【作者】 张磊；

【导师】 郝斌；

【作者基本信息】 河北大学 ， 中西医结合临床， 2016， 硕士

【摘要】 目的:本课题基于在导师临床工作经验的基础上,通过对RA运用风湿骨痛贴方外用贴敷治疗的临床研究,为中医药减轻或延缓RA炎症的进展,提供理论依据及新的临床治疗方法。方法:将符合纳入标准的患者按照随机分组原则分为治疗组和对照组。两组均给以洛索洛芬钠60mg 3/日口服,甲氨蝶呤片10mg 1/周口服,雷公藤多苷片2片3/日口服,正清风痛宁胶囊3粒3/日口服,在此基础上,治疗组给予风湿骨痛贴方外用贴敷,选取一个RA累及的关节(一般在近端指间关节、掌指关节、腕关节、膝关节、踝关节中选取),将所选膏药贴于患处1贴/关节/次,以覆盖局部肿痛面积为准,每天换药1次(贴敷18h,间隔6h)连续用药7d,停止用药1d,此为第一疗程,再连续用药7d结束,为第二疗程;分别于治疗前、第1、2疗程结束时进行访视,对DAS28评分、VAS疼痛评分、血沉、C-反应蛋白等炎性指标等实验室检查及安全性指标进行评估。用统计学软件对治疗前后结果进行分析处理。结果:两组治疗前DAS28评分、VAS疼痛评分、血沉、C-反应蛋白等指标差异无统计学意义(P>0.05);治疗后半月血沉、C-反应蛋白指标评价结果明显优于对照组,两组差异有统计学意义(P<0.05);治疗后1周、半月治疗组DAS28评分、VAS疼痛评分指标评价结果明显优于对照组,两组差异有统计学意义(P<0.05);同时治疗组未见明显不良反应,患者耐受性好。结论:风湿骨痛贴方可显著缓解患者关节肿胀数、关节疼痛程度及时间,降低血沉、C-反应蛋白、DAS28指标、VAS疼痛评分,该疗法无明显不良反应,操作简单,安全性高。本研究证实了风湿骨痛贴方治疗类风湿关节炎的有效性,并提供了理论依据。更多还原

【Abstract】 Object: This paper based on on the basis of my tutor’s clinical experience, through of RA by rheumatism paste for external use plaster application for clinical research, for traditional Chinese medicine to reduce or delay the progression of RA inflammation, providing theoretical basis and new methods of clinical treatment。Method:Patients who met the inclusion criteria were divided into the treatment group and the control group according to the principle of randomization. Two groups were given Yiluosuoluofen sodium 60 mg 3/ day orally, the Methotrexate Tablets 10 mg 1/ week oral Tripterygium wilfordii tablets 2 3/, orally, Zhengqingfengtongning capsules 3 3/ orally, on this basis, the treatment group was given Fengshigutong party paste used for dressing, select a RA involving the joint(usually in the past the proximal interphalangeal joint and metacarpophalangeal joint selection, wrist joint, knee joint and ankle joint), will be selected in the plaster to the affected part 1 / joint / time, to cover the local swelling area, daily dressing 1 times(sticking interval 18 h, 6h) continuous medication 7d, stop drug 1D, this is the first course of treatment, and continuous medication for second courses; the end of the 7d, respectively, were interviewed before treatment, first, 2 at the end of the treatment, the DAS28 score, VAS pain score, ESR, C- reactive protein and other inflammatory indicators of laboratory examination and safety indicators Line evaluation. Using statistical software to analyze and deal with the results before and after treatment。Result:The two groups before treatment differences between the DAS28 score, VAS pain score, erythrocyte sedimentation rate, C-reactive protein indicators no statistical significance(P > 0.05). After treatment of semilunar erythrocyte sedimentation rate, C-reactive protein(CRP) evaluation results significantly better than the control group, the difference between the two groups has statistical significance(P < 0.05); after treatment, 1 week and a half months treatment group DAS28 score, VAS pain score evaluation index is obviously superior to the control group, the difference between the two groups has statistical significance(P < 0.05); at the same time, the treatment group had no obvious adverse reaction and patient tolerance is good。Conclusion:Fengshi Gutong herb paste can significantly relieve patients with joint swelling number, joint pain and time and the decrease of the erythrocyte sedimentation rate, C-reactive protein, DAS28 index and VAS pain score, the therapy has no obvious adverse reaction, simple operation, safety of high. This study confirms the effectiveness of rheumatism paste Decoction in the treatment of rheumatoid arthritis, and provides a theoretical basis for。更多还原