目的：观察东垣升阳益胃法在类风湿关节炎中西医结合治疗中的作用。方法：将112例类风湿关节炎患者随机分为治疗组54例和对照组58例，两组患者均给予甲氨蝶呤、尼美舒利口服治疗，治疗组加用加减升阳益胃汤，对照组加用泮托拉唑钠胶囊，90 d后对两组上消化道症状发生率和胃黏膜损伤情况以及疗程中平均每天关节疼痛缓解时间进行比较，并分别在治疗前及治疗30 d、90 d观察患者的丙氨酸转氨酶、红细胞沉降率、C-反应蛋白。结果：治疗90 d后，治疗组上消化道症状发生率及胃黏膜损伤率低于对照组，差异有统计学意义（P<0.05），治疗过程中平均每天关节疼痛缓解时间明显高于对照组，差异有统计学意义（P<0.01）；两组治疗前后丙氨酸转氨酶、红细胞沉降率及C-反应蛋白比较，治疗组优于对照组，差异有统计学意义（P<0.05）。结论：加减升阳益胃汤对类风湿关节炎治疗过程中出现的消化系统副作用具有防治作用，并能增强中西医结合治疗类风湿关节炎的疗效。%Objective:To observe the effect of treating rheumatoid arthritis combining dong yuan’s strategy of raising yang to strengthen stomach with western medicine.Methods:109 cases with rheumatoid arthritis were randomly divided into the treatment group(54 cases)and the control group(58 cases)treated with methotrexate and nimesulide taken orally.In addition,the treatment group was given shengyang yiwei decoction and the other group was given pantoprazole sodium capsules.After 90 days,observed and compared the incidence of digestive tract symptoms,the gastric mucosa damage and the daily relieving time of joint pain between the two groups.After respectively 30 days and 90 days,observed before and after treatment the alanine transaminase,erythrocyte sedimentation rate and C-reactive protein.Results:After 90 day’s treatment,the incidence of upper digestive tract symptoms and the gastric mucosa damage rate of the treatment group were lower than those of the control group,the difference being statistically significant(P < 0.05);the daily relieving time of joint pain of the treatment group was longer than that of the control group,the difference being statistically signiifcant(P<0.01);the difference of alanine transaminase,erythrocyte sedimentation rate and C-reactive protein of the two groups before and after treatment was statistically signiifcant(P<0.05). Conclusion:Proper shengyang yiwei decoction could prevent the side effects on digestive system in the treatment of rheumatoid arthritis and enhance the therapeutic effect of the combination of traditional Chinese and western medicine during the treatment.
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