摘要
目的 观察补肾治尪汤对类风湿关节炎(rheumatoid arthritis,RA)骨侵蚀的临床疗效。方法 纳入50例辨证属肝肾不足证的RA患者,随机分为治疗组和对照组各25例。治疗组患者用补肾治尪汤联合传统改善病情抗风湿药(conventional disease modifying antirheumatic drugs,c DMARDs)治疗,对照组患者用c DMARDs治疗,疗程均为12个月。分别收集2个组患者治疗前后双手腕X线片,由2位放射科医师采用盲法以改良Sharp评分(modified total sharp score,m TSS)法对所有X线片进行评分。观察m TSS变化、放射学进展率,以m TSS增加≥0.5分判断为放射学进展,以中医证候积分和有效率为临床疗效评价标准。结果 共42例患者完成研究,其中治疗组22例,对照组20例。2位放射科医师评分一致性高,观察者内相关系数为0.90。2个组患者治疗前后关节间隙狭窄变化值、骨侵蚀变化值及m TSS变化值比较,差异无统计学意义(P>0.05)。治疗组患者放射学进展率低于对照组,差异有显著统计学意义(P<0.01)。2个组患者治疗后中医证候积分均较治疗前显著改善,差异均有统计学意义(P<0.01);治疗组有效率优于对照组,但差异无统计学意义(P>0.05)。结论补肾治尪汤中西医结合治疗RA,放射学进展率低于对照组,提示补肾治尪汤具有延缓RA骨侵蚀的作用。
Objective To observe the clinical effect of Bushen Zhiwang decoction on bone erosion in rheumatoid arthritis(RA).Methods 50 RA patients with liver and kidney deficiency syndrome were randomly divided into the treatment group and control group with 25 cases in each group.The treatment group was treated with Bushen Zhiwang decoction combined with conventional disease-modifying anti-rheumatic drugs(cDMARDs),and the control group was treated with cDMARDs.12 months later,the X-ray films of both wrists of the two groups were collected before and after treatment,and all X-ray films were scored by blind method and modified Total Sharp Score(mTSS)method by 2 radiologists.The changes of mTSS and the rate of radiological progress were observed,and the increase of mTSS≥0.5 was regarded as radiological progress,and the TCM syndrome score and effective rate were taken as the evaluation criteria of clinical curative effect.Results A total of 42 patients were included in the research,of which 22 cases in treatment group and 20 cases in control group.The consistency of the scores of the two radiologists was high,and the intra-observer correlation coefficient was 0.90.There was no significant difference in the changes of joint space stenosis,bone erosion and mTSS between the two groups before and after treatment(P>0.05).The radiological progression rate of the treatment group was lower than that of the control group,and the difference was statistically significant(P<0.01).TCM syndrome scores in both groups after treatment were significantly improved compared with those before treatment,and the difference was statistically significant(P<0.01).The effective rate of the treatment group was better than that of the control group,but the difference was not statistically significant(P>0.05).Conclusion The radiographic progress rate of Bushen Zhiwang decoction in the treatment of RA was lower than that of the control group,suggesting that Bushen Zhiwang decoction had the effect of delaying bone erosion in RA.
作者
姚传辉
徐才钦
张雨樵
鄢泽然
王金平
金笛儿
于洪伟
马恩森
陶庆文
徐愿
YAO Chuanhui;XU Caiqin;ZHANG Yuqiao;YAN Zeran;WANG Jinping;JIN Dier;YU Hongwei;MA Ensen;TAO Qingwen;XU Yuan(Beijing University of Chinese Medicine,Beijing 100029,China;China-Japan Friendship Hospital,Beijing 100029,China;Beijing Key Laboratory of Immune-Mediated Inflammatory Diseases,Beijing 100029,China)
出处
《中国中医基础医学杂志》
CAS
CSCD
北大核心
2023年第6期976-981,共6页
JOURNAL OF BASIC CHINESE MEDICINE
基金
中央高水平医院临床科研业务费(2022-NHLHCRF-LX-02-02)
北京市中医药科技发展资金项目(QN-2020-32)。
关键词
类风湿关节炎
补肾治尪汤
骨侵蚀
改良Sharp评分
临床研究
Rheumatoid arthritis
Bushen Zhiwang decoction
Modified total sharp score
Bone erosion
Clinical research
作者简介
姚传辉(1995-),男,在读博士研究生,从事风湿病的临床与基础研究;通讯作者:陶庆文(1966-),男,主任医师,教授,从事风湿病的临床与基础研究,E-mail:taoqg1@sina.com;通讯作者:徐愿(1982-),男,副主任医师,从事风湿病的临床与基础研究,E-mail:xuyuan2004020@163.com。
