Clinical Observation on Jiawei Shaogan Fuzi Decoction（加味芍甘附子汤） Combined with Western Medicine in the Treatment of 30 Rheumatoid Arthritis Patients with Cold-damp Obstruction Syndrome at Active Phase

ZHENG Wei; ZHU Yuelan; MA Junfu; ZHUGE Yeting; LIU Xiaoping; ZHANG Jisheng; HOU Xiujuan

doi:10.13288/j.11-2166/r.2018.09.011

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Clinical Observation on Jiawei Shaogan Fuzi Decoction（加味芍甘附子汤） Combined with Western Medicine in the Treatment of 30 Rheumatoid Arthritis Patients with Cold-damp Obstruction Syndrome at Active Phase

更新时间：2021-11-10

- Clinical Observation on Jiawei Shaogan Fuzi Decoction（加味芍甘附子汤） Combined with Western Medicine in the Treatment of 30 Rheumatoid Arthritis Patients with Cold-damp Obstruction Syndrome at Active Phase
- Journal of Traditional Chinese Medicine Vol. 59, Issue 9, Pages: 760-764(2018)
- 作者机构：
  
  1. 北京中医药大学
  2. 北京中医药大学东方医院
  3. 河南省中医院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2018.09.011
  CLC： R259
- Published：2018
- 稿件说明：
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[1]郑炜,朱跃兰,马俊福,诸葛叶婷,刘小平,张继胜,侯秀娟.加味芍甘附子汤联合西药治疗类风湿关节炎寒湿痹阻证活动期患者30例临床观察[J].中医杂志,2018,59(09):760-764.

ZHENG Wei, ZHU Yuelan, MA Junfu, et al. Clinical Observation on Jiawei Shaogan Fuzi Decoction（加味芍甘附子汤） Combined with Western Medicine in the Treatment of 30 Rheumatoid Arthritis Patients with Cold-damp Obstruction Syndrome at Active Phase[J]. Journal of Traditional Chinese Medicine2018, 59(9): 760-764.
[1]郑炜,朱跃兰,马俊福,诸葛叶婷,刘小平,张继胜,侯秀娟.加味芍甘附子汤联合西药治疗类风湿关节炎寒湿痹阻证活动期患者30例临床观察[J].中医杂志,2018,59(09):760-764. DOI： 10.13288/j.11-2166/r.2018.09.011.

ZHENG Wei, ZHU Yuelan, MA Junfu, et al. Clinical Observation on Jiawei Shaogan Fuzi Decoction（加味芍甘附子汤） Combined with Western Medicine in the Treatment of 30 Rheumatoid Arthritis Patients with Cold-damp Obstruction Syndrome at Active Phase[J]. Journal of Traditional Chinese Medicine2018, 59(9): 760-764. DOI： 10.13288/j.11-2166/r.2018.09.011.

摘要

目的观察加味芍甘附子汤治疗类风湿关节炎（RA）寒湿痹阻证临床疗效性及安全性。方法将60例RA患者随机分为治疗组与对照组各30例。对照组予甲氨蝶呤和/或来氟米特

治疗组在对照组基础上联合加味芍甘附子汤

每日1剂

两组疗程均为12周。记录患者中医证候积分

28个关节疾病活动度评分（DAS28）

ACR（20/50/70）达标率

晨僵时间、关节肿胀数、关节疼痛数及VAS评分

肌肉骨骼超声评价双手2

掌指关节（MCPJ）、2

近端指间关节（PIPJ）受累个数及MCPJ滑膜增生分级情况

安全性评价。结果治疗后治疗组中医证候即晨僵、关节肿胀、关节疼痛、关节压痛、关节作冷、畏恶风寒、腰膝酸软、肢冷不温评分低于对照组（P

0.05）。治疗组中医证候疗效总有效率为96.67%

高于对照组的66.67%（P

0.01）。与治疗前比较

两组治疗后晨僵时间、关节疼痛及肿胀个数、VAS评分均降低（P

0.05）;治疗后治疗组晨僵时间、关节肿胀个数及VAS评分较对照组降低（P

0.05）。治疗组疗后DAS28评分疗效总有效率90.00%

高于对照组的66.67%（P

0.05）。两组患者治疗后ACR20/50/70达标率比较差异无统计学意义（P

0.05）。治疗后两组MCPJ受累个数较本组治疗前减少（P

0.05）

MCPJ滑膜增生分级情况均较治疗前降低（P

0.05）。但治疗后两组MCPJ、PIPJ受累个数差异均无统计学意义（P

0.05）。治疗组仅有2例肝功能异常并于试验结束时消失。结论加味芍甘附子汤联合西药在改善RA寒湿痹阻证患者全身症状及体征方面优于单用传统西药

安全性较好。

Abstract

Objective To observe the clinical efficacy and safety of Jiawei Shaogan Fuzi（SGFZ） Decoction（加味芍甘附子汤） in treating rheumatoid arthritis（RA） with cold-damp obstruction syndrome. Methods Sixty RA patients were randomly divided into treatment group and control group

with 30 patients in each group. The control group was treated with methotrexate（MTX） or/anduse leflunomide（LEF）

and the treatment group was given SGFZ Decoction on the basis of control group

once a day. Both groups were treated for 12 weeks. Chinese medicine syndrome scores

DAS28 score

control rate of ACR（20/50/70）

time of morning stiffness

swollen joint count

painful joint count

VAS scores

musculoskeletal ultrasound evaluation of 2 to 5 metacarpophalangeal joints（MCPJ）

the number of affected 2 to 5 proximal interphalangeal joint（PIPJ）

and MCPJ hypertrophic synovium grading were recorded. The clinical efficacy and safety were evaluated. Results After treatment

the scores of Chinese medicine syndromes and symptoms of morning stiffness

joint swelling

joint pain

joint tenderness

joint cold

aversion to cold

soreness and weakness of waist and knees

cold in extremities of treatment group were lower than those in the the control group（P < 0. 05）. The total effective rate of Chinese medicine syndrome in the treatment group was 96. 67%

which was higher than 66. 67% in the control group（P < 0. 01）. Compared with before treatment

the time of morning stiffness

joint pain and swelling count

VAS score of two groups were decreased（P < 0. 05）. After treatment

the total effective rate of DAS28 in the treatment group was 90. 00%

which was higher than 66. 67% of control group（P < 0. 05）. There was not statistically significant difference in control rate of ACR20/50/70 of two groups after treatment（P > 0. 05）. After treatment

the number of affected MCPJ of two groups was decreased（P < 0. 05）

and MCPJ hypertrophic synovium grading was decreased（P < 0. 05）. There was no significant difference in the number of affected MCPJ

PIPJ of two groups after treatment（P > 0. 05）. Conclusion Jiawei Shaogan Fuzi Decoction combined with western medicine is better than simple conventional western medicine in improving the symptoms and signs of RA patients with cold-damp obstruction syndrome simple

with better safety.

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Related Institution

Guang'anmen Hospital，China Academy of Chinese Medical Sciences

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The First Affiliated Hospital of Anhui University of Chinese Medicine/Anhui Provincial Key Laboratory for Applied Basic and Clinical Translational Research of Traditional Chinese Medicine Rheumatology

Affiliated Hospital of Jiangxi University of Chinese Medicine

Clinical Medical College of Jiangxi University of Chinese Medicine

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