复方雷公藤逐痛颗粒辅助治疗痰瘀互结型类风湿关节炎的临床效果观察

目的:评价复方雷公藤逐痛颗粒治疗活动期类风湿关节炎痰瘀互结证的临床有效性和安全性。方法:选择2013年2月～2015年5月在上海光华中西医结合医院类风关内科门诊及住院的活动性痰瘀互结型类风湿关节炎患者63例,按治疗方式分为对照组33例和中西医结合治疗组30例,对照组采用西医治疗(甲氨蝶呤+青霉胺),治疗组采用中西医结合治疗(复方雷公藤逐痛颗粒+甲氨蝶呤+青霉胺)。治疗12周后,比较两组患者的临床疗效及各项观察指标的改善情况。结果:治疗后,两组患者晨僵持续时间、关节肿胀数、关节压痛数、中医症候积分、血沉(ESR)、血清CRP水平,疼痛VAS评分、患者总体状态自我VAS评分及DAS28评分均较治疗前显著下降(P0.05),且治疗组患者的上述各项指标均明显低于对照组(P0.05)。治疗期间,两组患者均未出现严重不良反应而中断治疗的情况,监测肝肾功能指标均未发现明显异常。结论:复方雷公藤逐痛颗粒辅助治疗痰瘀互结型类风湿关节炎的临床疗效确切,明显优于单用西医治疗,其有助于增强西医治疗对患者临床症状的缓解效果,提高患者的生活质量,且用药安全。

Effect of Compound Tripterygium Wilfordii Painkiller Granules in the Adjuvant Treatment of Patients with Phlegm-Blood Stasis Type Rheumatoid Arthritis

ABSTRACT Objective: To evaluate the efficacy and safety of Compound Tripterygium Wilfordii Painkiller Granules in the treat- ment of active phlegm-blood stasis type rheumatoid arthritis. Methods: 63 cases of patients with active phlegm-blood stasis type rheuma- toid arthritis from Feb. 2013 to May 2015 in Shanghai Guanghua hospital of integrated traditional Chinese and Western medicine were divided into the control group and the integrated traditional Chinese and Western medicine treatment group. The control group was treat- ed with western medicine (Methotrexate + Penicillamine), and the treatment group was treated with integrated traditional Chinese medicine and Western medicine(Compound Tripterygium Wilfordii Painkiller Granules + Methotrexate + Penicillamine). After 12 weeks of treatment, the clinical efficacy and the improvement of observation index were compared between the two groups. Results: After treat- ment, the duration of morning stiffness, number of joint swelling and joint pressure pain, TCM syndrome scores ESR, serum CRP levels, VAS scores of pain, self-assessment of the overall situation and DAS28 of both groups were significantly decreased(P<0.05). And the above indicators in the treatment group were significantly lower than those in the control group (P<0.05). During the treatment, no serious adverse reactions and interrupted treatment was found in both groups, and no obvious abnormalities were found in liver and kidney func- tion indexes. Conclusion: The clinical efficacy of Compound Tripterygium Wilfordii Painkiller Granules in the treatment of patients with phlegm-blood stasis type rheumatoid arthritis is better than western medicine alone, it can safely enhance the relief effect of clinical symptoms, improve the quality of life.