| 清热活血方药治疗类风湿关节炎1年后双手X线变化临床观察 |
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投稿时间：2011-06-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 周新尧 |
ZHOU Xin-yao |
中国中医科学院广安门医院风湿科，北京 100053 |
Department of Rheumatology, Guang'an Men Hospital, China Academy of Chinese Medical Science, Beijing 100053, China |
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| 王雷 |
WANG Lei |
中国中医科学院广安门医院放射科 |
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| 余卫 |
YU Wei |
北京协和医院放射科 |
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| 姜泉 |
JIANG Quan |
中国中医科学院广安门医院风湿科，北京 100053 |
Department of Rheumatology, Guang'an Men Hospital, China Academy of Chinese Medical Science, Beijing 100053, China |
doctorjiangquan@yahoo.com.cn |
| 汪平 |
WANG Ping |
中国中医科学院广安门医院放射科 |
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| 唐晓颇 |
TANG Xiao-po |
中国中医科学院广安门医院风湿科，北京 100053 |
Department of Rheumatology, Guang'an Men Hospital, China Academy of Chinese Medical Science, Beijing 100053, China |
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| 期刊信息：《中国骨伤》2011年，第24卷，第12期，第992-996页 |
| DOI：10.3969/j.issn.1003-0034.2011.12.006 |
| 基金项目:首都医学发展科研基金(编号：2005-SF-I-010) |
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中文摘要:
目的：通过观察双手腕X线1年后所见，评估清热活血方药治疗类风湿关节炎(RA)的作用。
方法：2007年7月至2009年3月将86例辨证属湿热瘀阻证的活动期RA患者随机分为中药组和中西药组，各43例。中药组使用清热活血方药治疗(药物组成：黄柏、赤芍、萆薢、丹参、莪术、青风藤、生黄芪、金银花、土茯苓、蜈蚣、蜂房、生薏苡仁),每剂水煎400 ml,每日分2次口服；中西药组在中药基础上加甲氨蝶呤治疗，疗程12个月。对中药组和中西药组其中各21例进行X线评估，中药组21例，女19例，平均年龄(43.0±11.3)岁，病程2(1,3)年；中西药组女18例，平均年龄(44.5±14.0)岁，病程3(1.7,5)年。于疗前和治疗12个月分别收集患者双手X线片，对读片者隐藏时间先后顺序和临床数据，以Sharp/van der Heijde方法对X线片进行评分。
结果：评分达到较高一致性，观察者内相关系数达0.95.中药组和中西药组1年时点放射学所见的双手骨侵蚀及关节间隙狭窄等改变与治疗前差异以及组间差异均无统计学意义(P>0.05).2组不同进展程度的病例数也相似(P=0.46),无放射学进展者中药组7例，中西药组8例；放射学进展较明显者，中药组3例，中西药组1例。
结论：中药组和中西药组RA患者的骨破坏进展程度相似，提示中药治疗RA中远期具有潜在的骨保护作用。 |
| 【关键词】关节炎，类风湿 中药疗法 活血通络 清热剂 放射学 |
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| One-year evaluation of radiographic progress in patients with rheumatoid arthritis treated by Qingre Huoxue decoction(清热活血方) |
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ABSTRACT
Objective: To investigate the effect of Qingre Huoxue decoction(清热活血方，QRHX)on radiographic progression in patients with rheumatoid arthritis (RA) with X-ray imaging.
Methods: From July 2007 to March 2009,86 patients with active RA who were diagnosed as damp-heat and blood stasis syndrome were randomly divided into QRHX group and QRHX plus methotrexate (MTX) group,43 cases in each group. Patients in the QRHX group were treated with QRHX decoction [composed of Huangbai (黄柏),Chishao (赤芍),Bixie (萆薢),Danshen (丹参),Ezhu (莪术),Qingfengteng (青风藤),raw Huangqi (生黄芪),Jinyinhua (金银花),Tufuling (土茯苓),Wugong (蜈蚣),Fengfang (蜂房),raw Yiyiren (生薏苡仁)],which was cooked with water as 400 ml liquid); while patients in the other group were treated with QRHX decoction plus MTX. After one-year observation,21 patients in each group (42 in total) were evaluated,with 19 females in QRHX group,average age of (43.0±11.3) years,and the course of the disease was 2(1,3)years;and 18 females in QRHX+MTX group,average age of (44.5±14.0) years,and the course of the disease was 3(1.7,5)years. Radiographs of hands were obtained at baseline and 12 months after treatment. Images were evaluated by investigators blinded to chronology and clinical data,and assessed according to Sharp/van der Heijde methods.
Results: High intrareader agreements were reached (mean intraobserver intraclass coefficients:0.95). No significant change in any imaging parameters of joint destruction was observed at 12 months after treatment in both groups;and there were no statistical differences between the two groups (P>0.05). The severity of progress in two groups was also similar(P=0.46),7 patients without radiographic progress in QRHX group and 8 patients in QRHX+MTX group,3 patients with obvious radiographic progress in QRHX group and 1 patient in QRHX+MTX group.
Conclusion: Radiographic progress of RA patients in two groups is similar,indicating QRHX decoction has a potential role in preventing bone destruction. |
| KEY WORDS Arthritis,rheumatoid Drug therapy(TCD) Activate blood dred collater Antipyretic agents Radiology |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 周新尧,王雷,余卫,姜泉,汪平,唐晓颇.清热活血方药治疗类风湿关节炎1年后双手X线变化临床观察[J].中国骨伤,2011,24(12):992~996 |
| 英文格式: | ZHOU Xin-yao,WANG Lei,YU Wei,JIANG Quan,WANG Ping,TANG Xiao-po.One-year evaluation of radiographic progress in patients with rheumatoid arthritis treated by Qingre Huoxue decoction(清热活血方)[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(12):992~996 |
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