辨病辨证结合治疗银屑病关节炎疗效分析

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1、提要目的：本研究通过比较两组银屑病关节炎患者治疗后组间的症状体征及疗效差异，初步客观评价辨病辨证结合组方的临床疗效。方法：以美国风湿病学会（ACR）制定的疾病观察指标评定关节炎疗效，以银屑病面积与严重性指数（PASI）和皮肤病生活质量调查表（DLQI）评定皮损疗效，统计2009.9～2011.9住院和门诊银屑病关节炎患者40例，按1:1比例随机分为试验组和对照组，试验组用辨病辨证结合组方，对照组用甲氨蝶呤，治疗3个月，观察两组中医量化评分、ACR各指标、PASI评分、DLQI评分的改善程度，及达到

2、ACR缓解20%（ACR20）、PASI减少50%（PASI50）的例数。结果：两组比较在中医症状量化评分的鳞屑、口渴改善比例上有统计学意义（P＜0.05），其中口渴改善比例有显著统计学意义（P＜0.01），在ACR的患者对疼痛的VAS评分、健康评估问卷（HAQ）评分改善上，两组差异有统计学意义（P＜0.05）。结论：辨病辨证结合组方治疗银屑病关节炎缓解关节和皮损病变均有良好疗效，证明了辨病辨证结合思路的正确性。关键词银屑病关节炎；辨病辨证结合；疗效CurativeEffectAnalysisof

3、PsoriaticArthritisBasedonCombinationofDiseaseandSyndromeDifferentiationSpeciality:TCMInternalMedicineofRheumatismAuthor:WangHaiyueTutor:Prof.SongShaoliangAbstractObjective:Toevaluatecurativeeffectofprescriptionbasedoncombinationofdiseaseandsyndromedif

4、ferentiation,symptoms,signsandcurativeeffectswerecomparedbetweenpatientswithpsoriaticarthritis(PsA)inthetwogroups.Methods:IndexesofAmericanCollegeofRheumatology(ACR)werechoosedtoevaluatearthriticeffect,whilePsoriasisAreaandSeverityIndex(PASI)andDermat

5、ologyLifeQualityIndex(DLQI)toevaluatepsoriaticrash.Afterthreemonths,decreasesinTCMquantitativescores,ACRindexes,PASIandDLQIwereanalyzedin40PsApatients,whowereequallyassignedtoexperimentalgroupwithTCMprescriptionandcontrolgroupwithmethotrexate.Thenumbe

6、rofrespondersto20%improvementofACRindexes(ACR20)and50%improvementofPASI(PASI50)wascomparedinthetwogroups.Results:TherewerestatisticaldifferencesbetweenthetwogroupsonproportionofpatientswhogetareductiveTCMquantitativescoreonscale(P＜0.05),andsignificant

7、statisticaldifferencesonproportionofpatientswhogetascoreonthirst(P＜0.01).Therewerestatisticaldifferencesonscoresonthepatients'painonthevisualanaloguescale(VAS)andtheHealthAssessmentQuestionnaire(HAQ)(P＜0.05).Conclusions:Combinationofdiseaseandsyndrome

8、differentiationisacorrectmethodofPsA,whoseprescriptionhasagoodeffectonpsoriaticarthritisandrash.KeyWordspsoriaticarthritis;combinationofdiseaseandsyndromedifferentiation;curativeeffect目录引言.......................................................