来源：风湿病与关节炎,2018,7（7）:28-32.

中药配伍对雷公藤治疗育龄女性类风湿关节炎减毒增效的研究（临床研究）

袁作武，游济洲，陈海丽，杨　祎，李　慧，鲁小梅

　　【摘　要】目的：观察中药配伍对雷公藤治疗育龄女性类风湿关节炎临床减毒增效的作用。方法：将80例育龄女性类风湿关节炎患者分为治疗组和对照组，每组40例。治疗组予中药配伍雷公藤治疗，成方雷公藤、鸡血藤、丹参、白及等，对照组予雷公藤片每日3次，每次2片。2组均以１个月为１个疗程，共治疗4个疗程。观察2组ACR临床疗效、治疗前后各临床指标和实验室指标的变化，以及不良反应发生情况。结果：治疗组ACR70者21例，ACR20～ < ACR70者18例，< ACR20者1例，总有效率为97.50%；对照组ACR70者8例，ACR20～ < ACR70者27例，< ACR20者5例，总有效率为87.50%。2组比较，差异有统计学意义（P < 0.05）。治疗后，２组关节肿胀数、关节压痛数、关节受限数、晨僵时间、实验室指标等较治疗前均有明显改善（P < 0.05）；且治疗组关节活动受限、红细胞沉降率、血红蛋白、类风湿因子、血小板计数优于对照组（P < 0.05）。治疗组不良反应发生率17.5%，且程度轻，药物耐受性好；对照组发生率47.5%，且频发次数较高，程度较重。结论：中药配伍雷公藤治疗育龄女性类风湿关节炎不但增加临床疗效，而且降低雷公藤的不良反应，为雷公藤治疗类风湿关节炎安全性提供了新的方案。

　　【关键词】　关节炎，类风湿；中药配伍；雷公藤；减毒增效；育龄女性

Effect of Compatibility of Chinese Medicine on Toxicity Reducing and Efficacy Enhancing of Leigongteng in the Treatment of Rheumatoid Arthritis in Women of Childbearing Age

YUAN Zuo-wu,YOU Ji-zhou,CHEN Hai-li,YANG Yi,LI Hui,LU Xiao-mei

　　【ABSTRACT】Objective:To observe the effect of compatibility of Chinese medicine on toxicity reducing and efficacy enhancing of Leigongteng（Tripterygium Wilfordii Hook.F）in the treatment of rheumatoid arthritis in women of childbearing age.Methods:Eighty women of childbearing age with rheumatoid arthritis were divided into a treatment group and a control group,40 cases in each group.The treatment group was treated with Leigongteng combined with Jixueteng（Millettia dielsiana）,Danshen（Radix Salviae Miltiorrhiae）and Baiji（Rhizoma Bletillae）,and the control group was given Leigongteng tablets,three times a day,two tablets each time.Both groups were treated for a month as a course,four courses all together.The clinical efficacy of ACR,the changes of clinical and laboratory indexes before and after treatment,and the incidence of adverse reactions of both groups were observed.Results:There were 21 cases of ACR70 in the treatment group,18 cases were between ACR20 and ACR70,and one case was less than ACR20,and the total effective rate was 97.50%.In the control group,8 cases were ACR70,27 cases were between ACR20 and ACR70 and 5 cases were less than ACR20,and the total effective rate was 87.50%.The difference between the two groups was statistically significant（P < 0.05）.After treatment,joint swelling count,joint tenderness count,joint constraint count,morning stiffness time,and laboratory indexes were significantly impr-oved（P < 0.05）in both groups,and the hemoglobin,rheumatoid factor and platelet count in the treatment group were better than those of the control group（P < 0.05）.The incidence of adverse reactions in the treatment group was 17.5%,with mildness and good drug tolerance.The incidence of control group was 47.5% with high frequency and severeness.Conclusion:The compatibility of Chinese medicine with Leigongteng in the treatment of female with rheumatoid arthritis of childbearing age not only increases the clinical effect,but also reduces the adverse reaction of it,providing a new scheme for the safety of Leigongteng in the treatment of rheumatoid arthritis.

　　【Keywords】 arthritis,rheumatoid;compatibility of Chinese medicine;Leigongteng;

toxicity reducing and efficacy enhancing;female of childbearing age