目的 观察应用微创针刀镜联合甲氨喋呤治疗类风湿关节炎(RA)的临床疗效和安全性.方法 自2018年1月～2018年6月,采用微创针刀镜联合甲氨喋呤治疗RA患者30例,治疗8周后,观察患者疼痛视觉模拟评分法(VAS)的评分、晨僵时间、关节压痛数、关节肿胀数、双手握力、ESR,CRP及DAS28等指标.结果 微创针刀镜联合甲氨喋呤治疗8周后,患者VAS评分、关节压痛数、关节肿胀数均显著降低,晨僵时间明显缩短,双手握力增加(P＜0.05),患者ESR,CRP及DAS28较治疗前有明显改善(P＜0.05).结论 采用微创针刀镜联合甲氨喋呤治疗RA,能够缓解RA患者关节疼痛和肿胀,使患者整体病情能够更快达标治疗.

Objective To observe the effect of Baisai Buxie granules on Behcet's disease.Methods 40 patients with Behcet's disease were randomly divided into treatment group (n=20) and control group (n=20). The treatment group was given Baisai Buxie granules treatment, early, half an hour after dinner to take the 6g, the control group treated with 100mg, 1 time /d, oral before night sleep. The 2 groups were treated continuously for 2 months. 2 months later, the 2 groups were compared to observe symptoms, erythrocyte sedimentation, C reactive protein, and adverse reactions.Results The treatment group patients with the total effective rate (90％) was significantly higher than the control group (75％), and the patients in the treatment group ESR (18.10 + 3.96) mm, H-1, CRP (9.03±3.33) Mg - L-1 was significantly better than the control group (23.10±4.60) mm, H-1 (12.29±3.79) Mg - L-1. The 2 groups were significantly different (P<0.05), recurrence rate of the patients in the treatment group is lower than the control group (P<0.05).Conclusion Effect of Baisai Buxie granules in BD is better than thalidomide, may be related to its anti-infl ammatory anti-infection, immune function, microcirculation and hemorheology improvement.

目的:观察经筋刀联合中医微创针刀镜治疗类风湿关节炎(rheumatoid arthritis,RA)的疗效.方法:选取2016年6月至2017年6月在潍坊市中医院风湿免疫科住院的类风湿关节炎患者60例,随机分为治疗组和对照组,每组30例.对照组给予西乐葆、甲氨蝶呤、叶酸、云克2套治疗,治疗组在对照组治疗的基础上给予经筋刀联合中医微创针刀镜治疗.结果:与治疗前相比较,两组患者晨僵时间、关节肿胀数、关节压痛数、疼痛VAS评分、医师评价、患者评价、血沉、C反应蛋白均明显改善(P＜0.05),且治疗组治疗后优于对照组,差异有统计学意义;治疗组治疗8周后DAS28评分优于对照组,差异有统计学意义(P＜0.05).结论:经筋刀联合中医微创针刀镜治疗类风湿关节炎可以松解粘连的滑膜组织,清除纤维素样坏死,修复关节面,缩短疗程,不仅可以解决局部关节的顽固痹,而且有利于整体病情的控制.

Objective To investigate the clinical effect of Baisai Buxie Granule in treating Behcet's disease(BD). Methods Totally 40 patients with BD in our hospital were selected and randomly divided into the experimental group and the control group,20 cases in each group. The control group was treated with conventional western medicine(thalidomide)and the experimental group was treated with Baisai Buxie Granule. Results The total effective rate of the experimental group was 90. 00% ,which was significantly higher than 75. 00% of the control group( P< 0. 05). After treatment,the scores of bitter taste,eye diseases,fatigue and oral ulcer,the levels of CRP and ESR in the experimental group were significantly lower than those in the control group( P< 0. 05). The incidence rates of adverse reactions in the experimental group and the control group were 15. 00% and 10. 00% without significant difference ( P > 0. 05). The recurrence rate of the experimental group was 15. 00%,which was significantly lower than 45. 00% of the control group( P < 0. 05). Conclusion Baisai Buxie Granule in treating BD is beneficial to promote the improvement of clinical symptoms,reduce the inflammatory reaction and the ESR. It is worthy of clinical promotion.

文中探讨白塞病的中医病因病机,并辨证论治,认为本病属虚实夹杂之证,湿热互结、瘀血阻络为实,是其标;脾失健运、相火不位为虚,是其本.临床根据该病的病因病机特点运用补虚泻实法,采用具有清热利湿、活血通络、益气健脾、补虚伏火之功能的白塞补泻汤治疗.

<正>强直性脊柱炎(ankylosing spondylitis,AS)为常见风湿病之一。在我国的患病率约为5%,多于青少年时期发病,以中轴关节的慢性炎症为主。也可累及内脏及其他组织,致残率较高[1]。我科应用血塞

[Objective]To observe the clinical efficacy of injection Xueshuantong(lyophilized powder) combined with western medicine in the treatment of ankylosing spondylitis.[Methods]Using a randomized,parallel control method,Randomly divide 120 patients into two groups,one control group of 60 patients was treated with Votalin,Thalidomide and Total Glucosides of Paeony Capsules,based on treatment of the control group,the other treatment group of the rest 60 patients was injected Xueshuantong(lyophilized powder).Before and after the treatment,the two groups were separately detected ESR,CRP under one treatment course of two weeks,the assessment of efficacy would be made after one course treatment.[Results]The treatment group in the reduction of ESR,CRP and other indexes is obviously better than the control group(P0.05) and the total clinical efficiency is significantly better than the control group(P0.01).[Conclusion] There is a satisfied effect on the treatment of ankylosing spondylitis by injecting Xueshuantong(lyophilized powder) with the combination of western medicine,without increased side effects,and it is worth learning from.

目的:观察蠲痹强脊方熏蒸治疗强直性脊柱炎(AS)的疗效和安全性。方法:将确诊的60例活动性AS患者,采用随机数字表法随机分为治疗组和对照组各30例(其中对照组脱落3例),对照组单纯口服沙利度胺、洛索洛芬钠,治疗组在对照组治疗基础上加用蠲痹强脊方(由熟地黄、川续断、狗脊、羌活等组成)熏洗。2组均以10 d为1个疗程,均治疗2个疗程。观察2组患者的临床指标,包括病情活动指数、病人总体评价、患者躯体功能、肿胀关节总数、骨骼和肌肉系统活动度评估和实验室炎性指标,并进行安全性指标检测。结果:治疗组疗效满意25例,疗效不满意5例;对照组疗效满意15例,疗效不满意12例。2组对比,差别有统计学意义(P<0.05)。2组患者治疗后ASAS 20方案中各项指标积分改善情况对比,差别有统计学意义(P<0.05或P<0.01)。2组治疗后实验室炎性指标对比,差别有统计学意义(P<0.01)。结论:蠲痹强脊方熏蒸治疗能有效地缓解AS患者的临床症状,减轻活动期的炎症反应,安全性高,是治疗AS活动期的一种有效方法。

目的:观察痛风消痹汤治疗急性痛风性关节炎的临床疗效。方法:将90例急性痛风性关节炎患者随机分为2组,治疗组45例采用痛风消痹汤(水牛角、生地黄、赤芍、牡丹皮、玄参、土茯苓、萆薢、金银花、黄柏、地龙、薏苡仁、甘草)治疗,对照组45例采用洛索洛芬钠联合碳酸氢钠片治疗。结果:治疗组显效27例,有效14例,无效4例,有效率占91.1%;对照组显效25例,有效17例,无效3例,有效率占93.3%。2组对比,差别无统计学意义(P>0.05)。结论:痛风消痹汤治疗湿热阻痹型急性痛风性关节炎有显著疗效。

目的:调查就诊的类风湿关节炎(RA)患者伴发抑郁症的患病率.方法:使用HAMD 量表对160例RA患者进行抑郁症评定.结果:RA患者伴发抑郁症的发生率为35%,相关的危险因素包括女性、病程、文化程度、婚姻状况.结论:RA患者中存在一定程度的抑郁症.

<正>类风湿关节炎(rheumatoid arthritis,RA)早期即可出现关节肿痛,随着病程进展可出现关节畸变甚至丧失工作生活能力,这些都可能对患者心理造成巨大压力。国内外多项研究证实

目的:调查就诊的类风湿关节炎(RA)患者伴发抑郁症的患病率。方法:使用HAMD量表对160例RA患者进行抑郁症评定。结果:RA患者伴发抑郁症的发生率为35%,相关的危险因素包括女性、病程、文化程度、婚姻状况。结论:RA患者中存在一定程度的抑郁症。

干燥综合征(Sjogren's syndrome,SS)是一种慢性炎症性自身免疫病.笔者于2007年1月～2008年12月间采用清热解毒汤并静脉滴注双黄连冻干粉治疗20例SS患者,并与使用强的松治疗的20例SS患者作对照,现将结果报道如下.

燥综合征(SS)是一种慢性炎症性自身免疫性疾病.2007-01-2008-12,笔者采用养阴清热解毒汤治疗SS患者20例,并与泼尼松对照组进行对比,现将结果总结报道如下.

Objective:To evaluate clinical curative effects and adverse effects of jinwugutongjiaonang treating AS patients who were the type of cold wetness blocked in Joints.Methods:Sixty patients were randomly diuided into to 2 groups.The treatment group was treated with jinwugutongjiaonang and the control group was treated with SASP.We observed the signs and symptoms,chemical examination result and record adverse effect after treatment of 2 groups.Result:The effective rate of the treatment group was 86.67% and that of the control group was 83.33%,which had no significant differences in 2 groups(P0.05).Morning stiffness time,Schober test,finger-ground test,pain score,ESR and CRP had significant differences before and after treatment of jinwugutongjiaonang group,P0.05.Morning stiffness time,Schober test,finger-ground test and pain score had significant differences between 2 groups after treatment,P0.05.Adverse effect of jinwugutongjiaonang was less than that of SASP.Conclusion:It had been proved to be effective and safe to apply jinwugutongjiaonang which suited to AS patients who were the type of cold wetness blocked in Joints.

目的:观察强脊胶囊治疗早中期强直性脊柱炎(AS)的临床疗效及不良反应。方法:将60例患者随机分为两组,治疗组给予强脊胶囊,对照组给予柳氮磺吡啶(SASP),比较两组患者治疗后不同时点各项疗效评价指标的改善情况,并记录不良反应。结果:治疗6个月时,治疗组总有效率占83.33%,对照组占84.00%,两组对比差别无统计学意义(P>0.05)。强脊胶囊在治疗1个月时可明显改善患者的晨僵、病人评价、Schober试验、指地距,与治疗前对比差别有统计学意义(P<0.05)。治疗3,6个月时,6项主要疗效指标和6项次要疗效指标与治疗前对比,差别有统计学意义(P<0.05)。治疗1,3,6个月与对照组各疗效指标比较,差别无统计学意义(P>0.05)。不良反应少于后者。结论:强脊胶囊治疗早中期AS具有疗效肯定、起效迅速、不良反应少的优点,适合临床推广使用。

附子理中丸出自<阎氏小儿方论>,功效为温阳祛寒,益气健脾,主治脾胃虚寒,脘腹疼痛,霍乱吐利转筋等.笔者应用该方治疗抗生素相关性腹泻取得了较好疗效,现举验案两则如下.