补肾蠲痹汤联合甲氨蝶呤治疗老年类风湿关节炎的临床效果
Clinical Effect on Bushen Juanbi Decoction Combined with Methotrexate in the Treatment of El-derly Rheumatoid Arthritis
胡刚明 1高杰元 1吴正刚 1曾进军 1贾天 1王勇1
作者信息
- 1. 武汉大学人民医院汉川医院/汉川市人民医院,湖北 汉川 431600
- 折叠
摘要
目的 研究补肾蠲痹汤与甲氨蝶呤联合使用对老年类风湿关节炎的治疗效果.方法 回顾性选取2019年10月—2022年10月汉川市人民医院收治的118例老年类风湿关节炎患者的临床资料,以不同治疗方式分为两组,对照组(58例)给予口服甲氨蝶呤片治疗,观察组(60例)采用口服甲氨蝶呤片+补肾蠲痹汤治疗.比较两组晨僵时间及中医证候积分、视觉模拟评分法、类风湿性关节炎28个关节疾病活动评分、健康评估问卷评分、炎症因子水平、不良反应、治疗有效率.结果 治疗后,观察组晨僵时间短于对照组,中医证候积分、视觉模拟评分法评分、类风湿性关节炎28个关节疾病活动评分及健康评估问卷评分低于对照组,差异有统计学意义(P均<0.05).治疗后,观察组红细胞沉降率、类风湿因子、C反应蛋白、肿瘤坏死因子-α、白细胞介素-1β、白细胞介素-6水平低于对照组,差异有统计学意义(P均<0.05).治疗后,两组不良反应发生率比较,差异无统计学意义(P>0.05).观察组治疗有效率为95.00%(57/60),高于对照组的82.76%(48/58),差异有统计学意义(χ2=4.505,P<0.05).结论 与单独使用甲氨蝶呤相比,补肾蠲痹汤与甲氨蝶呤联合使用在改善老年类风湿关节炎的临床症状方面具有更显著的优势,还能有效降低炎症因子水平,同时不增加不良反应的发生风险.
Abstract
Objective To study the therapeutic effect of Bushen Juanbi Decoction combined with metho-trexate on elderly patients with rheumatoid arthritis.Methods Clinical data of 118 elderly patients with rheuma-toid arthritis treated in Hanchuan People's Hospital from October 2019 to October 2022 were retrospectively se-lected,and divided into two groups based on different treatment methods.The control group(58 cases)was treated with oral methotrexate tablets,and the observation group(60 cases)was treated with oral methotrexate tablets plus Bushen Juanbi Decoction.The time of morning stiffness,traditional Chinese medicine syndrome score,Visual Analog Scale,Disease Activity Score in 28 Joints,Health Assessment Questionnaire,levels of in-flammatory factors,adverse reactions and treatment effectiveness were compared between the two groups.Re-sults After treatment,the morning stiffness time of the observation group was shorter than that of the control group,and the traditional Chinses medicine syndrome score,Visual Analog Scale score,Disease Activity Score in 28 Jaints and Health Assessment Questionnaire score were lower than those of the control group,and the dif-ferences were statistically significant(all P<0.05).After treatment,the levels of erythrocyte sedimentation rate,rheumatoid factor,C-reactive protein,tumor necrosis factor-α,interleukin-1β,interleukin-6 levels in the ob-servation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).After treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The effective rate of the observation group was 95.00%(57/60),which was higher than 82.76%(48/58)of the control group,the difference was statistically significant(χ2=4.505,P<0.05).Conclusion Compared with methotrexate alone,the combined treatment of Bushen Juanbi Decoction and methotrexate has more significant advantages in improving the clinical symptoms of elderly rheumatoid arthritis,and can effec-tively reduce the level of inflammatory factors without increasing the risk of adverse reactions.
关键词
补肾蠲痹汤/甲氨蝶呤/老年类风湿关节炎/联合治疗/临床效果Key words
Bushen Juanbi Decoction/Methotrexate/Elderly rheumatoid arthritis/Combination therapy/Clinical effect引用本文复制引用
基金项目
孝感市自然科学计划立项(孝科技发[2022]8号)
孝感市自然科学计划立项(XGKJ2022010068)
第五批湖北省中医药"三堂一室"项目(鄂卫通[2017]9号)
出版年
2024
NETL
NSTL
万方数据