温经蠲痹汤联合益赛普注射液治疗风寒湿痹型类风湿性关节炎90例
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摘要
目的观察温经蠲痹汤联合益赛普治疗风寒湿痹型类风湿性关节炎的临床疗效。方法将90例风寒湿痹型类风湿性关节炎患者随机分为对照组和治疗组各45例,对照组采用常规的抗风湿治疗,治疗组采用中药温经蠲痹汤联合益赛普治疗,疗程为3个月。治疗3个月后,观察2组治疗前后晨僵时间、肿胀关节数目、压痛关节数目的变化。研究采用28个关节疾病活动度评分(DAS28评分)和美国健康评估问卷(HAQ评分)进行临床评价;检测并比较2组治疗前后类风湿性关节炎相关指标水平的变化及治疗前后关节功能改善的变化。结果治疗组总有效率为93.3%,显著高于对照组73.3%,差异有统计学意义(х2=6.480,P<0.01);治疗后2组相关检验指标均低于治疗前(P<0.05),治疗组相关检验指标显著低于对照组(P<0.01);治疗后2组患者DAS28评分和HAQ评分均降低(P<0.05),治疗组患者DAS28评分和HAQ评分显著低于对照组,2组比较差异有统计学意义(P<0.01);治疗组恶心、呕吐、肝功能损害、腹痛、感染等不良发应发生率均明显低于对照组,比较有显著性差异(P<0.05)。结论温经蠲痹汤联合益赛普治疗风寒湿痹型类风湿性关节炎具有较好的临床治疗效果,可以明显改善关节炎相关症状、降低检验指标水平,且副作用小。
Objective To study the clinical effect of Wenjing Juanbi decoction combined etanercept in the treatment of rheumatoid arthritis of wind-cold-dampness type. Methods 90 cases of patients with rheumatoid arthritis of wind-cold-dampness type were divided into treatment group and control group with 45 cases in each group. The control group was treated with conventional antirheumatic treatment, and the treatment group was received Wenjing Juanbi decoction combined Etanercept. 3 months was a treatment cycle. After3 months of treatment, morning stiffness, number of swollen joints and number of tender joints were observed before and after treatment,and all data were used the DAS28 scale and HAQ scale for clinical evaluation. The levels of relevant indicators of rheumatoid arthritis before and after treatment and the changes of joint function before and after treatment were measured and compared between the two groups. Results The total effective rate of the treatment group(93.3%) was significantly higher than that of the control group(73.3%).After treatment, the related test indexes of the two groups were lower than those before treatment(P<0.05), and the related test indexes of the treatment group were significantly lower than those of the control group(P<0.01). After treatment, the scores of DAS28 and HAQ in both groups were lower than those in the control group(P <0.05). The scores of DAS28 and HAQ in the treatment group were significantly lower than those in the control group(P<0.01). The incidence of nausea, vomiting, liver dysfunction, abdominal pain and infection in the treatment group was significantly lower than that in the control group(P<0.05). Conclusion Wenjing Juanbi decoction combined with Etanercept has a better clinical effect in treating rheumatoid arthritis of wind-cold-dampness type. It can significantly improve the symptoms of arthritis, reduce the level of related test indicators, and has fewer side effects.
Objective To study the clinical effect of Wenjing Juanbi decoction combined etanercept in the treatment of rheumatoid arthritis of wind-cold-dampness type. Methods 90 cases of patients with rheumatoid arthritis of wind-cold-dampness type were divided into treatment group and control group with 45 cases in each group. The control group was treated with conventional antirheumatic treatment, and the treatment group was received Wenjing Juanbi decoction combined Etanercept. 3 months was a treatment cycle. After3 months of treatment, morning stiffness, number of swollen joints and number of tender joints were observed before and after treatment,and all data were used the DAS28 scale and HAQ scale for clinical evaluation. The levels of relevant indicators of rheumatoid arthritis before and after treatment and the changes of joint function before and after treatment were measured and compared between the two groups. Results The total effective rate of the treatment group(93.3%) was significantly higher than that of the control group(73.3%).After treatment, the related test indexes of the two groups were lower than those before treatment(P<0.05), and the related test indexes of the treatment group were significantly lower than those of the control group(P<0.01). After treatment, the scores of DAS28 and HAQ in both groups were lower than those in the control group(P <0.05). The scores of DAS28 and HAQ in the treatment group were significantly lower than those in the control group(P<0.01). The incidence of nausea, vomiting, liver dysfunction, abdominal pain and infection in the treatment group was significantly lower than that in the control group(P<0.05). Conclusion Wenjing Juanbi decoction combined with Etanercept has a better clinical effect in treating rheumatoid arthritis of wind-cold-dampness type. It can significantly improve the symptoms of arthritis, reduce the level of related test indicators, and has fewer side effects.
引文
[1] Smolen J S,Aletaha D,Mclnnes. IB. Rheumatoid arthritis[J]. Lancet,2016,388(1055):2023-2038.
[2] Mc Innes I B,Schett G. Pathpgenetic insights from the treatment of rheumatoid arthritis[J]. Lancet,2017,389(10086):2328-2337.
[3] Meinnes I B,Schett G. The pathogenesis of rheumatoid arthritis[J]. N Engl J Med,2011,365(23):2205-2219.
[4] Burmester G R,Pope J E. Novel treatment strategies in rheumatoid arthritis[J]. Lancet,2017,389(10086):2338-2348.
[5] Aletaha D,Neogi T,Silman A J,et al.2010 Rheumatoid arthritis classification criteria:an american college of rheumatology/european league against rheumatism collaborative initiative[J]. Arthitis Rheum,2010,62(9):2569-2581.
[6]周仲瑛.中医内科学[M]. 2版.北京:中国中医药出版社,2007:463-466.
[7]中华人民共和国卫生部.中药新药临床研究指导原则(第一辑)[S].北京:中华人民共和国卫生部,1993:210-214.
[8]张奉春,栗占国.内科学·风湿免疫科分册[M].北京:人民卫生出版社,2015:26.
[9]朱婉华,中华中医药学会.朱良春益肾蠲痹法治疗风湿病[M].北京:科学出版社,2016:40-41.
[10]林艳,李志军,马玲,等.益赛普治疗20例风湿免疫疾病的护理观察[J].中华全科医学,2015,13(8):1348-1350.
[11]李小芳,唐跃琼,朱其香,等.生物制剂益赛普治疗白塞病的观察和护理[J].中华现代护理杂志,2009,15(35):3757-3758.
[12]付文轶,张宁.重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合甲氨蝶呤对改善病情抗风湿药治疗无效活动性类风湿关节炎的疗效[J].中华临床免疫和变态反应杂志,2008,2(3):184-189.
[13]周文煜,陈文莉,黄小妹,等.重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对类风湿关节炎患者血清IgM-IgG-和IgA-类风湿因子的影响[J].中华风湿病学杂志,2012,16(4):267-270.
[2] Mc Innes I B,Schett G. Pathpgenetic insights from the treatment of rheumatoid arthritis[J]. Lancet,2017,389(10086):2328-2337.
[3] Meinnes I B,Schett G. The pathogenesis of rheumatoid arthritis[J]. N Engl J Med,2011,365(23):2205-2219.
[4] Burmester G R,Pope J E. Novel treatment strategies in rheumatoid arthritis[J]. Lancet,2017,389(10086):2338-2348.
[5] Aletaha D,Neogi T,Silman A J,et al.2010 Rheumatoid arthritis classification criteria:an american college of rheumatology/european league against rheumatism collaborative initiative[J]. Arthitis Rheum,2010,62(9):2569-2581.
[6]周仲瑛.中医内科学[M]. 2版.北京:中国中医药出版社,2007:463-466.
[7]中华人民共和国卫生部.中药新药临床研究指导原则(第一辑)[S].北京:中华人民共和国卫生部,1993:210-214.
[8]张奉春,栗占国.内科学·风湿免疫科分册[M].北京:人民卫生出版社,2015:26.
[9]朱婉华,中华中医药学会.朱良春益肾蠲痹法治疗风湿病[M].北京:科学出版社,2016:40-41.
[10]林艳,李志军,马玲,等.益赛普治疗20例风湿免疫疾病的护理观察[J].中华全科医学,2015,13(8):1348-1350.
[11]李小芳,唐跃琼,朱其香,等.生物制剂益赛普治疗白塞病的观察和护理[J].中华现代护理杂志,2009,15(35):3757-3758.
[12]付文轶,张宁.重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合甲氨蝶呤对改善病情抗风湿药治疗无效活动性类风湿关节炎的疗效[J].中华临床免疫和变态反应杂志,2008,2(3):184-189.
[13]周文煜,陈文莉,黄小妹,等.重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对类风湿关节炎患者血清IgM-IgG-和IgA-类风湿因子的影响[J].中华风湿病学杂志,2012,16(4):267-270.
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