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目的:观察桂枝芍药知母汤加减治疗对类风湿性关节炎(RA)患者体像及活动度的改善机制。方法:选取2013年12月至2014年9月我院收治的RA患者98例为研究对象,采用随机数表法分为观察组和对照组各49例,对照组给予常规西药治疗,观察组在此基础上加服桂枝芍药知母汤,治疗1个月比较两组红细胞沉降率(ESR)、抗环瓜氨酸肽抗体(CCP)、类风湿因子(RF)水平;治疗后6个月比较两组体像改善率,应用关节活动度评分表(ROM)及卡氏评分表(KPS)比较两组活动度与生活质量,并观察6个内两组不良反应发生情况。结果:治疗1个月观察组ESR、CCP、RF较对照组显著降低(P<0.05);治疗后6个月观察组体像改善率显著高于对照组(P<0.05),观察组治疗后ROM评分、KPS评分均明显高于对照组(P<0.05);两组不良反应发生率比较无显著差异(P>0.05)。结论:桂枝芍药知母汤加减治疗类风湿性关节炎效果较单纯西药好,可通过调节炎症因子有效改善患者体像、活动度及生活质量,且不良反应轻,值得在临床广泛应用。
Objective: To observe the mechanism of Guizhi Shaoyao Zhimu Decoction on the improvement of body image and activity of patients with rheumatoid arthritis (RA). Methods: From December 2013 to September 2014, 98 cases of RA patients admitted to our hospital were selected as the research object. The random number table was divided into observation group (49 cases) and control group (49 cases). The control group On the basis of adding Guizhi Shaoyao Zhimu Decoction, the erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated peptide antibody (CCP) and rheumatoid factor (RF) The rate of improvement was compared between the two groups. ROM and KPS were used to compare the activity and quality of life between the two groups. The occurrence of adverse reactions in the two groups were also observed. Results: After 1 month of treatment, the ESR, CCP and RF in the observation group were significantly lower than those in the control group (P <0.05). After 6 months of treatment, the body image improvement rate in the observation group was significantly higher than that in the control group (P <0.05) ROM score and KPS score were significantly higher than those in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion: Guizhi Shaoyao Zhimu Decoction is more effective than western medicine alone in the treatment of rheumatoid arthritis. It can effectively improve body image, activity and quality of life of patients with mild adverse reactions by adjusting inflammatory cytokines. It is worth widely used in clinical practice.