来源：风湿病与关节炎,2020,9（10）:12-15.

益气补肾活血方联合甲氨蝶呤治疗肾虚瘀血痹阻型类风湿关节炎28例临床观察（临床研究）

刘淑清¹，吉缤郡¹，葛华迅¹，刘龙民¹，黄　蓓¹，纪翠霞¹，曹会杰¹，顾昳赟¹，

田　雨²  

　　【摘　要】目的：观察益气补肾活血方联合甲氨蝶呤治疗肾虚瘀血痹阻型类风湿关节炎的临床疗效。方法：将56例肾虚瘀血痹阻型类风湿关节炎患者随机分为治疗组和对照组，每组28例。对照组给予甲氨蝶呤片治疗，治疗组在对照组治疗基础上加用益气补肾活血方。2组均以3个月为1个疗程。观察2组治疗前后中医证候积分、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（抗CCP抗体）、IL-1和TNF-α的变化。结果：治疗后，2组患者中医证候均较治疗前明显改善（P < 0.05）。2组患者ESR、CRP、RF、抗CCP抗体、IL-1、TNF-α较治疗前均明显下降（P < 0.05），治疗组RF、IL-1、TNF-α下降较对照组更明显（P < 0.05）。结论：益气补肾活血方联合甲氨蝶呤治疗肾虚瘀血痹阻型类风湿关节炎具有较好的疗效，能有效下调炎症因子IL-1、TNF-α水平，具有明显的抑制免疫炎症作用。

　　【关键词】　关节炎，类风湿；益气补肾活血方；甲氨蝶呤；白细胞介素-1；肿瘤坏死因子-α

Clinical Observation on 28 Cases of Rheumatoid Arthritis with Kidney Deficiency and Blood Stasis Bi-obstruction Type Treated by Yiqi Bushen Huoxue Fang（益气补肾活血方）Combined with Methotrexate

LIU Shu-qing,JI Bin-jun,GE Hua-xun,LIU Long-min,HUANG Bei,JI Cui-xia,CAO Hui-jie,GU Yi-yun,TIAN Yu

　　【ABSTRACT】Objective:To observe the clinical efficacy of Yiqi Bushen Huoxue Fang（益气补肾活血方）combined with methotrexate in the treatment of rheumatoid arthritis of kidney deficiency and blood stasis bi-obstruction type.Methods:Fifty-six patients with rheumatoid arthritis of kidney deficiency and blood stasis bi-obstruction type were randomly divided into a treatment group and a control group,28 cases in each group.The control group was given methotrexate tablets,and the treatment group was given Yiqi Bushen Huoxue Fang based on the treatment for the control group.The course of treatment was 3 months for both groups.The changes of TCM syndrome scores,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,rheumatoid factor（RF）,anti cyclic citrullinated peptide antibody（anti CCP antibody）,IL-1 and TNF-α were observed before and after treatment.Results:After treatment,the TCM Syndromes of the two groups were significantly decreased（P < 0.05）.ESR,CRP,RF,anti CCP antibody,IL-1,TNF-α in the two groups were significantly improved compared with those before treatment（P < 0.05）.RF,IL-1,TNF-α in the treatment group decreased more significantly than those in the control group（P < 0.05）.Conclusion:Yiqi Bushen Huoxue Fang combined with methotrexate has a good curative effect on rheumatoid arthritis of kidney deficiency and blood stasis bi-obstruction type,which can effectively down regulate the levels of IL-1 and TNF-α,and has an obvious inhibitory effect on immune inflammation.

　　【Keywords】 arthritis,rheumatoid;Yiqi Bushen Huoxue Fang（益气补肾活血方）;methotrexate;IL-1;TNF-α