解毒活血汤联合甲氨蝶呤治疗老年发病类风湿关节炎的临床研究

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1、提要目的：观察解毒活血汤联合甲氨蝶呤治疗老年发病类风湿关节炎的临床疗效，探讨老年发病类风湿关节炎的中医病因病机及治则治法，为该病的治疗提供新的思路和方法。方法：将50例入选的老年发病类风湿关节炎患者随机分为治疗组（25例），对照组（25例），治疗组采用解毒活血汤联合甲氨蝶呤治疗，对照组采用甲氨蝶呤治疗，疗程为3个月，采用美国风湿病学会制定的ACR标准作为疾病疗效观察标准。结果：临床观察显示，疗程结束时，治疗组达到ACR70标准1例，达到ACR50标准9例，达到ACR20标准13例，总有效率92.00%，对照组无达到ACR70标准病例，达到ACR

2、50标准2例，达到ACR20标准14例，总有效率64.00%，治疗组优于对照组（P<0.05）。在改善主要症状、体征及实验室检查指标等方面均优于对照组（P<0.05）。结论：解毒活血汤联合小剂量甲氨蝶呤是老年发病类风湿关节炎的有效疗法，具有改善患者的临床症状体征，降低血沉（ESR）及C反应蛋白（CRP），缓解病情等作用。关键词老年发病类风湿关节炎；解毒活血汤；临床研究ClinicalStudyonJieduhuoxuetangunitedMethotrexateintreatingofElderly-onsetRheumatoidArthrit

3、isSpeciality:InternalMedicineofTCMRheumaticDiseaseAuthor:JiaDongmeiTutor:Prof.FuXinliAbstractObjective:ToobservetheJieduhuoxuetangunitedMethotrexatetreatmentofElderly-onsetrheumatoidarthritisclinicalefficacy.ToexploretheElderly-onsetrheumatoidarthritisTCMEtiology,Pathogenesi

4、sandnewtreatment.Methods:50selectedpatientswithElderly-onsetrheumatoidarthritiswererandomlydividedintotreatmentgroup(25cases),thecontrolgroup(25cases),patientsinthetreatmentgroupwereadministeredwithJieduhuoxuetangUnitedMethotrexate,whilethoseinthecontrolgrouptreatedwithMethot

5、rexate.Totaltherapeuticcoursewas3monthes,usingtheUnitedStatesInstituteofRheumatologyissuedbytheACRcriteriatoevaluatetheeffieacy.Results:Theclinicalobservationshowedthatattheendofthestady，thetreatmentgrouphas1caseachievedACR70criteria，9casesoftheACR50criteria,andACR20criteriar

6、eached13cases,thecontrolgrouphave2casesofACR50criteria,ACR20criteriareached14cases,thetreatmentgroupissignificantlyhigherthanthecontrolgroup(P<0.05).Theeffectiverateofthetreatmentgroupis92.00%,whichisalsosignificantlysuperiortothatofthecontrolgroup(64.00%,P<0.05).Inimprovingt

7、hemajorsymptoms,signsandlaboratoryindicatorsthetreatmentgrouparebetterthanthecontrolgroup(P<0.05).Conclusion:Jieduhuoxuetangunitedsmall-doseMethotrexateisaeffectivetherapyofElderlyonsetrheumatoidarthritis,Itpossessessuchfunctionsasimprovingtheclinicalsignsandsymptoms,reducing

8、erythrocytesedimentationrate(ESR)andC-reactiveprotein(CRP),alleviati