高妤 冯福海 李晓雨 原莎莎 张淑君

[摘要]目的对尪痹片联合瘀血痹胶囊治疗肝肾不足型类风湿关节炎（RA）进行临床观察，客观评价其临床疗效。方法选取2018年1月至2020年1月河南中医药大学第一附属医院风湿科门诊符合纳入标准的120例肝肾不足型 RA 患者，按照随机数字表法分成治疗组（60例）和对照组（60例）。治疗组给予尪痹片（1.5 g，每日3次）、瘀血痹胶囊（2.0 g，每日3次），对照组给予雷公藤多苷片（20 mg，每日3次），疗程均为6个月。治疗结束后比较两组压痛关节数、肿胀关节数、视觉疼痛评分（VAS）、血沉（ESR）、C 反应蛋白（CRP）、DAS28评分的变化，根据症状体征改善程度评估临床疗效。结果治疗6个月后，治疗组总有效率为84.7%，对照组总有效率为72.4%，治疗组优于对照组（ P <0.05）;两组治疗后压痛关节数、肿胀关节数、疼痛 VAS 评分、 DAS28评分、ESR、CRP 有明显改善，差异有统计学意义（ P <0.05）。其中，治疗组治疗后压痛关节数、肿胀关节数及 DAS28评分改善程度优于对照组，差异有统计学意义（ P <0.05），治疗后 ESR、CRP、疼痛 VAS 评分组间比较，差异无统计学意义（ P >0.05）。结论尪痹片联合瘀血痹胶囊和单纯口服雷公藤多苷片均可以改善肝肾不足型 RA 患者的临床症状，在关节疼痛、肿胀症状的改善上，尪痹片联合瘀血痹胶囊疗效更佳。

[关键词]尪痹片聯合瘀血痹胶囊;肝肾不足;类风湿关节炎;雷公藤多苷片

[中图分类号] R259  [文献标识码] A   [文章编号]2095-0616（2021）23-0005-05

Clinical research on treating rheumatoid arthritis with syndrome of deficiency of liver and kidney with Wangbi Tablet combined with

Yuxuebi Capsule

GAO  Yu1      FENG  Fuhai2      LI  Xiaoyu1      YUAN  Shasha1      ZHANG  Shujun3

1.He'nan University of Chinese Medicine， He'nan， Zhengzhou 450000， China;2.Department of Rheumatology， the First Affiliated Hospital of He'nan University of Chinese Medicine， He'nan， Zhengzhou 450000， China;3.Department of Acupuncture and Moxibustion， the Third Affiliated Hospital of He'nan University of Chinese Medicine， He'nan， Zhengzhou 450000， China

[Abstract] Objective To make clinical observation of treating rheumatoid arthritis （RA） with syndrome of deficiency of liver and kidney with Wangbi Tablet combined with Yuxuebi Capsule and evaluate its clinical effect objectively. Methods A total of 120 RA patients with liver and kidney deficiency from the out-patient department of Department of Rheumatology of the First Affiliated Hospital of He'nan University of Chinese Medicine from January 2018 to January 2020， who conformed to the inclusion criteria， were randomly divided into the treatment group （n=60） and the control group （n=60） according to the random number table method. The treatment group was administered Wangbi Tablet （1.5 g， 3 times a day） and Yuxuebi Capsule （2.0 g， 3 times a day） for six months. The control group was administered tripterygium tablet （20 mg， 3 times a day） for six months. After treatment， the changes of tender joint counts， swollen joint counts， Visual Analogue Scale （VAS） scores， erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP） and DAS28 scores were compared between the two groups， and the clinical efficacy was evaluated according to the improvement degree of symptoms and signs. Results After 6 months of treatment， the total effective rate of the treatment group was 84.7%， while that of the control group was 72.4%， with the treatment group being superior to the control group （P <0.05）. After treatment， the changes of tender joint counts， swollen joint counts， VAS scores， DAS28 scores， ESR and CRP of the two groups were obviously improved， and the differences were statistically significant （P <0.05）. Among the changes， the improvement degree of TJCs and SJCs and DAS28 scores after treatment of the treatment group was superior to that of the control group， and the difference was statisticallysignificant （P <0.05）. After treatment when ESR， CRP and VAS pain scores were compared between the two groups， the differences were statistically insignificant （P >0.05）. Conclusion Both Wangbi Tablet combined with Yuxuebi Capsule and oral administration of tripterygium tablet alone can ameliorate the clinical symptoms of RA patients with syndrome of deficiency of liver and kidney. In ameliorating the symptoms of joint pain and swelling， Wangbi Tablet combined with Yuxuebi Capsule produces better effect.

[Key words] Wangbi Tablet combined with Yuxuebi Capsule; Deficiency of liver and kidney; Rheumatoid arthritis; Tripterygium tablet

类风湿关节炎（rheumatoid arthritis，RA）是一种慢性自身免疫病。本病以侵蚀性关节炎为主要表现，随着病情发展，可出现关节畸形，甚至功能丧失，影响患者的生命健康，降低生活质量[1]。随着现代医学的发展，本病的治疗多采用改善病情的抗风湿药（DMARDs）、生物制剂及非甾体抗炎药（NSAIDs）等，然而这些药物有诸多不足之处，如不良反应、价格昂贵等[2]。RA 中医属“痹病”的范畴，病机以正虚为本，风寒湿热等外邪侵袭为标。……