来源：风湿病与关节炎,2020,9（1）:14-16,30.

桂枝附子汤合当归芍药散加减联合常规西药治疗寒湿痹阻证类风湿关节炎27例临床观察（临床研究）

刘俊瑶¹，王　玲^２

　　【摘　要】目的：观察桂枝附子汤合当归芍药散加减联合常规西药治疗寒湿痹阻证类风湿关节炎的临床疗效。方法：将54例类风湿关节炎患者按照随机数表法分为治疗组和对照组，每组27例。2组均给予来氟米特、美洛昔康胶囊常规治疗，治疗组加用桂枝附子汤合当归芍药散加减治疗，2组疗程均为8周。观察2组临床疗效，以及治疗前后疾病活动度（DAS28）评分、视觉模拟评分法（VAS）评分、红细胞沉降率（ESR）和C-反应蛋白（CRP）。结果：治疗组显效20例，有效6例，无效1例，总有效率为96.30%；对照组显效14例，有效6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，2组DAS28评分、VAS评分、ESR、CRP较治疗前均改善明显（P < 0.05），且治疗组优于对照组，差异有统计学意义（P < 0.05）。结论：桂枝附子汤合当归芍药散加减联合常规西药治疗寒湿痹阻证类风湿关节炎患者，可降低疾病活动度与实验室指标，疗效确切。

　　【关键词】　关节炎，类风湿；寒湿痹阻证；桂枝附子汤；当归芍药散；临床疗效

Clinical Observation of Treating 27 Cases of Rheumatoid Arthritis of Cold-dampness Obstruction Syndrome with Modified Guizhi Fuzi Tang（桂枝附子汤）and Danggui Shaoyao San（当归芍药散）Combined with Conventional Western Medicine  

LIU Jun-yao,WANG Ling

　　【ABSTRACT】Objective:To observe the clinical effect of modified Guizhi Fuzi Tang（桂枝附子汤）and Danggui Shaoyao San（当归芍药散）combined with conventional western medicine in the treatment of rheumatoid arthritis of cold-dampness obstruction syndrome.Methods:Fifty-four patients with rheumatoid arthritis were divided into two groups according to the random number table:a treatment group and a control group,with 27 cases in each.Both groups were treated with leflunomide and meloxicam,while the treatment group was also treated with modified Guizhi Fuzi Tang and Danggui Shaoyao San for 8 weeks.The DAS28 score,VAS,ESR and CRP were observed before and after treatment.Results:In the treatment group,20 cases were markedly effective,6 cases were effective,1 case was ineffective,and the total effective rate was 96.30%.In the control group,14 cases were markedly effective,6 cases were effective,7 cases were ineffective and the total effective rate was 74.07%.The difference between the two groups was statistically significant（P < 0.05）.After treatment,the scores of DAS28,VAS,ESR and CRP in the two groups were significantly improved（P < 0.05）,and the treatment group was better than the control group,the difference being statistically significant（P < 0.05）.Conclusion:Modified Guizhi Fuzi Tang and Danggui Shaoyao San combined with conventional western medicine can reduce the disease activity and test index,and ensure the effect and safety of the treatment.

　　【Keywords】 arthritis,rheumatoid;cold-dampness obstruction syndrome;Guizhi Fuzi Tang（桂枝附子汤）;Danggui ShaoyaoSan（当归芍药散）;clinical efficacy