目的:评价芙蓉膏外敷联合中药内服对活动期类风湿关节炎患者炎症指标的影响.方法:利用安徽中医药大学第一附属医院住院病历数据处理系统采集患者信息.收集我院风湿病科2012年5月至2016年12月类风湿关节炎住院患者的病历资料.依据是否使用芙蓉膏外敷将患者分为实验组和对照组,采用随机行走模型评价芙蓉膏外敷联合中药内服对活动期类风湿关节炎患者的炎症指标血沉(ESR)、超敏C反应蛋白(Hs-CRP)的影响.结果:共计4 832例类风湿关节炎患者符合本研究要求,其中实验组2 579例,对照组2 253例.基线资料分析显示,患者的一般情况、内服中药频次及核心处方情况等方面,差异无统计学意义(P＞0. 05),具有可比性.实验组炎症指标ESR随机波动最大值968,行走步数3 756步,行走正向增长率0. 257 7,比值3. 88,随机波动幂律值0. 364 2±0. 124 6,综合评价指标的正向递增率0. 479 9,综合评价指标记录次数2 017次.对照组炎症指标ESR随机波动最大值398,行走步数2 251步,行走正向增长率0. 176 8,比值5. 66,随机波动幂律值0. 173 5±0. 128 8,综合评价指标的正向递增率0. 357,综合评价指标记录次数1 115次.实验组炎症指标Hs-CRP随机波动最大值1 523,行走步数5 149步,行走正向增长率0. 295 8,比值3. 38,随机波动幂律值0. 389 5±0. 108 1,综合评价指标的正向递增率0. 537 4,综合评价指标记录次数2 834次.对照组炎症指标Hs-CRP随机波动最大值809,行走步数3 463步,行走正向增长率0. 233 6,比值4. 28,随机波动幂律值0. 362 9±0. 073 8,综合评价指标的正向递增率0. 448 2,综合评价指标记录次数1 805次.结论:我院风湿病科从脾论治类风湿关节炎,内服中药处方以健脾化湿药、活血通络药、祛风除湿药、清热解毒药为主,两组患者综合评价指标和接受的干预措施存在长程关联,芙蓉膏外敷联合中药内服患者炎症指标的改善效果优于单纯使用中药内服.%Objective:To evaluate the effect of Hibiscus paste external application combined with traditional Chinese medicine on the inflammatory markers in patients with active rheumatoid arthritis (RA). Methods: The patient information was collected by the data processing system of hospitalized medical records in the First Affiliated Hospital of Anhui University of traditional Chinese medicine. The medical records of patients with rheumatoid arthritis in the Department of Rheumatology from May 2012 to December 2016 were collected. Patients were divided into experimental group and control group according to whether Furong ointment was applied. The random walk model was used to evaluate the influence of Furong ointment combined with traditional Chinese medicine on inflammatory index,erythrocyte sedimentation rate ( ESR) and high sensitivity C reactive protein ( Hs-CRP) in patients with active rheumatoid arthritis. Results: A total of 4 832 patients with rheumatoid arthritis were in accordance with the requirements of the study, including 2 579 in the experimental group and 2 253 in the control group. Baseline data analysis showed that there was no significant difference in general condition, frequency of oral Chinese medicine and core prescriptions between two groups ( P＞0. 05 ) . In the experimental group,the maximum ESR of inflammation index was 968,the walking rate was 3 756,the positive growth rate of walking was 0. 257 7,the ratio was 3. 88,the random fluctuation power law value was 0. 364 2±0. 124 6,the comprehensive evaluation index in-creased by 0. 479 9,and the comprehensive evaluation index was 2 017 times. In the control group,the maximum ESR of inflammation index was 398,the number of walking steps was 2 251,the positive growth rate of walking was 0. 176 8,the ratio was 5. 66,the random fluctuation power law value was 0. 173 5±0. 128 8,the comprehensive evaluation index increased by 0. 357,and the comprehensive evaluation index was 1 115 times. In the experimental group,the maximum Hs-CRP of inflammation index was 1 523,the walking rate was 5 149,the positive growth rate of walking was 0. 295 8,the ratio was 3. 38,the random fluctuation power law value was 0. 389 5± 0. 108 1,the comprehensive evaluation index increased by 0. 537 4,and the comprehensive evaluation index was 2 834 times. In the control group,the maximum Hs-CRP of inflammation index was 809,the number of walking steps was 3 463,the positive growth rate of walking was 0. 233 6,the ratio was 4. 28,the random fluctuation power law value was 0. 362 9±0. 073 8,the comprehensive evaluation index increased by 0. 448 2,and the comprehensive evaluation index was 1 805 times. Conclusion: Our hospital rheumatology on the treatment of rheumatoid arthritis from the spleen, oral Chinese medicine prescription to Jianpihuashi drugs, Huoxue Tongluo drugs, Qufengchushi drugs,drug detoxification,two groups of patients with comprehensive evaluation index and acceptable interventions are long-range correlation,a better effect than that of inflammatory markers associated with traditional Chinese medicine in patients with Furong ointment the simple use of Chinese herbs.
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