辨病辨证结合治疗银屑病关节炎疗效分析.pdf

提要目的:本研究通过比较两组银屑病关节炎患者治疗后组间的症状体征及疗效差异,初步客观评价辨病辨证结合组方的临床疗效。方法:以美国风湿病学会(ACR)制定的疾病观察指标评定关节炎疗效,以银屑病面积与严重性指数(PASI)和皮肤病生活质量调查表(DLQI)评定皮损疗效,统计 ~ 住院和门诊银屑病关节炎患者40 例,按1:1 比例随机分为试验组和对照组,试验组用辨病辨证结合组方,对照组用甲氨蝶呤,治疗3 个月,观察两组中医量化评分、ACR各指标、PASI评分、DLQI 评分的改善程度,及达到ACR 缓解20%(ACR20)、PASI 减少50%(PASI50)的例数。结果:两组比较在中医症状量化评分的鳞屑、口渴改善比例上有统计学意义(P<),其中口渴改善比例有显著统计学意义(P<),在ACR 的患者对疼痛的VAS 评分、健康评估问卷(HAQ)评分改善上,两组差异有统计学意义(P<)。结论:辨病辨证结合组方治疗银屑病关节炎缓解关节和皮损病变均有良好疗效,证明了辨病辨证结合思路的正确性。关键词银屑病关节炎;辨病辨证结合;疗效Curative Effect Analysis of Psoriatic Arthritis Based bination of Disease and Syndrome Differentiation Speciality: TCM Internal Medicine of Rheumatism Author: Wang Haiyue Tut or: Prof. Song Shaoliang Abstract Objective: To evaluate curative effect of prescription based bination of disease and syndrome differentiation, symptoms, signs and curative effects pared between patients with psoriatic arthritis (PsA) in the two groups. Methods: Indexes of American College of Rheumatology (ACR) were choosed to evaluate arthritic effect, while Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) to evaluate psoriatic rash. After three months, decreases in TCM quantitative scores, ACR indexes, PASI and DLQI were analyzed in 40 PsA patients, who were equally assigned to experimental group with TCM prescription and control group with methotrexate. The number of responders to 20% improvement of ACR indexes (ACR20) and 50% improvement of PASI (PASI50) pared in the two groups. Results: There were statistical differences between the two groups on proportion of patients who get a reductive TCM quantitative score on scale (P<), and significant statistical differences on proportion of patients who get a score on thirst (P<). There were statistical differences on scores on the patients' pain on the visual analogue scale (VAS) and the Health Assessment Questionnaire (HAQ) (P<). Conclusions: Combination of disease and syndrome differentiation is a correct method of PsA,