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目的筛选治疗类风湿关节炎(RA)贫血的有效方剂。方法将60例RA贫血患者随机分为治疗组和对照组各30例,治疗组用独活寄生汤联合甲氨蝶呤、来氟米特治疗,对照组用归脾汤联合甲氨蝶呤、来氟米特治疗;两组均以4周为1个疗程,3个疗程后观察临床综合及疾病疗效,进行RA主要症状体征及贫血症状评分,同时进行实验室指标检测及健康指数调查(HAQ),并观察药物的不良反应。结果对照组临床综合疗效总有效率70.0%,治疗组总有效率90.0%,治疗组优于对照组(P<0.05)。两组治疗后临床症状及体征均较治疗前有所改善(P<0.05),并且治疗组改善程度优于对照组(P<0.05)。治疗组患者治疗后贫血症状积分及HAQ积分较治疗前明显减少(P<0.05),两组治疗后各积分比较差异有统计学意义(P<0.05)。两组治疗后血红蛋白含量升高,而血小板、类风湿因子、血沉、C反应蛋白下降(P<0.05),两组治疗后组间比较差异有统计学意义(P<0.05)。治疗组美国风湿病学会(ACR)指定标准50%改善率为86.7%,优于对照组的66.7%(P<0.05)。两组不良反应均较轻,均能完成临床观察。结论独活寄生汤治疗RA贫血疗效优于归脾汤。
Objective To screen effective agents for the treatment of rheumatoid arthritis (RA) anemia. Methods Sixty patients with RA anemia were randomly divided into treatment group (30 cases) and control group (30 cases). Treatment group was treated with “live alone” and methotrexate and leflunomide, while control group was treated with Guipi Decoction combined with methotrexate The two groups were treated with 4 weeks as a course of treatment. After 3 courses of treatment, clinical efficacy and disease efficacy were observed. The main symptoms and signs of RA and symptom scores of anemia were observed. Laboratory tests and health index (HAQ) , And observe the adverse drug reactions. Results In the control group, the total effective rate was 70.0%. The total effective rate in the treatment group was 90.0%. The treatment group was better than the control group (P <0.05). The clinical symptoms and signs in both groups were better than those before treatment (P <0.05), and the improvement in the treatment group was better than that in the control group (P <0.05). After treatment, the scores of anemia symptom and HAQ in treatment group were significantly lower than those before treatment (P <0.05), and there was significant difference between the two groups after treatment (P <0.05). After treatment, hemoglobin content increased, but platelet, rheumatoid factor, erythrocyte sedimentation rate and C-reactive protein decreased (P <0.05). There was significant difference between the two groups after treatment (P <0.05). Treatment group American College of Rheumatology (ACR) designated standard 50% improvement rate of 86.7%, better than the control group 66.7% (P <0.05). Two groups of adverse reactions are lighter, can complete the clinical observation. Conclusion Dafu parasitic soup treatment of RA anemia better than the spleen soup.