摘要
目的:探讨活络效灵方加减治疗瘀阻型类风湿关节炎的临床疗效及作用机制。方法:选取我院2017年8月~2021年2月收治的瘀阻型类风湿关节炎110例作为研究对象,随机数字表法分为观察组与对照组各55例,对照组予口服常规治疗药物,观察组在对照组基础上予口服活络效灵方加减,观察患者症状及体征、中医证候积分、生活质量、实验室指标[C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)、白细胞介素-6(IL-6)]、临床疗效及不良反应。结果:(1)两组关节肿胀、关节压痛、关节肿胀指数、休息痛、晨僵时间较前显著降低(P<0.05),双手平均握力较前显著升高(P<0.05),且观察组较对照组改善显著(P<0.05);(2)两组中医证候积分较前显著降低(P<0.05),且观察组显著降低于对照组(P<0.05);(3)两组生活质量各指标及总评分较前显著上升(P<0.05),且观察组显著高于对照组(P<0.05);(4)两组实验室各指标较前显著降低(P<0.05),且观察组显著降低于对照组(P<0.05);(5)观察组ACR20和DAS28改善率高于对照组(P<0.05);(6)观察组总不良反应率4%显著低于对照组13%(P<0.05)。结论:活络效灵方加减用于瘀阻型类风湿关节炎患者治疗中,可有效减轻患者临床症状及体征,缓解中医证候,提高疗效及生活质量,减少不良反应,安全性高,其作用机制可能和降低CRP、ESR、RF、IL-6表达有关,值得临床推广。
Objective:To explore the clinical effect and mechanism of using Modified Huoluo Xingling Recipe in the treatment of rheumatoid arthritis with blood stasis syndrome.Methods:110 cases of rheumatoid arthritis with blood stasis syndrome in our hospital from August 2017 to February 2021 were selected as the research objects and randomly divided into an observation group and a controlled group,with 55 cases in each group.The controlled group was given routine treatment drugs orally,and the observation group was given Huoluo Xiaoling Recipe on the basis of the controlled group.The symptoms and signs,TCM syndrome score,quality of life,the treatment effect,laboratory parameters[C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),interleukin-6(IL-6)],clinical efficacy and adverse reactions were observed.Results:(1)The joint swelling,joint tenderness,swelling index,rest pain and morning stiffness time were significantly lower in the two groups(P<0.05),and the average grip strength of both hands was significantly higher than that of the controlled group(P<0.05),and the observation group was significantly improved(P<0.05);(2)The TCM syndrome score of the two groups was significantly lower than that of the former(P<0.05),and the observation group was significantly lower than that of the controlled group(P<0.05);(3)The quality of life index and total score of the two groups were significantly higher than that of the former(P<0.05),and the observation group was significantly higher than that of the controlled group(P<0.05);(4)The indexes of the two groups were significantly lower than that of the controlled group(P<0.05),and the observation group was significantly lower than that of the controlled group(P<0.05);(5)The total effective rate of the observation group was higher than that of the controlled group(P<0.05);(6)The total adverse reactions rate of the observation group was 4%lower than that of controlled group 13%(P<0.05).Conclusion:Modified Huoluo Xiaoling Recipe can effectively reduce the clinical symptoms and signs of patients with rheumatoid arthritis of blood stasis syndrome,relieve the symptoms of traditional Chinese medicine,improve the curative effect and quality of life,reduce adverse reactions,and has high safety.Its mechanism of action may be related to the reduction of CRP,ESR,RF and IL-6.It is worthy of clinical promotion.
作者
宋为民
张玉慧
SONG Weimin;ZHANG Yuhui(Department of Traditional Chinese Medicine,the People's Hospital of Bozhou City,Bozhou Anhui 236800,China;Department of Rheumatology and Immunology,the People's Hospital of Bozhou Ctiy,Bozhou Anhui 236800,China)
出处
《四川中医》
2022年第6期105-109,共5页
Journal of Sichuan of Traditional Chinese Medicine
关键词
活络效灵方
瘀阻型
类风湿关节炎
临床疗效
作用机制
Huoluo Xiaoling Recipe
Blood-stasis syndrome
Rheumatoid arthritis
Clinical effect
Mechanism of action
作者简介
通讯作者:张玉慧,博士研究生,副主任医师,研究方向:风湿病的基础与临床,Tel:18905688161;宋为民,硕士研究生,主治医师,研究方向:风湿病的中西医结合治疗与康复,Tel:18905688161。
