| 引用本文: |
徐丹, 刁本恕, 吕霞, 王冰冰, 王蝶, 杨慧琳, 冯奕.蠲痹消肿止痛酊联合白芍总苷胶囊治疗类风湿关节炎湿热痹阻证的临床疗效[J].湖南中医药大学学报,2026,46(9):1915-1920[点击复制] |
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| 蠲痹消肿止痛酊联合白芍总苷胶囊治疗类风湿关节炎湿热痹阻证的临床疗效 |
| 徐丹,刁本恕,吕霞,王冰冰,王蝶,杨慧琳,冯奕 |
| (成都市第七人民医院中医科/中西医结合科/风湿免疫科, 四川 成都 610200) |
| 摘要: |
| 目的 探讨蠲痹消肿止痛酊联合白芍总苷胶囊治疗类风湿关节炎（RA）湿热痹阻证的临床疗效，并评估其安全性。方法 选取成都市第七人民医院中医科/中西医结合科/风湿免疫科2023年1月至2025年12月收治的RA湿热痹阻证患者120例，随机分为对照组与观察组，每组60例。两组均给予健康宣教及基础支持治疗，对照组在此基础上给予白芍总苷胶囊口服，每次0.6 g，每日3次；观察组在对照组基础上加用蠲痹消肿止痛酊，每次3~5 mL，涂抹于肿痛关节处，轻柔按摩至局部发热，每日3次。两组均连续治疗8周。比较两组患者28个关节疾病活动度评分（DAS28）、健康评估问卷（HAQ）评分、中医证候积分、炎症及免疫指标[包括红细胞沉降率（ESR）、C反应蛋白（CRP）、类风湿因子（RF）、抗环瓜氨酸肽抗体（anti-CCP）水平]、临床疗效以及治疗期间不良反应发生情况。结果 治疗后，观察组总有效率高于对照组（P<0.05）；两组患者DAS28、HAQ评分、中医证候积分及ESR、CRP、RF、anti-CCP水平均较治疗前下降（P<0.05），且观察组患者DAS28、HAQ评分、中医证候积分及ESR、CRP、RF和anti-CCP水平均低于对照组（P<0.05）。两组患者不良反应发生率比较，差异无统计学意义（P>0.05）。结论 蠲痹消肿止痛酊联合白芍总苷胶囊治疗RA湿热痹阻证的临床观察提示，该联合疗法在疾病活动度与功能、中医证候、炎症及免疫指标方面均优于白芍总苷胶囊单药治疗，且短期安全性良好。 |
| 关键词: 类风湿关节炎|湿热痹阻证|蠲痹消肿止痛酊|白芍总苷胶囊|炎症因子|免疫调节 |
| DOI：10.3969/j.issn.1674-070X.2026.09.024 |
| 投稿时间：2026-09-04 |
| 基金项目:四川省中医药管理局科学技术研究专项课题(2020LC0021)。 |
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| Clinical efficacy of Juanbi Xiaozhong Zhitong Tincture combined with Total Glucosides of Paeony Capsule for rheumatoid arthritis with damp heat obstruction pattern |
| XU Dan, DIAO Benshu, LYU Xia, WANG Bingbing, WANG Die, YANG Huilin, FENG Yi |
| (Department of Chinese Medicine/Department of Integrated Chinese and Western Medicine/Department of Rheumatology and Immunology, Chengdu Seventh People's Hospital, Chengdu, Sichuan 610200, China) |
| Abstract: |
| Objective To investigate the clinical efficacy and safety of Juanbi Xiaozhong Zhitong Tincture combined with Total Glucosides of Paeony Capsule for rheumatoid arthritis (RA) with damp heat obstruction pattern. Methods A total of 120 patients with RA and damp heat obstruction pattern treated at the Department of Chinese Medicine/Department of Integrated Chinese and Western Medicine/Department of Rheumatology and Immunology, Chengdu Seventh People's Hospital from January 2023 to December 2025 were enrolled and randomly divided into control group and observation group, with 60 cases in each group. Both groups received health education and basic supportive care. Control group received oral Total Glucosides of Paeony Capsule, 0.6 g each time, three times daily. Observation group additionally received Juanbi Xiaozhong Zhitong Tincture, 3-5 mL each time, which was applied to swollen and painful joints with gentle massage until local warmth was felt, three times daily. Both groups were treated for 8 weeks. The 28-joint Disease Activity Score (DAS28), Health Assessment Questionnaire (HAQ) score, TCM pattern scores, inflammatory and immune indicators [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and anti-cyclic citrullinated peptide antibody (anti-CCP) levels], clinical efficacy, and incidence of adverse reactions during treatment were compared between the two groups. Results After treatment, the total effective rate was higher in observation group than in control group (P<0.05). DAS28 and HAQ scores, TCM pattern scores, and ESR, CRP, RF, and anti-CCP levels decreased after treatment in both groups (P<0.05), and were lower in observation group than in control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Juanbi Xiaozhong Zhitong Tincture combined with Total Glucosides of Paeony Capsule was superior to Total Glucosides of Paeony Capsule alone in terms of disease activity and function, TCM pattern, and inflammatory and immune indicators in patients with RA and damp heat obstruction pattern, with favorable short-term safety. |
| Key words: rheumatoid arthritis|damp heat obstruction pattern|Juanbi Xiaozhong Zhitong Tincture|Total Glucosides of Paeony Capsule|inflammatory factors|immunomodulation |
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