化痰祛瘀蠲痹方治疗类风湿关节炎随机对照探究摘要：目的：观察中药化痰祛瘀蠲痹方治疗类风湿关节炎（RA）的临床疗效、促进西药减量及稳定病情作用，以初步探讨中药化痰祛瘀蠲痹方治疗RA疗效及的机理。方法：70例RA患者随机分为两组，中药化痰祛瘀蠲痹方加西药治疗组（中药治疗组）35例，西药对照组35例，其中西药对照组口服甲氨喋吟（MTX,每周1次，每次7.5mg）,柳氮磺毗唳片（每天3次，每次0.5g）,美洛昔康片（莫比可，每天2次，每次7.5mg）o中药治疗组在口服上述西药的同时，加用化痰祛瘀蠲痹方治疗，疗程3个月。观察临床疗效，治疗前后症状、体征及实验室指标变化，西药用量和治疗后3个月病情复发情况。结果：中药治疗组的总有效率优于西药对照组（PV0.05）；在改善症状体征（关节疼痛度、肿胀度、压痛度、活动度、握力、晨僵）的积分，与治疗前及对照组治疗后比较差异有显著性（P<0.05或PV0.01）；中药治疗组的美洛昔康及MTX的用量（P<0.05或PV0.01）。两组在改善RF、ESR、CRP、PLT、Ig等指标，与治疗前比较差异有显著性（P<0.05或PV0.01）,中药治疗组治疗后上述指标改善优于西药对照组（P<0.05或P<0.01）o结论：中药化痰祛瘀蠲痹方加西药治疗RA的疗效优于单独西药治疗，具有促进西药减量作用。温化蠲痹方具有抗炎等免疫调节作用，---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---可能通过抑制RF、Ig等达到治疗RA的作用。关键词：化痰祛瘀蠲痹方；类风湿关节炎中图分类号：R593.21文献标识码：B文章编号：1673-7717(2011)12-2808-03EffectsofWenhuaJuanbiRescriptiononTNF-aand1L~1BinPeripheralBloodofRheumatoidArthritisPatientsHANShulil,SONGYawei2(1.XixiCommunityHealthCenter,Hangzhou310012,Zhejiang,China；2.LingyinCommunityHea1thCenterHangzhou310003,Zhejiang,China)收稿日期：2011-07-15作者简介：韩树利(1962-),男，辽宁大连人，副主任医师，研究方向：全科、综合内科临床。Abstract：Objective：Toobservetheclinicaleffectonpromotingdosesdecreaseofwesternmedicineandstabilizingpatients，conditionofWenhuaJuanbiRescriptionintreatingrheumatoidarthritis(RA)・TostudytheeffectsofWenhuaJuanbiPrescriptiononTNF-a,ILTBandanti-cycliccitrullinatedpeptide(CCP)---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---antibodyinperipheralbloodofRApatients,andtoexplorethemechanismofWenhuaJuanbiPrescriptiontreatingRApreliminary.Methods：OnehundredpatientswithRAwererandomlydividedinto2groups,50ineachgroup：thecontrolgroupweretreatedwithoraladministTationofmethotrexate(MTX,7.5mg,qw),sulfasalazine(0.5g,tid),meloxicam(Mobic,7.5mg,bid).TheChineseherbstreatmentgroupweretreatedwithWenhuaJuanbiPrescriptionandwesternmedicine.Thetherapeuticcourseforbothgroupswas3months.Clinicaleffectaftertreatment,changesofsymptomsandphysicalsignsbeforetreatment,thedosesofwesternmedicineandthechangesoflaboratoryindexesin2groupsbeforeandaftertreatment,andrelapseofpatients^conditionafter3monthsintheendoftreatmentwereobserved・ResuIts：ThetotaleffectiverateintheChineseherbstreatmentgroupwassuperiortothatinthewesternmedicinecontrolgroup(P<0.05)・Theimprovementinaspectsofintegralscoringofsymptomsandphysicalsigns,includingjointswelling,jointactivity,jointpain,jointpressingpain,morningstiff,griping,andnumberofjointswelling---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---intheChineseherbstreatmentgroupaftertreatmentweresinificantlydifferentfromthosebeforetreatmentandthoseinthewesternmedicinecontrolgroup(P<0.05orP<0.01)・Comparingwiththewesternmedicinecontrolgroup,dosesofMTXandme1oxicam,therateofrelapseofpatients'conditionintheChineseherbstreatmentgroupdecreasedsignificantly(P<0.05...