-当归四逆汤合小活络丸(当归、没药、乳香、地龙、桂枝、通草、大枣、胆南星~制各10g,白芍15g,川乌~制6g);阴虚湿热-猪苓桂枝芍药知母汤(猪苓、桂枝、知母、泽泻、地龙、防风、阿胶、白术各10g,赤芍、滑石各15g,川乌~制6g);正虚邪恋-阳和汤(当归、地黄~熟、淫羊藿各15g,桃仁、红花、川芎、桂枝、麻黄、地龙、鹿角胶、白芥子各10g,川乌~制6g);痰瘀互结-桃红四物汤合二陈汤(川芎6g,牛膝、白芍各9g,红花、桃仁各10g,地黄~熟、当归各20g,半夏、橘红各15g,茯苓9g,甘草~炙4.5g)。连续治疗4周为1疗程。观测临床症状、疼痛评分、晨僵时间、不良反应。连续治疗3疗程(12周),判定疗效。[结果]治疗组显效27例,有效21例,无效2例,总有效率96.00%;对照组显效18例,有效22例,无效10例,总有效率80.00%;治疗组疗效优于对照组(P<0.05)。疼痛评分、晨僵时间两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]辨证分型联合西药治疗类风湿性关节炎,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of syndrome differentiation combined with western medicine in treating rheumatoid arthritis. [Methods] Using random parallel control method, 100 outpatients were randomly divided into two groups according to the random number table method. In the control group, 50 cases were diclofenac, 75 mg/times, 1 times/d; methotrexate, 5 mg/times, 1 times/week; leflunomide, initial dose 20 mg/times, 1 times/d, to 50 mg/times, 1 times/d according to the specific condition. Treatment group 50 cases of syndrome differentiation, decoction of traditional Chinese medicine decoction 200 m L, oral, 2 times/d, western medicine treatment with the control group; cold dampness arthralgia-Angelica four inverse soup combined with small activating collaterals pills（Danggui, Moyao, Ruxiang, Dilong, Guizhi, Tongcao, Dazao, Dannanixng each 10 g, Baishao 15 g, Zhichuanwu 6 g）; Yin deficiency and damp heat-hog Guizhi peony Paeonia soup（Zhuling, Guizhi, Zhimu, Zexie, Dilong, Fangfeng, Ejiao, Baizhu each 10 g,Chishao,Huashai each 15 g, zhichuanwu 6 g）Yang Hetang（Danghui, Shudi, Yinyanghuo each 15 g, Taoren, Honghua,Chuanxiong,Guizhi, Mahuang, Dilong, Lujiaojiao, Baijiezi each 10 g, Zhichuanwu 6 g）; phlegm and blood stasis to peach red four Two Chen Tang（Ligusticum chuanxiong 6 g, Radix Achyranthes, Paeonia lactiflora 9 g, safflower, peach kernel each 10 g, cooked ground yellow, angelica 20 g, pinellia, tangerine 15 g, tuckahoe 9 g, licorice 4.5 g）. Continuous treatment for 4 weeks was the 1 course of treatment. Clinical symptoms, pain scores, morning stiffness and adverse reactions were observed. 3 courses of continuous treatment（12 weeks） were used to determine the curative effect. [Results] 27 cases were found in the treatment group, 21 cases were effective, 2 cases were invalid, the total effective rate was 96%, the control group was 18 cases, 22 cases were effective, 10 cases were invalid and the total effective rate was 80%. The curative effect of the treatment group was better than the control group（P〈0.05）. Pain score and morning stiffness time were improved in the two groups（P〈0.01）,and the improvement in the treatment group was better than that in the control group （P〈0.01）. [Conclusion]Syndrome differentiation combined with western medicine in the treatment of rheumatoid arthritis has satisfactory curative effect, no serious adverse reactions, and is worthy of promotion.
作者
沈萍
沈忠达
SHEN Ping, SHEN Zhongda(Department of Rheumatism,Jiamusi Traditional Chinese Medicine Hospital,Jiamusi 154002, Heilongjiang,Chin)
出处
《实用中医内科杂志》
2018年第6期25-28,共4页
Journal of Practical Traditional Chinese Internal Medicine
关键词
类风湿性关节炎
痹症
辨证分型
寒湿
阴虚湿热
正虚邪恋
痰瘀互结
当归四逆汤
小活络丸
猪苓桂枝芍药知母汤
阳和汤
桃红四物汤
二陈汤
双氯芬酸
甲氨蝶呤
来氟米特
疼痛评分
晨僵时间
中药复方
随机平行对照研究
rheumatoid arthritis
arthralgia
syndrome differentiation
cold dampness
Yin deficiency and damp heat
positive and evil spirit
phlegm and blood stasis
Danggui Sini decoction （当归四逆汤）
Xiaohuoluowan（小活络丸）
Zhuling Guizhi Shaoyao Zhimu decoction（猪苓桂枝芍药知母汤）
Yanghe de-coction（阳和汤）
Taohong Siwu decoction（桃红四物汤）
Erchen decoctio（二陈汤）
diclofenac
methotrexate
leflunomide
pain score
morning stiffness
Chinese medicine compound
parallel control study of machine
