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目的:观察桂枝汤加术附加减联合来氟米特治疗类风湿关节炎临床疗效。方法:选取2014年6月至2016年6月廉江市人民医院中医科收治的类风湿关节炎80例,按就诊顺序简单随机分成两组,对照组30例给予来氟米特每次10 mg,每日1次。观察组50例在对照组的基础上加服桂枝汤加术附加减中药汤剂,每日1剂。两组疗程12周,观察两组患者中医证候疗效、28个关节数疾病活动度评分(DAS28)、血清红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)水平及不良反应。结果:观察组治疗总有效率为96.0%,对照组为76.7%,观察组中医证候疗效显著优于对照组,差异具有统计学意义(P<0.05);治疗后观察组血清ESR、CRP、RF水平及DAS28评分均较对照组低,差异具有统计学意义(P<0.05);观察组不良反应发生率4.00%较对照组23.33%低,差异具有统计学意义(P<0.05)。结论:桂枝汤加术附加减联合来氟米特治疗类风湿关节炎,能有效的改善患者的临床症状,疗效确切,不良发应少,安全性高。
Objective: To observe the clinical efficacy of Guizhi Decoction combined with leflunomide in the treatment of rheumatoid arthritis. Methods: From June 2014 to June 2016, 80 cases of rheumatoid arthritis admitted to the Department of Traditional Chinese Medicine, Lianjiang People’s Hospital were randomly divided into two groups according to the order of their visits. The control group received leflunomide 10 mg , 1 day. Observation group of 50 cases in the control group based on the plus Guizhi Tong plus additional Chinese medicine decoction, a day. The two groups were treated for 12 weeks. The curative effect of TCM syndromes, DAS28, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factor (RF) Adverse reactions. Results: The total effective rate was 96.0% in the observation group and 76.7% in the control group. The curative effect of TCM syndrome in the observation group was significantly better than that in the control group (P <0.05). After treatment, serum ESR, CRP, RF level and DAS28 score were lower than the control group (P <0.05). The incidence of adverse reactions in the observation group was 4.00% lower than that in the control group (23.33%), the difference was statistically significant (P <0.05). Conclusion: Guizhi Decoction combined with leflunomide treatment of rheumatoid arthritis can effectively improve the clinical symptoms of patients with definite curative effect, fewer adverse reactions and high safety.