论文部分内容阅读
目的观察双藤清痹丸结合醋酸泼尼松治疗热毒瘀阻型皮肌炎的临床疗效,探讨双藤清痹丸对泼尼松增效减毒作用。方法将71例热毒瘀阻型皮肌炎患者随机分为治疗组(36例)和对照组(35例),两组均予醋酸泼尼松口服,治疗组同时加用双藤清痹丸;两组均治疗3个月,观察临床疗效及治疗后中医临床症状体征、肌力、肌肉疼痛(VAS)、生活质量(ADL)积分及外周血急性时相反应物水平、肌酶水平、激素用量、激素副反应、病情复发等变化情况。结果治疗组、对照组总有效率分别为100.0%和97.1%;组间临床疗效比较,差异无统计学意义(P>0.05);两组治疗前后组内比较,临床症状体征、肌力、肌肉疼痛和ADL积分差异均有统计学意义(P<0.05,P<0.01);组间治疗后比较,各指标差异均有统计学意义(P<0.05)。两组治疗后ESR、CRP和肌酶水平均明显降低(P<0.05,P<0.01);组间治疗后比较,ESR和肌酶水平差异有统计学意义(P<0.05)。两组治疗1个月、2个月、3个月激素用量较初用量均明显减少(P<0.05,P<0.01);组间同期比较,激素用量差异均有统计学意义(P<0.05,P<0.01)。治疗组在避免感染、预防高血压、高血糖、改善失眠、消除痤疮方面明显优于对照组(P<0.05)。治疗组的复发率为8.33%,对照组复发率为77.14%,组间差异有统计学意义(P<0.05)。结论双藤清痹丸能够有效改善热毒瘀阻型皮肌炎患者的肌无力和肌痛症状,提高患者的生活质量,减少激素用量,缓解激素的毒副反应,降低合并症的发生率,具有增效减毒、稳定病情、预防复发的作用。
Objective To observe the clinical efficacy of Shuangteng Qingbi Pill combined with prednisone acetate in the treatment of heat-induced stasis dermatomyositis, and to explore the synergistic effect and attenuation of Shuangteng Qingbi Pill on prednisone. Methods Seventy-one patients with heat-induced stasis dermatomyositis were randomly divided into treatment group (36 cases) and control group (35 cases). Both groups were given oral prednisone acetate. The treatment group was treated with Shuangteng Qingbi Pill ; Both groups were treated for 3 months to observe the clinical efficacy and clinical symptoms and signs, muscle strength, muscle pain (VAS), quality of life (ADL) points and acute phase response of peripheral blood levels of creatinine, hormone levels , Hormone side effects, recurrence and other changes. Results The total effective rates of the treatment group and the control group were 100.0% and 97.1% respectively. There was no significant difference in the clinical efficacy between the two groups (P> 0.05). The clinical symptoms and signs, muscle strength, muscle There were significant differences in pain and ADL scores between the two groups (P <0.05, P <0.01). There was significant difference between the two groups after treatment (P <0.05). The levels of ESR, CRP and muscle enzymes were significantly decreased in both groups after treatment (P <0.05, P <0.01). There were significant differences in ESR and muscle enzymes between the two groups after treatment (P <0.05). The amount of hormones in the two groups was significantly reduced at 1 month, 2 months and 3 months compared with the initial dosage (P <0.05, P <0.01). There was significant difference in hormonal dosage between the two groups (P <0.05, P <0.01). The treatment group was significantly better than the control group in avoiding infection, preventing hypertension, hyperglycemia, improving insomnia and eliminating acne (P <0.05). The recurrence rate was 8.33% in the treatment group and 77.14% in the control group, with statistical significance (P <0.05). Conclusion Shuang Teng Qing Bi Pills can effectively improve the symptoms of muscle weakness and myalgia in patients with heat-induced stasis dermatomyositis, improve the quality of life of patients, reduce the dosage of hormones, relieve the side effects of hormones and reduce the incidence of comorbidities, With synergistic attenuated, stable condition, the role of prevention of recurrence.