金黄散外敷治疗类风湿关节炎湿热痹阻证的近期临床观察-中医内科学专业论文.docxVIP

PAGE PAGE 10 中文摘要 目的：观察金黄散外敷治疗类风湿关节炎湿热痹阻证的临床疗效及不良反 应，进而探讨其可能的作用机制。 方法：采用随机、对照的试验方法，将符合纳入标准的 60 例合格受试者随 机分为对照组（药物组）和治疗组（金黄散外敷加药物组）。对照组治疗用甲氨 喋呤、美洛昔康和帕夫林。治疗组则在对照组基础上加用金黄散外敷。共治疗 8 周。选取关节压痛数、关节肿胀数、双手平均握力、晨僵持续时间、疼痛 10cm 水平视力对照表(VAS)测试以及实验室指标（ESR、CRP、RF）等作为观察项目， 评价该疗法的临床疗效及两组治疗中的不良反应发生情况。所得数据符合正态分 布者，采用 t 检验和 x2 检验进行统计分析；数据不符合正态分布者，采用秩和检 验进行统计分析。 结果：（1）治疗组临床总有效率为 83.3 %，对照组为 76.7%，疗效优于对 照组（p﹤0.05）；（2）治疗组中医证候总有效率 86.7 %，对照组为 80.0 %，疗 效优于对照组（p﹤0.05）；（3）治疗组患者主要症状与体征的改善优于对照组（p ﹤0.05）；（4）类风湿关节炎主要实验室指标（血沉、C-反应蛋白）的改善优于 对照组（p﹤0.05）；（5）临床中未见明显不良反应。 结论：金黄散外敷治疗类风湿关节炎湿热痹阻证安全有效。该外敷方可能与 抑制机体免疫功能；抗炎；镇痛；改善全身和局部微循环；改善病变部位局部组 织的血液循环等方面的作用有关，虽然该法治疗后患者远期随访关节功能情况尚 缺乏，远期疗效目前仍无法评定，但该治疗方法明显改善了类风湿关节炎湿热痹 阻证患者的临床症状与体征，同时部分实验室指标得到好转，减轻了病人的痛苦， 值得推广。 关键词：类风湿关节炎，湿热痹阻证，金黄散，外敷 ABSTRACT Objective：To observe the clinical efficacy and adverse reaction of Jinhuang powder used to Treat rheumatoid arthritis(RA) which belongs to the retention of wet-heat . Methods：A randomized,controlled trial would be in line with the standard of 60 cases of qualified subjects which were randomly divided into control group (drug group) and treatment group (add external Jinhuang powder group). The control group treated with methotrexate, meloxicam and Pavlin. The treatment group was added the prescription of the external use of of Jinhuang powder. The patients are treated for 8 weeks. Select the number of tender joint, the number of swelling joint, the average grip strength of hands, morning stiffness duration, visual analogue scale and the target laboratory (ESR ﹑ CRP ﹑ RF) as the observation of the project, to evaluate the clinical efficacy of therapy and the occurrence of adverse reactions. T-test and X2 test were used for normal distribution, and the same time, nonparametric test were used for non-normal distribution in processing data. Results：(1) The treatment of clinical total effective rate was 83.3%, 76.7% for the control group, more effective than the control group (p 0.05);(2)The total effective rate of i