目的 探讨皮内针法对气阴两虚型干燥综合征患者的疗效.方法 选择本院接诊的气阴两虚型干燥综合征患者79例进行研究,根据治疗方法分为两组,对照组39例行常规西医治疗,观察组40例在对照组基础上加以皮内针治疗.对比两组临床疗效、中医证候积分、口干眼干客观指标、免疫功能、炎症因子.结果 观察组总有效率为82.50％,明显高于对照组的61.54％(P<0.05);治疗后两组患者中医证候积分明显下降,且观察组低于对照组(P<0.05);治疗后两组患者唾液流率及Schirmer氏泪液试验结果 均明显升高,且观察组高于对照组(P<0.05);治疗后两组患者IgG、补体C3、补体C4均明显升高,且观察组高于对照组(P<0.05);治疗后两组患者TNF-α、CRP及IL-6均明显下降,且观察组低于对照组(P<0.05).结论 皮内针法联合常规西医治疗较单独使用常规西医治疗气阴两虚型干燥综合征患者,可明显提高疗效、改善其中医证候及临床症状、提高免疫功能、降低炎症反应.

目的 探究结直肠炎合并关节病患者HLA-B27表达情况及其与视觉模拟评分(VAS)相关性.方法 选取2016年1月至2019年1月该院诊治的结肠炎和/或直肠炎患者,将合并关节病和纳入条件的93例患者纳入观察组,选取同期同年龄段就诊的仅患结肠炎和/或直肠炎患者50例作为对照组,另外选取50例来于该院体检的健康人50例作为健康对照组.分别检测两组HLA-B27、VAS评分和红细胞沉降率(ESR)等指标,并按VAS评分对观察组进行再分组,分析各指标将差异.结果 三组HLA-B27阳性率、VAS评分和ESR等指标比较,差异有统计学意义(P＜0.05),其中观察组患者各指标水平最高,对照组其次,健康对照组最低;观察组HLA-B27阳性患者VAS评分明显高于HLA-B27阴性患者(P＜0.05);对照组患者HLA-B27是否呈阳性与VAS分级分布无明显关联(P＞0.05),且其VAS分级分布与观察组比较,差异有统计学意义(P＜0.05);观察组HLA-B27阳性和阴性患者Kellgren-Lawrence分级分布比较,差异有统计学意义(P＜0.05);对照组HLA-B27阳性和阴性患者患者Kellgren-Lawrence分级比较,差异无统计学意义(P＞0.05),但均与观察组分布情况差异有统计学意义(P＜0.05).结论 结直肠炎合并关节病患者中HLA-B27阳性表达水平异常,其阳性表达与关节受累有一定关联,即阳性表达患者VAS评分更高,受累关节疼痛更为明显.

目的:观察温阳补肾法对高原类风湿关节炎患者血清25羟维生素D3水平的影响.方法:选取2015年7月至2017年8月青海省中医院收治的高原类风湿关节炎患者132例作为研究对象,随机分为对照组和观察组,每组66例.对照组应用常规西医治疗,观察组在对照组治疗基础上应用温阳补肾法治疗,2组均连续治疗3个月.比较2组治疗后临床疗效,统计2组治疗前后主要临床症状与体征、健康状况评定量表(HAQ)评分和DAS28评分,检测2组治疗前后实验室检查指标、血清25羟维生素D3以及血液流变学指标水平.结果:治疗后,观察组临床治疗总有效率显著高于对照组(P<0.05);2组关节肿胀指数、关节疼痛指数、关节压痛指数、晨僵时间、关节功能分级和20 m步行时间均较治疗前显著降低(P<0.05),且观察组均显著低于对照组(P<0.05);2组HAQ评分、DAS28评分、类风湿因子(RF)、C反应蛋白(CRP)和红细胞沉降率(ESR)水平均较治疗前显著降低(P<0.05),且观察组均显著低于对照组(P<0.05);2组血清25羟维生素D3水平均较治疗前显著升高(P<0.05),且观察组显著高于对照组(P<0.05);2组红细胞电泳指数、红细胞压积、血浆黏度、全血低切黏度、全血高切黏度水平均较治疗前显著降低(P<0.05),且观察组均显著低于对照组(P<0.05).结论:温阳补肾法治疗高原类风湿关节炎,疗效满意,同时能明显增加血清25羟维生素D3水平.

目的:研究中药当归拈痛汤联合西药治疗早期类风湿性关节炎湿热痹阻证临床疗效及不良反应发生率.方法:选取自2014年9月～2016年9月入青海省中医院接受治疗的类风湿性关节炎患者188例为研究对象,随机分为研究组97例和对照组91例,对照组患者给予布洛芬片,研究组患者给予中药当归拈痛汤,同时服用布洛芬片,7周为1个疗程.治疗期间观察两组患者的疼痛时间、肿胀数、晨僵时间、C-反应蛋白(C-reactive protein,CRP)等症状体征的情况,治疗前后进行对比.观察两组患者的CRP、类风湿因子(Rheumatoid factor,RF)、血沉(erythrocyte sedimentation rate,ESR)、抗环瓜氨酸(Cyclic citrullinated peptide,CCP)等理化指标,治疗前后进行对比.观察两组患者的不良反应情况.结果:两组患者的症状、体征在治疗后和治疗前对比,差异明显有统计学意义(P＜0.05).治疗后,在症状和体征方面,研究组患者和对照组患者对比,差异明显有统计学意义(P＜0.05).两组患者的CRP、RF、ESR、抗CCP值在治疗后和治疗前对比,差异明显有统计学意义(P＜0.05).治疗后,研究组患者和对照组患者的CRP、RF、ESR值对比,差异明显有统计学意义(P＜0.05),研究组患者和对照组患者的抗CCP值对比,无差异没有统计学意义(P＞0.05).两组患者在观察期间,大小便正常,心肝肾等功能正常.不良反应主要表现在消化方面,两组患者在消化道的不良反应率方面的比较,研究组小于对照组,且差异明显有统计学意义(P＜0.05).结论:中药当归拈痛汤和西药都具有治疗早期类风湿性关节炎湿热痹阻证的效果,但中西药结合更具有有效性和安全性,可以更有效地改善患者的主要症状体征,改善患者的主要理化指标,不良反应也较少,对治疗早期类风湿性关节炎有较好的疗效,值得推广.

Objective:To study the efficacy and safety of using Xiaochaihu Decoction in the treatment of SLE.Methods:A total of 218 patients with SLE who were treated in our hospital from June 2012 to June 2016 were selected.They were divided in to treatment group (109 cases) and controlled group (109 cases).The treatment group was treated with Xiaochaihu Decoction and Prednisone Acetate Tablets.The controlled group was treated with Chloroqaine,Prednisone acetate and Methotrexate.The two groups of patients were treated two courses,each course of 4 weeks.Results:After treatment,the serum WBC,RBC,PLT and HGB of the treatment group were significantly different from the controlled group (P ＜ 0.05).After treatment,the SLEDAI index of the two groups decreased,(P ＜ 0.05).In the controlled group,the total effective rate was 88.1％ and the total effective rate was 90.8％ in the treatment group.There was no significant difference between the two groups (P ＜ 0.05).There was significant difference between the two groups (P ＜ 0.05).After treatment,the total effective rate of TCM syndromes in the controlled group was significantly lower than that in the controlled group 61.5％.The total effective rate was 91.7％.There were significant difference between the two groups (P ＜ 0.05).There were 6 cases in the treatment group and 27 cases in the controlled group.The incidence of the controlled group was higher than that of the treatment group.Conclusion:Xiaochaihu Decoction can improve physical symptoms and serum indexes of SLE patients,decrease the activity index of SLE,improve TCM syndrome score and treatment effect,and have fewer side effects in treatment.

Objective:To study the effect of using Xijiao Dihuang Decoction combined with low-dose corticosteroids on the clinical curative effect and the regulation of serum markers for patients with systemic lupus erythematosus (LPS).Methods:A total of 426patients with SLE were enrolled in our hospital from June 2014to June 2016.The patients were randomly divided into treatment group (213cases) and controlled group (213cases).The patients in the treatment group were treated with prednisone and prednisone.The two groups of patients were treated for 12weeks.Results:The total curative effect was 64.32％ in the controlled group and 86.38％ in the treatment group,the difference was significant (P＜0.05).The total curative effect of the TCM group in the controlled group was 69.48％,the treatment group was 90.61％ (P＜0.05).There was significant difference in serum IgG,ANA,WBC and PLT between the treatment group and the controlled group (P＜0.05),and the difference was significant (P＜0.05).There were 9cases in the controlled group,6cases in the treatment group,the treatment group was less than the controlled group,and the treatment group was less than the controlled group,and the treatment group was less than the controlled group,and the other side was no difference;the treatment of adverse reactions occurred mainly in patients with acne,lung infection,gastrointestinal bleeding,patients after symptomatic treatment did not affect their follow-up treatment.Conclusion:The combination of prednisone and Xijiao Dihuang Decoction can effectively treat patients with systemic lupus erythematosus,enhance the clinical and TCM syndromes and improve the serum indexes.

目的 探讨泻心汤联合小剂量沙利度胺对白塞病口腔黏膜病变患者的疗效及安全性.方法 选择2014年1月至2017年12月本院接诊的白塞病口腔黏膜病变患者80例进行研究.采用随机数字表法将患者分为两组,每组各40例.对照组给予沙利度胺片4片/晚,待口腔溃疡愈合后降至1~2片/晚,观察组采用沙利度胺2片/晚基础上加以泻心汤加减,早晚各服1次,待溃疡痊愈后沙利度胺减至1片/晚,最终控制在1片/晚,3次/周.两组均以3个月为1个疗程.对比两组患者疗效、溃疡发作频次、溃疡总间歇时间、血清炎症因子、血沉、免疫功能、安全性指标.结果 观察组缓解率为95.0%,明显高于对照组的80.0%(P<0.05).两组患者治疗后各炎症因子与免疫功能指标均明显下降(P<0.05),但除IgG两组差异无统计学意义(P>0.05),其他各炎症因子及免疫功能指标干预后观察组水平均明显低于对照组(P<0.05).治疗后两组患者溃疡发生次数均明显下降(P<0.05),但两组差异无统计学意义(P>0.05);治疗后两组患者溃疡总间歇时间明显延长(P<0.05),但观察组延长更为明显(P<0.05).对照组不良反应发生率为20.0%,明显高于观察组的5.0%(P<0.05).结论 泻心汤联合小剂量沙利度胺较单独使用沙利度胺治疗白塞病可明显提高疗效,延长溃疡总间歇时间,其机制可能与改善免疫、降低炎症因子水平有关,还可降低不良反应的发生率.

Objective:To investigate the effect of self-made shengjin decoction combined with iguratimod on the serum levels of anticardiolipin antibody and rheumatoid factor of patients with primary dry syndrome and its clinical efficacy.Methods:82 patients with primary dry syndrome who were treated in our hospital were selected and randomly divided into two groups.41 cases in the control group were treated with iguratimod,and another 41 cases in the experiment group were treated with self-made shengjin decoction on the basis of the control group.Then the serum levels of anticardiolipin antibody (ACL) and rheumatoid factor (RF) in the two groups were observed and compared before and after the treatment.Results:The total effective rate in the treatment group was higher than that of the control group (P＜0.05).After treatment,the serum levels ofACL,RF,IL-10 and IgG in the two groups were lower than before,and the experiment group was lower than that of the control group,and the differences were statistically significant (P＜0.05).Conclusion:Self-made shengjin decoction and iguratimod can effectively improve the syndrome of primary sjogren's and reduce the serum levels of ACL,RF,IL-10 and IgG of patients.

目的:探讨熏洗1号方联合常规西药治疗风湿寒性关节痛的临床效果与安全性.方法:选取2010年1月至2012年10月间入院治疗的风湿寒性关节痛患者168例,随机分为实验组(84例)和对照组(84例),其中对照组应用常规西药治疗,实验组在对照组基础上联合应用中药熏洗1号方,治疗期结束后观察2组患者的治疗效果、安全性及生活质量.结果:实验组显效18例,好转64例,总有效82例(97.62％);对照组显效10例,好转56例,总有效66例(78.57％).实验组恶心1例,头痛1例,总发生率2.38％;对照组恶心4例、消化道出血3例、头痛3例等,总不良反应发生率15.47％(13例).治疗后实验组总体健康、积极感受等生活质量均相对于对照组得到一定的提高.结论:熏洗1号方联合常规西药治疗疗效显著、安全性高,患者生活质量得到一定提高,为临床治疗提供了可靠的治疗依据.

目的:探讨狼疮Ⅰ号方对系统性红斑狼疮(SLE)活动期患者疾病活动的影响.方法:将74例患者随机按数字法分为观察组和对照组各37例.两组均给予常规激素治疗,并给予必要的对症、支持处理.观察组加用狼疮Ⅰ号方,1剂/d,常规水煎分2次服用.疗程4个月.记录面部红斑、关节疼痛、发热等主症状评分,记录激素用量及系统性红斑狼疮疾病活动度评分(SLEDAI)评分,检测治疗前后血清IL-10,IL-12,β-抑制蛋白质-1(β-arrestinl)及血栓调节蛋白(sTM)水平.结果:观察组疾病疗效总有效率达100％,优于对照组的83.8％(P＜0.05);治疗后2个月,两组激素用量均较治疗前降低(P＜0.01),治疗后4个月,观察组激素用量少于对照组(P＜0.01),治疗后观察组激素撤减量多于对照组(P＜0.05);治疗后观察组面部红斑、关节疼痛、发热等症状评分均低于对照组(P＜0.01);治疗后观察组血清IL-10明前下降,并低于对照组(P＜0.01),观察组血清IL-12水平升高,并高于对照组(P＜0.01);治疗后观察组血清β-arrestinl水平高于对照组(P＜0.01),观察组血清sTM水平低于对照组(P＜0.01).结论:狼疮Ⅰ号方能有效控制SLE患者病情活动,协助患者激素的撤减,提高了临床疗效.

<正>强直性脊柱炎是一种原因尚不明确的血清阴性脊柱关节病,主要侵犯脊柱、骶髂关节、髋关节、膝关节,表现为关节和关节周围组织、韧带、椎间盘的钙化,椎间关节和四肢关节的滑膜增生,最终发展为骨性强直。强直性脊柱炎目前尚无根治的办法,笔者近年来采用中西医结合的方法治疗,取得了较好疗效,结果报道如下。

类风湿性关节炎(RA)属自身免疫性疾病,以慢性、进行性、对称性及侵蚀性骨破坏为特征.2007年1月～2008年12月,我院共收治39例RA合并乙型肝炎患者.现将治疗体会报告如下.