来源：风湿病与关节炎,2019,8（4）:16-19.

桂枝芍药知母汤加减联合常规西药治疗寒热错杂型银屑病关节炎28例临床观察（临床研究）

周定华，周正球，吴　炅，金　艳，黄佳珉，周　琪，杨　婷

　　【摘　要】目的：观察桂枝芍药知母汤加减联合常规西药治疗寒热错杂型银屑病关节炎的临床疗效。方法：将56例寒热错杂型银屑病关节炎患者随机分为治疗组和对照组，每组28例。对照组予美洛昔康加甲氨蝶呤口服治疗，治疗组在对照组的基础上加桂枝芍药知母汤加减治疗。2组均以8周为1个疗程。观察2组临床疗效，以及治疗前后临床症状、体征、C-反应蛋白（CRP）、红细胞沉降率（ESR），并观察2组不良反应。结果：治疗组显效8例，进步11例，有效5例，无效4例，总有效率为85.71%；对照组显效7例，进步8例，有效5例，无效7例，总有效率为74.07%。2组比较，差异有统计学意义（P < 0.05）。治疗后，治疗组肿胀关节数、压痛关节数、视觉模拟评分法（VAS）评分、综合Psoriatic疾病活动指数评分、CRP、ESR与治疗前比较，差异均有统计学意义（P < 0.05或P < 0.01），对照组肿胀关节数、压痛关节数、VAS评分、CRP与治疗前比较，差异有统计学意义（P < 0.05或P < 0.01）。治疗后，治疗组压痛关节数、VAS评分、CRP、ESR均优于对照组，差异有统计学意义（P < 0.05）。2组均无明显不良反应。结论：桂枝芍药知母汤加减联合常规西药治疗寒热错杂型银屑病关节炎疗效较好，且无明显不良反应。

　　【关键词】　银屑病关节炎；寒热错杂型；桂枝芍药知母汤；美洛昔康；甲氨蝶呤；临床疗效

Clinical Observation of Modified Guizhi Shaoyao Zhimu Tang（桂枝芍药知母汤）Combined with Routine Western Medicine Treating 28 Cases of Psoriatic Arthritis of Mixed Cold and Heat Type

ZHOU Ding-hua,ZHOU Zheng-qiu,WU Jiong,JIN Yan,HUANG Jia-min,ZHOU Qi,YANG Ting

　　【ABSTRACT】Objective:To observe the clinical effect of modified Guizhi Shaoyao Zhimu Tang（桂枝芍药知母汤）combined with routine western medicine in the treatment of psoriatic arthritis of mixed cold and heat type.Methods:Fifty-six patients with psoriatic arthritis of mixed cold and heat type were randomly divided into a treatment group and a control group,28 cases in each group.The control group was treated with meloxicam and methotrexate,while the treatment group was treated with Guizhi Shaoyao Zhimu Tang on the basis of the control group.Eight weeks was a course for both groups.The clinical efficacy,clinical symptoms,signs,C-reactive protein（CRP）,erythrocyte sedimentation rate（ESR）and adverse reactions were observed before and after treatment.Results:In the treatment group,8 cases were markedly effective,11 cases were progressive,5 cases were effective,4 cases were ineffective,and the total effective rate was 85.71%;while in the control group,7 cases were markedly effective,8 cases were progressive,5 cases were effective,7 cases were ineffective,and the total effective rate was 74.07%.There was a significant difference between the two groups（P < 0.05）.After treatment,swollen joint count,tender joints,visual analogue score（VAS）,CPDAI scores,CRP and ESR in the treatment group were significantly different from those before treatment（P < 0.05 or P < 0.01）.The swollen joint count,tender joints,VAS scores and CRP in the control group were significantly different from those before treatment（P < 0.05 or P < 0.01）.After treatment,tender joint count,VAS scores,CRP and ESR in the treatment group were better than those in the control group（P < 0.05）.There were no obvious adverse reactions in both groups.Conclusion:Modified Guizhi Shaoyao Zhimu Tang combined with routine western medicine is effective in the treatment of psoriatic arthritis of mixed cold and heat type without obvious side effects.

　　【Keywords】 psoriatic arthritis;mixed cold and type;Guizhi Shaoyao Zhimu Tang（桂枝芍药知母汤）;meloxicam;methotrexate;clinical efficacy