虎潜丸加减治疗类风湿关节炎肝肾阴虚证的临床观察

展俊平; 谷慧敏; 孟庆良; 左瑞庭; 杜旭召; 王慧莲; 周子鹏; 苗喜云; 范围

doi:10.13422/j.cnki.syfjx.20182424

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虎潜丸加减治疗类风湿关节炎肝肾阴虚证的临床观察

经典名方 | 更新时间：2021-02-09

- 虎潜丸加减治疗类风湿关节炎肝肾阴虚证的临床观察
- Clinical Observation on Modified Huqianwan in Treatment of Rheumatoid Arthritis Liver-kidney Yin Deficiency Syndrome
- 中国实验方剂学杂志 2019年25卷第1期页码：107-113
- 作者机构：
  
  河南省中医院，郑州　 450002
- 作者简介：
  
  展俊平，博士，主治医师，从事中西医结合治疗自身免疫性疾病研究，Tel：0371-53312126，E-mail：zjp123sun@126.com
  杜旭召，硕士，主治医师，从事中医治疗风湿病研究，Tel：0371-59915379，E-mail:gouqi66669999@163.com
- 基金信息：
  
  河南省科技厅科技攻关项目(162102310447);河南省中医院院级项目(2017YJKT6)
- DOI：10.13422/j.cnki.syfjx.20182424
  中图分类号： R22;R242;R2-031;R287
- 收稿日期：2018-06-07，
  
  网络出版日期：2018-09-28，
  
  纸质出版日期：2019-01-05
- 稿件说明：
移动端阅览
展俊平, 谷慧敏, 孟庆良, 等. 虎潜丸加减治疗类风湿关节炎肝肾阴虚证的临床观察[J]. 中国实验方剂学杂志, 2019,25(1):107-113.

Jun-ping ZHAN, Hui-min GU, Qing-liang MENG, et al. Clinical Observation on Modified Huqianwan in Treatment of Rheumatoid Arthritis Liver-kidney Yin Deficiency Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(1): 107-113.
展俊平, 谷慧敏, 孟庆良, 等. 虎潜丸加减治疗类风湿关节炎肝肾阴虚证的临床观察[J]. 中国实验方剂学杂志, 2019,25(1):107-113. DOI： 10.13422/j.cnki.syfjx.20182424.

Jun-ping ZHAN, Hui-min GU, Qing-liang MENG, et al. Clinical Observation on Modified Huqianwan in Treatment of Rheumatoid Arthritis Liver-kidney Yin Deficiency Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(1): 107-113. DOI： 10.13422/j.cnki.syfjx.20182424.

摘要

目的：

观察虎潜丸加减治疗类风湿关节炎（RA）肝肾阴虚证的临床疗效及安全性。

方法：

将符合条件的184例肝肾阴虚型RA患者按照数字表法随机分为中药组（62例），西药组（57例）和中西药组（65例）。中药组给予虎潜丸加减治疗，西药组给予甲氨蝶呤片联合来氟米特片治疗，中西药组同时给予虎潜丸加减、甲氨蝶呤片及来氟米特片，疗程均为12周。比较各组治疗前后疼痛视觉模拟评分（VAS），28个关节的肿胀和压痛评分（DAS28），双手平均握力，晨僵时间和中医辨证肝肾阴虚证评分；测定各组治疗前后血沉（ESR），C反应蛋白（CRP），免疫球蛋白（Ig）G，肿瘤坏死因子-

（TNF-

）和类风湿因子（RF）等理化指标的变化；比较各组临床疗效及给药后的胃肠反应、肝损伤情况、白细胞减少、血清谷氨酸草酰乙酸氨基转移酶（GOT）及血小板（PLT）变化等不良反应情况，以考察各组药物的有效性和安全性。

结果：

治疗12周后，中药组、西药组、中西药组的临床疗效总有效率分别为79.0%，80.7%，92.3%，中西药组显著优于中药组及西药组（

0.01），中药组和西药组无明显差异；各治疗组均能有效改善RA患者的肝肾阴虚证（

0.05），其中中西药组优于中药组（

0.05），中药组优于西药组（

0.05）；不良反应的发生率中药组（1.61%，1/62）

中西药组（7.69%，5/65）

西药组（22.81%，13/57）。

结论：

虎潜丸加减治疗RA肝肾阴虚证的疗效与西药甲氨蝶呤片及来氟米特片联合用药的疗效无显著差异，且具有不良反应少的优点。虎潜丸加减结合西药甲氨蝶呤片及来氟米特片联合用药治疗RA肝肾阴虚证疗效优于西药甲氨蝶呤片及来氟米特。

Abstract

Objective:

To explore the clinical efficacy and safety of modified Huqianwan in treatment of rheumatoid arthritis (RA) liver-kidney Yin deficiency syndrome

and investigate its possible mechanism.

Method:

A total of 184 patients with RA liver-kidney Yin deficiency syndrome were randomly divided into Chinese medicine group (62 cases)

western medicine group (57 cases) and integrated Chinese and western medicine group (65 cases) according to the digital table method. The patients in Chinese medicine group were treated with Huqianwan; the patients in western medicine group were treated with methotrexate tablets and leflunomide tablets; and the patients in integrated Chinese and western medicine group received Huqianwan+ methotrexate tablets and leflunomide tablets

with a treatment course of 12 weeks in all groups. The pain visual analog scale (VAS)

swelling and tenderness scores of 28 joints (DAS28)

average hands grip strength

morning stiffness time and liver-kidney Yin deficiency syndrome differentiation of traditional Chinese medicine (TCM) syndrome score were compared between groups before and after treatment. The changes of erythrocyte sedimentation rate (ESR)

C reactive protein (CRP)

immunoglobulin (Ig)G

tumor necrosis factor-alpha (TNF-

) and rheumatoid factor (RF) were detected in all groups after treatment. Clinical efficacy

and incidence of adverse reactions such as gastrointestinal response

liver injury

leukopenia

serum glutamate oxaloacetic aminotransferase (GOT) and platelet (PLT) level changes were compared between the groups

so as to investigate the efficiency and safety of the different medicines.

Result:

After 12 weeks of treatment

the total clinical effective rate was 79.0%

80.7%

and 92.3% respectively in Chinese medicine group

western medicine group

and integrated Chinese and western medicine group; the integrated Chinese and western medicine group was significantly better than the Chinese medicine group and western medicine group (

0.01)

but there was no difference between the Chinese medicine group and western medicine group. Every treatment group can effectively improve liver and kidney Yin deficiency syndrome in RA patients (

0.05)

and the effect in integrated Chinese and western medicine group was superior to that in Chinese medicine group (

0.05); the effect in Chinese medicine group was superior to that in western medicine group (

0.05). The incidence of adverse reactions was Chinese medicine group (1.61%

1/62)

integrated Chinese and western medicine group (7.69%

5/65)

western medicine group (22.81%

13/57).

Conclusion:

The efficacy in treating RA liver and kidney Yin deficiency syndrome shows no significant difference between modified Huqianwan and methotrexate tablets+ leflunomide tablets. In the treatment of RA liver and kidney Yin deficiency syndrome

Huqianwan has fewer adverse reactions. Huqianwan combined with methotrexate tablets+ leflunomide tablets is superior to that in methotrexate tablets+ leflunomide tablets in treatment of RA liver-kidney Yin deficiency syndrome.

关键词

Keywords

references

Sandro M M , David A , Daniel A , et al . Myocellular characteristics in rheumatoid arthritis and osteoarthritis patients [J]. Arthritis Res Ther , 2018 , 20 ( 1 ): 51 - 52 .

都帅刚，郭中华，孔倩倩，等 . 散痹汤加减治疗类风湿关节炎肾虚寒湿证的临床研究 [J]．中国中药杂志， 2017 ， 42 ( 14 ): 2802 - 2807 .

Gulsen O , Diane L K , Ted R M , et al . Trends and determinants of osteoporosis treatment and screening in patients with rheumatoid arthritis compared to osteoarthritis [J]. Arthritis Care Res , 2018 , 70 ( 5 ): 713 - 723 .

ZHEN P , LI X S , ZHOU S H , et al . Total hip arthroplasty to treat acetabular protrusions secondary to rheumatoid arthritis [J]. J Orthop Surg Res , 2018 , 13 ( 1 ): 92 - 94 .

Karagülle M , Kardeş S , Dişçi R , et al . Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial [J]. Int J Biometeorol , 2018 , 62 ( 2 ): 195 - 205 .

Versteeg G , Steunebrink L , Vonkeman H , et al . Long-term disease and patient-reported outcomes of a continuous treat-to-target approach in patients with early rheumatoid arthritis in daily clinical practice [J]. Clin Rheumatol , 2018 , 37 ( 5 ): 1189 - 1197 .

Khatri A , Goss S , Jiang P , et al . Pharmacokinetics of ABT-122, a TNF- α - and IL-17A-targeted dual-variable domain immunoglobulin,in healthy subjects and patients with rheumatoid arthritis: results from three phase I trials [J]. Clin Pharmacokinet , 2018 , 57 ( 5 ): 613 - 623 .

张攀科，王芳，张国胜，等 . 小活络丹合桂枝芍药知母汤加减治疗风湿性关节炎寒湿痹阻证的临床观察 [J]．中国实验方剂学杂志， 2017 ， 23 ( 3 ): 181 - 186 .

McCarty D , Robinson A. Efficacy and safety of sarilumab in patients with active rheumatoid arthritis [J]. Ther Adv Musculoskelet Dis , 2018 , 10 ( 3 ): 61 - 67 .

Jeffrey R C , Mona T , Boulos H , et al . Defining and characterizing sustained remission in patients with rheumatoid arthritis [J]. Clin Rheumatol , 2018 , 37 ( 4 ): 885 - 893 .

王丽萍，王春燕，王晓元，等．复方玄驹胶囊联合甲氨蝶呤治疗难治性类风湿关节炎的临床研究 [J]. 中成药， 2018 ， 40 ( 2 ): 299 - 304 .

Kristen D M , Bowers E , Lauren J L , et al . Antibody responses to citrullinated and noncitrullinated antigens in the sputum of subjects with rheumatoid arthritis and subjects at risk for development of rheumatoid arthritis [J]. Arthritis Rheumatol , 2018 , 70 ( 4 ): 516 - 527 .

Curtis J R , Trivedi M , Haraoui B , et al . Defining and characterizing sustained remission in patients with rheumatoid arthritis [J]. Clin Rheumatol , 2018 , 37 ( 4 ): 885 - 893 .

中华人民共和国卫生部．中药新药临床研究指导原则 [M]．北京：人民卫生出版社， 1993 ： 115 - 119 .

ZHANG F Z , MA C L. Comparison of the effectiveness on intra-articular and subcutaneous TNF inhibitor in rheumatoid arthritis patients [J]. Clin Rheumatol , 2018 , 37 ( 1 ): 199 - 204 .

钱鑫，陈璇，魏刚，等．独活寄生汤联合美洛昔康治疗类风湿性关节炎临床观察 [J]．中国实验方剂学杂志， 2016 ， 22 ( 7 ): 173 - 176 .

Burggraaf B , Breukelen S D , Vries M , et al . Progression of subclinical atherosclerosis in subjects with rheumatoid arthritis and the metabolic syndrome [J]. Atherosclerosis , 2018 , 271 ( 1 ): 84 - 91 .

JIANG L , JIANG D D , HAN Y , et al . Association of HLA-DPB1 polymorphisms with rheumatoid arthritis: a systemic review and Meta-analysis [J]. Int J Surg , 2018 , 52 ( 1 ): 98 - 104 .

陈锋，闵重函，周瑛，等 . 蚁参蠲痹胶囊联合西药治疗肾气虚寒型类风湿关节炎35 例临床观察 [J]．中医杂志， 2016 ， 57 ( 12 ): 1045 - 1048 .

Cho S , Kim D , Won S , et al . Impact of anti-rheumatic treatment on cardiovascular risk in Asian patients with rheumatoid arthritis [J]. Semin Arthritis Rheum , 2018 , 47 ( 4 ): 501 - 506 .

XING R , SUN L , WU D , et al . Autoantibodies against interleukin-21 correlate with disease activity in patients with rheumatoid arthritis [J]. Clin Rheumatol , 2018 , 37 ( 1 ): 75 - 80 .

Sabry D , Kaddafy S , Abdelaziz A , et al . Association of SIRT-1 gene polymorphism and vitamin D level in egyptian patients with rheumatoid arthritis [J]. J Clin Med Res , 2018 , 10 ( 3 ): 189 - 195 .

Cecli Z. Clearing up potential misconceptions about the treatment of rheumatoid arthritis and the use of methotrexate in combination therapy [J]. Can Pharm J , 2018 , 151 ( 2 ): 94 - 97 .

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