目的 观察中西医结合治疗活动期类风湿关节炎的效果.方法 将93例类风湿关节炎活动期患者随机分为对照组(46例)和治疗组(47例).对照组予奥沙普秦肠溶片联合甲氨喋呤治疗,治疗组在对照组基础上加用养阴活血通痹汤加减,主要药物:生地黄、 当归、白芍、骨碎补、仙茅、全蝎、雷公藤、清风藤、甘草等.2组均以3个月为1疗程.结果 治疗组总有效率93.6%,对照组总有效率82.6%,2组差异比较有统计学意义(P<0.05).治疗后2组的的疼痛(VAS)评分、关节压痛数、关节肿胀数均显著降低,晨僵时间明显缩短,双手握力增加,DAS28明显改善(P<0.05),且治疗组的改善程度优于对照组,2组比较差异有统计学意义(P<0.05).治疗后2组的ESR、CR、RF均显著降低,同组治疗前后差异有统计学意义(P<0.01),且治疗组的下降程度明显优于对照组,2组比较差异有统计学意义(P<0.05).治疗组的不良反应发生率为19.1%,对照组为34.8%,2组相比有统计学意义(P<0.05).结论 中西医结合治疗活动期类风湿关节炎疗效明显优于单用西药治疗,主要机制可能是中西医结合治疗RA本身可优势互补,同时与中医药针对其虚损这一病理特点从养阴补元入手,早期介入,标本同治有关.%Objective To evaluate the therapeutic effect of integrated traditional Chinese and western medicine in the treatment of active rheumatoid arthritis. Methods 93 patients of active rheumatoid arthritis were randomly divided into control group (46 cases) and treatment group (47 cases). The control group was treated with oxaprozin enteric coated tablets and methotrexate and the treatment group was treated with Yangyin Huoxue Tongbi decoction in addition to the same treatment as the control group, the Yangyin Huoxue Tongbi decoction is made of Shengdi, Danggui, Baishao, Gusuibu, Xianmao, Quanxie, Qingfengteng, Gancao and so on. The two groups were treated for three months with a course of one months. Results The total effective rate of the treatment group was 93.61% and the total effective rate of the control group was 82.6%, and the difference between the two groups was statistically significant (P < 0.05). (VAS) pain score, joint tenderness, joint swelling number of the two group after treatment were decreased significantly, morning stiffness time was shorten, hand grip strength was increased and DAS28 significantly improved (P < 0.05); And the improvement of the treatment group was better than that of the control group, the difference between the two groups was statistically significant (P < 0.05). After treatment, the ESR, CR, RF were significantly reduced in the two groups, the difference was statistically significant (P <0.01); And decline degree in the treatment group was significantly better than the control group, the difference between the two groups was statistically significant (P <0.05). The adverse reaction rate of the treatment group was 19.1%, while that of the control group was about 34.8%, the two groups were statistically significant (P <0.05). Conclusion The curative effect of traditional Chinese and western medicine in the treatment of active rheumatoid arthritis is better than single treatment with western medicine, there are two main mechanisms, firstly, integrated traditional Chinese and western medicine in the treatment of RA can complement the advantage of each other, secondly, traditional Chinese medicine uses the method of nourishing yin and tonifying yuan in the treatment of Xusun, early intervention and it can treat both internal and external causes.significantly reduced in the two groups, the difference was statistically significant (P <0.01); And decline degree in the treatment group was significantly better than the control group, the difference between the two groups was statistically significant (P <0.05). The adverse reaction rate of the treatment group was 19.1%, while that of the control group was about 34.8%, the two groups were statistically significant (P <0.05). Conclusion The curative effect of traditional Chinese and western medicine in the treatment of active rheumatoid arthritis is better than single treatment with western medicine, there are two main mechanisms, firstly, integrated traditional Chinese and western medicine in the treatment of RA can complement the advantage of each other, secondly, traditional Chinese medicine uses the method of nourishing yin and tonifying yuan in the treatment of Xusun, early intervention and it can treat both internal and external causes.
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