刘倩颖 曹永芬 姚血明 马武开

【摘 要】目的：观察扶正化瘀通络汤联合来氟米特片治疗老年类风湿关节炎的临床疗效。方法：选取60岁以上类风湿关节炎患者80例，随机分为治疗组和对照组，每组40例。对照组给予口服来氟米特治疗，治疗组在对照组基础上给予扶正化瘀通络汤治疗。2组均以12周为1个疗程。观察2组临床疗效，以及治疗前后症状、体征、炎症因子等指标。结果：治疗组脱落2例，对照组脱落4例。治疗组显效23例，有效10例，无效5例，总有效率为86.84%；对照组显效19例，有效9例，无效8例，总有效率为77.78%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组症状、体征及炎性指标较治疗前均有改善（P < 0.01或P < 0.05），且治疗组明显优于对照组（P < 0.05）。治疗过程中治疗组5例、对照组

9例出现不同程度的不良反应。结论：扶正化瘀通络汤联合来氟米特治疗老年类风湿关节炎临床疗效优于单独服用来氟米特，不仅可以辅助提高疗效，同时可明显缓解来氟米特的副作用，疗效显著，安全可靠。

【关键词】 关节炎，类风湿；老年；扶正化瘀通络汤；来氟米特；临床疗效

【ABSTRACT】Objective：To observe the clinical efficacy of Fuzheng Huayu Tongluo Tang（扶正化瘀通络汤）combining Leflunomide Tablets in the treatment of senile rheumatoid arthritis.Methods：Eighty patients over sixty years old with rheumatoid arthritis were randomly divided into a treatment group and a control group，with 40 cases in each.The control group was orally given leflunomide，and the treatment group was treated with Fuzheng Huayu Tongluo Tang based on the treatment for the control group.The two groups were treated with 12 weeks as a course.The clinical effects of the two groups were observed，as well as the symptoms，signs，and inflammatory factors before and after the treatment.Results：There were 2 cases in the treatment group and 4 cases in the control group called off.In the treatment group，23 cases were markedly effective，10 cases were effective，5 cases were invalid，and the total effective rate was 86.84%.In the control group，19 cases were markedly effective，9 cases were effective，8 cases were ineffective，and the total effective rate was 77.78%.The difference between the two groups was statistically significant（P < 0.05）.After treatment，the symptoms，signs and inflammatory indexes of the two groups were improved（P < 0.01 or P < 0.05），and the treatment group was obviously better than the control group（P < 0.05）.Five cases in the treatment group and nine cases in the control group had different levels of adverse reactions.Conclusion：Fuzheng Huayu Tongluo Tang combining leflunomide Tablets is better than leflunomide alone in the treatment of senile rheumatoid arthritis.It can not only help improve the curative effect，but also relieve the side effects of leflunomide，which is effective，safe and reliable.

【Keywords】 arthritis，rheumatoid；senile；Fuzheng Huayu Tongluo Tang（扶正化瘀通絡汤）；leflunomide；clinical efficacy

类风湿关节炎（rheumatoid arthritis，RA）以发病率高、复发率高及致残率高为特点，临床上把年龄大于60岁的RA患者称为老年RA，根据发病时间可分两型：一为老年发病患者（elderly onset rheumatoid arthritis，EORA），二为青年发病迁延至老年患者（non-elderly onset rheumatoid arthritis，NEORA），临床以后者多见。因患者年老体衰、脏腑功能衰退加之久痹正虚及基础疾病多样复杂等特点，在临床用药上既要疗效显著又要安全可靠。笔者采用扶正化瘀通络汤联合来氟米特治疗老年RA患者40例，现总结报告如下。

1 临床资料

1.1 一般资料 选取2015年9月至2016年9月在贵阳中医学院第二附属医院风湿免疫科就诊的门诊及住院老年RA患者80例，随机分为治疗组和对照组，每组40例。……