基于改良Sharp评分观察补肾治尪汤对类风湿关节炎肝肾不足证骨破坏的延缓作用

兰天仪; 王子涵; 鄢泽然; 姚传辉; 于洪伟; 马恩森; 张刘波; 张雨樵; 徐才钦; 王金平; 张楠; 陶庆文; 徐愿

doi:10.3969/j.issn.1006-2157.2023.04.017

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基于改良Sharp评分观察补肾治尪汤对类风湿关节炎肝肾不足证骨破坏的延缓作用

临床研究 | 更新时间：2023-05-09

- 基于改良Sharp评分观察补肾治尪汤对类风湿关节炎肝肾不足证骨破坏的延缓作用
- The delaying effect of Bushen Zhiwang Decoction on bone destruction in rheumatoid arthritis patients with a pattern of deficiency of both liver and kidney based on modified total Sharp score
- 北京中医药大学学报 2023年46卷第4期页码：557-563
- 作者机构：
  
  1.北京中医药大学　北京　100029
  2.中日友好医院中医风湿病科
  3.中日友好医院放射科
- 作者简介：
  
  兰天仪，女，在读硕士生
  徐愿，男，博士，主任医师，副教授，硕士生导师，主要研究方向：中医药治疗风湿病，E-mail：xuyuan2004020@163.com
- 基金信息：
  
  北京市自然科学基金面上项目(7232319);北京市中医药科技发展资金项目(QN－2020－32);中央高水平医院临床科研业务费(2022－NHLHCRF-LX－02－0105)
- DOI：10.3969/j.issn.1006-2157.2023.04.017
  中图分类号： R255.6
- 收稿：2022-10-29，
  
  网络首发：2023-01-31，
  
  纸质出版：2023-04-30
- 稿件说明：
移动端阅览
兰天仪, 王子涵, 鄢泽然, 等. 基于改良Sharp评分观察补肾治尪汤对类风湿关节炎肝肾不足证骨破坏的延缓作用[J]. 北京中医药大学学报, 2023,46(4):557-563.

LAN Tianyi, WANG Zihan, YAN Zeran, et al. The delaying effect of Bushen Zhiwang Decoction on bone destruction in rheumatoid arthritis patients with a pattern of deficiency of both liver and kidney based on modified total Sharp score[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(4): 557-563. DOI: 10.3969/j.issn.1006-2157.2023.04.017.
兰天仪, 王子涵, 鄢泽然, 等. 基于改良Sharp评分观察补肾治尪汤对类风湿关节炎肝肾不足证骨破坏的延缓作用[J]. 北京中医药大学学报, 2023,46(4):557-563. DOI： 10.3969/j.issn.1006-2157.2023.04.017.

LAN Tianyi, WANG Zihan, YAN Zeran, et al. The delaying effect of Bushen Zhiwang Decoction on bone destruction in rheumatoid arthritis patients with a pattern of deficiency of both liver and kidney based on modified total Sharp score[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(4): 557-563. DOI: 10.3969/j.issn.1006-2157.2023.04.017. DOI：

摘要

目的

基于改良Sharp评分(mTSS)探讨补肾治尪汤对类风湿关节炎(RA)肝肾不足证骨破坏的延缓作用。

方法

以前瞻性随机对照试验的方法，纳入2020年9月—2021年9月就诊于中日友好医院中医风湿病科的RA肝肾不足证患者共170例。采用随机分组的方法将患者分配进入试验组或对照组，试验组使用补肾治尪汤联合常规剂量传统改善病情抗风湿药(cDMARDs)，对照组仅使用常规剂量cDMARDs，观察周期为12个月。以mTSS为主要研究指标，观察治疗后2组患者骨破坏进展程度。

结果

共153例患者完成了观察，其中试验组76例，对照组77例。2组患者基线特征差异无统计学意义。经过12个月的治疗，试验组患者较对照组患者红细胞沉降率和中医证候积分改善更加明显(

0.05)。2组患者mTSS均随时间增加而升高，但试验组治疗后mTSS增长值小于对照组(

0.01)。试验组中59例(77.6%)患者发生骨破坏放射学进展，与对照组中75例(97.4%)比较，差异有统计学意义(

0.01)。可视化累积概率分布图显示，试验组mTSS增长值持续低于对照组。

结论

补肾治尪汤联合cDMARDs的治疗方案可以有效延缓RA肝肾不足证骨破坏进展。

Abstract

Objective

We aimed to explore the delaying effect of

Bushen Zhiwang

Decoction (a compound prescription for tonifying the kidney and treating arthritis) on bone destruction in rheumatoid arthritis (RA) patients with a pattern of deficiency of both liver and kidney based on the modified total Sharp score (mTSS).

Methods

A total of 170 RA patients with a pattern of deficiency of both liver and kidney attending the Department of TCM Rheumatism of the China-Japan Friendship Hospital from September 2020 to September 2021 were prospectively enrolled in this randomized controlled trial. A stochastic grouping method was used to assign patients to the experimental group or the control group. Patients in the experimental group were treated with

Bushen Zhiwang

Decoction combined with regular doses of conventional synthetic disease-modifying antirheumatic drugs (cDMARDs)

and patients in the control group were treated only with regular doses of cDMARDs. The observation period was 12 months. The mTSS was used as the main index to observe the degree of bone destruction in both groups after treatment.

Results

A total of 153 patients completed the final observation (76 in the experimental group and 77 in the control group). There were no significant differences in baseline characteristics between the two groups. After 12 months of treatment

patients in the experimental group showed a more significant improvement in erythrocyte sedimentation rate and traditional Chinese medicine syndrome score compared to patients in the control group (

0.05). Radiographic evaluation revealed an increase in mTSS in both groups

but the increase in mTSS was significantly smaller (

0.01) in the experimental group. Radiological progression of bone destruction occurred in 59 patients (77.6%) in the experimental group

a much lower proportion than in the control group (75 patients

97.4%) (

0.01). Visualization of the proportional distribution showed that mTSS growth values were consistently lower in the experimental group than in the control group.

Conclusion

Treatment with

Bushen Zhiwang

Decoction combined with cDMARDs can effectively delay the progression of bone destruction in RA patients with a pattern of deficiency of liver and kidney.

关键词

Keywords

references

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