综合疗法治疗类风湿关节炎100例的疗效观察被引量：7

Effective observation on treating 100 cases of rheumatoid arthritis by comprehensive therapy

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摘要目的:观察中药、西药、疼痛介入、理疗四联疗法治疗类风湿关节炎大关节肿痛畸形的临床疗效和安全性。方法:选取2015年1月-2016年12月我院住院治疗的类风湿关节炎患者200例,按随机数字查法分为治疗组100例、对照组100例,治疗组给予洛索洛芬抗炎镇痛,60mg,2次/d;泮托拉唑护胃,40mg,1次/d;碳酸钙D3片,1g/d及阿法骨化醇0.5μg/d,抗骨质疏松;来氟米特10mg,2次/d;甲氨蝶呤10mg,1周1次;每月复查肝肾功能和血常规。中药煎剂辨证论治,分型如下:气血亏虚型,用补中益气汤、归脾汤加味;湿热痹阻型,用宣痹汤、四妙散加味;肝肾亏虚型,用独活寄生汤加味;痰瘀阻络型,用五积散加味。针对肿胀的大关节实行关节腔灌洗治疗、银质针软组织松解抗炎治疗,每个大关节治疗3次左右。对照组与上述治疗基本相同,但不采用关节腔灌洗治疗和银质针软组织松解抗炎治疗。中频、超短波、红外线、药物导入。两组均以3个月为1个疗程。结果:治疗组显效率85%,对照组显效率61%,治疗组服用抗炎镇痛药少于对照组,功能活动优于对照组,未出现严重副作用。结论:以疼痛介入治疗为特色的四联疗法优于药物、理疗方法,安全可靠。 Objective:To observe the clinical effects and safety of TCM medicine,western medicine,interventional pain therapy,quadruple therapy on rheumatoid arthritis joint pain deformity.Methods:200cases of rheumatoid arthritis treated in our hospital from January2015to December2016were selected and randomly divided into two groups,namely the treatment group(100cases)and the control group(100cases).The treatment group received loxoprofen anti-inflammatory and analgesic,60mg,twice a day;pantoprazole to protect the stomach,40mg,once every day;Calcium Carbonate and Vitamin D3Tablets,1g every day and alfacalcidol,0.5μg/d,anti-osteoporosis;leflunomide,10mg,twice a day;methotr exate,10mg,once every week;the liver and kidney function and blood routine were examined every month.Chinese medicine syndrome differentiation and decoction of classification were as follows:for deficiency of Qi and blood type,the Buzhong Yiqi decoction and Guipi decoction were given;for damp heat blockage type,the Xuanbi decoction and Simiao powder were given;for liver and kidney deficiency type,Duhuo Jisheng decoction was given;for blood stasis and phlegm accumulation,Wuji Powder was given.The implementation of joint cavity lavage,silver needle and soft tissue release anti-inflammatory treatment was applied in the treatment of the joint swelling,each joint was treated for3times.The control group received the above mentioned treatment without implementation of joint cavity lavage,silver needle and soft tissue release anti-inflammatory treatment.Medium frequency,ultrashort wave,infrared ray,drug introduction were applied.3months formed a treatment course.Results:The total efficiency in the treatment group was85%,while that in the control group was61%.Anti-inflammatory drugs was less in the treatment group,and the function was better than that in the control group,and there was no serious side effects.Conclusion:The interventional pain quadruple therapy was better than drug and physical therapy,and it was safe and reliable.