补肾通络方联合甲氨蝶呤+益赛普治疗肾虚血瘀型类风湿关节炎临床观察

文章信息/Info

• Title:补肾通络方联合甲氨蝶呤+益赛普治疗肾虚血瘀型类风湿关节炎临床观察

• 卷期:2023年21卷24期

• 作者: 墨云舒1,王立柱2

• 薛军丽1 贾飞1 赵欣愉2 燕茹1 索小清1 韩婷婷1 郭玲玲1 董卫1 △

• Author(s):Junli Xue1, Fei Jia1, Xinyu Zhao2, Ru Yan1, Xiaoqing Suo1, Tingting Han1, Lingling Guo1,Wei Dong1△

• 1. Department of Rheumatology,Shanxi Hospital of Integrated Traditional and Western Medicine ,TaiyuanCity030013,Shanxi Province

• 关键词类风湿关节炎、肾虚血瘀、补肾通络方

• Keywords:Rheumatoid Arthritis, Renal deficiency and blood stasis, Renal tonic formula

• 摘要:目的：观察补肾通络方联合甲氨蝶呤+益赛普治疗肾虚血瘀型类风湿关节炎的临床疗效。方法：选取2020年10月-2022年3月我科收治的86例肾虚血瘀型类风湿关节炎患者，将其随机分为2组，即对照组和治疗组各43例。对照组给予甲氨蝶呤+益赛普治疗；治疗组在对照组基础上联合自拟补肾通络方治疗。2周为1疗程，连续治疗6个疗程，对比两组患者对疼痛的VAS评分、疾病活动度（DAS28）评分、实验室指标（ESR、CRP、TNF-α、IL-1β、IL-6）。结果：治疗组较对照组VAS评分降低更显著,差异具有统计学意义（P<0.05）；治疗组在控制疾病活动度、改善实验室指标方面优于对照组，差异具有统计学意义（P<0.05）。结论：类风湿关节炎在甲氨蝶呤+益赛普治疗基础上联合自拟补肾通络方治疗，能有效改善患者临床症状、降低疾病活动度、降低实验室炎性指标，可以提升患者生活质量。                                                                                                                                                                                

• Abstract: To observe the clinical effect of Chinese traditional medicine renal tonic formula combined with Methotrexate + YISAIPU (recombinant human tumor necrosis factor-α receptor II:IgG Fc fusion protein for injection) in the treatment of rheumatoid arthritis of kidney deficiency and blood stasis type. Methods A total of 86 patients with rheumatoid arthritis of kidney deficiency and blood stasis type who were admitted to our department from October 2020 to March 2022 were selected and randomly divided into 2 groups, namely the control group and the treatment group, with 43 cases in each group. The control group was treated with Methotrexate + YISAIPU, and the treatment group was treated with additional self-made renal tonic formula on top of the control group. After continuous treatment for 6 courses (2 weeks serve as one course), the VAS score, disease activity (DAS28) score, laboratory indicators (ESR, CRP, TNF-α, IL-1β, IL-6) were compared between the two groups. Results Compared with the control group, the VAS score of the treatment group decreased more significantly, and the difference was statistically significant (P<0.05). Furthermore, the treatment group was better than the control group in controlling disease activity and improving laboratory indicators, and the difference was statistically significant (P<0.05). Conclusion The treatment of rheumatoid arthritis using Methotrexate + YISAIPU combined with self-made renal tonic formula can effectively improve the clinical symptoms of patients, reduce disease activity and laboratory inflammatory indicators, and thus improve patients’ quality of life.

  类风湿关节炎（RA）是一种以侵蚀性关节炎为主要表现的全身性自身免疫病。本病表现为以双手、腕、膝、距小腿和足关节等小关节受累为主的对称性、持续性多关节炎[1]。RA的发病机制目前尚不明确，基本病理表现为滑膜炎、血管翳形成，并逐渐出现软骨和骨破坏，最终导致关节畸形和功能丧失，可并发肺部疾病、心血管疾病、恶性肿瘤和抑郁症等[2]。RA关节病变是由炎性细胞浸润及其释放的炎性介质所致。