类风湿性关节炎慢作用药治疗后中医证候规律研究-中医内科学专业论文.docxVIP

— — PAGE 1— 摘 要 类风湿性关节炎慢作用药治疗后中医证候规律研究 研究生：王成 导师：刘春景主任医师 摘 要 目的：探讨类风湿性关节炎(RA)患者慢作用药治疗后的中医临床证候规律，为 类风湿关节炎的中医证候研究提供一定的理论依据。方法：采用类临床实验的研究 方法，选择 120 例接受慢作用药治疗的 RA 患者，采用《类风湿性关节炎证候调查 表》进行研究，详细观察、记录类风湿性关节炎患者慢作用药治疗前后的临床症状、 体征(含舌、脉)、主要实验室指标，并按研究设计确定中医证候，探讨该研究对象的 证候规律。结果：(1)慢作用药治疗前类风湿性关节炎中医证候以湿热阻络(28.33)、 寒湿阻络(28.33%)居多，治疗后以肝肾亏损(41.67%)、痰瘀阻络((38.33%)、气血亏虚 (22.50%)居多，差异有统计学意义(P﹤0.05)。(2)临床常见症状比较：治疗前以关节 游走痛、遇冷加重、活动受限、关节漫肿、烦躁、自汗居多，治疗后以腰膝酸软、 脱发、面色晄白、畏寒、面色无华、乏力、头晕、纳呆、肌肤甲错、口鼻干燥居多， 差异有统计学意义(P﹤0.05)。(3)舌象比较：治疗前以舌质红，舌苔薄黄、黄腻、少 苔居多；治疗后以舌质暗淡，舌苔白居多，差异有统计学意义(P﹤0.05)。(4)脉象比 较：治疗前以脉滑数、弦数居多。治疗后以脉弦涩、细涩居多，差异有统计学意义(P ﹤0.05)。(5) 慢作用药治疗后证候有效比较(率)：湿热阻络(90.91%)、寒热错杂 (75.00%)、寒湿阻络(64.71%)、气血亏虚(42.86%)、痰瘀阻络(29.17%)、肝肾亏损 (29.17%)。结论：(1)慢作用药治疗前 RA 证候以湿热阻络、寒湿阻络为主，治疗后以 肝肾亏损、痰瘀阻络、气血亏虚为主。(2)慢作用药对湿热阻络、寒热错杂证疗效较 好，气血亏虚、痰瘀阻络、肝肾亏损证较差。 关键词：类风湿关节炎；慢作用药；中医证候 新疆医科大学医学硕士学位论文 Study on pattern of TCM identification of Rheumatoid Arthritis treated with DMARDS Postgraduate: Wang Cheng Supervisor: Pro.Liu Chun-qing Abstract Objective：To explore the Chinese medical pattern characteristic of rheumatoid arthritis (RA) patients between and after treatment by DMARDS, we hope that we can discover some rules. Methods：According to clinical test method was used to observe 120 in-patients of RA. Collected symptoms and classified syndromes by the questionnaire of prospective study on syndrome distribution of RA patients. By the research on the TCM syndrome and tracing its change among before and after 3 month treatment, we try to find some rules. Results：1. The main TCM syndromes of advanced RA include Bi syndrome cause by hot and dampness blocking, Bi syndrome cause by cold and dampness blocking, their proportion are separately: 28.33 percent, 28.33 percent; After treatment the main syndromes are the deficiency of liver and kidney, Phlegm-blood stasis obstructing channel,the deficiency of qi-blood, Their proportion are separately: 41.67 percent, 38.33 percent, 22.50 percent. 2. There are significant differences with regard to the m