目的:观察以毒攻毒疗法治疗类风湿关节炎的临床疗效。方法:将480例类风湿关节炎分为风毒痹阻证、寒毒痹阻证、热毒痹阻证、湿毒痹阻证、痰毒痹阻证、瘀毒痹阻证、虚毒痹阻证等7种证型,分型辨证选用具有一定毒性的祛风湿中药为主,并辅助其他方法治疗。结果:临床缓解216例,病情改善242例,无效22例,有效率95.2%;中医证候临床缓解230例,显效144例,有效87例,无效19例,总有效率为96.0%。对216例临床缓解病例进行随访,无反复者130例。治疗后,晨僵时间、关节疼痛指数、关节肿胀指数、关节压痛指数、双手握力、关节功能障碍均有改善,血沉(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)均降低,分别与治疗前比较,差异均有统计学意义( P <0.01)。结论:以毒攻毒疗法治疗类风湿关节炎近期与远期疗效均较好。
Objective:To observe the clinicaleffect of the therapy of counteracting toxin with toxin for rheumatoid arthritis.Methods:Divided 480 cases of patients with rheumatoid arthritis into 7 types including the wind-toxin arthralgia syndrome,the cold-toxin arthralgia syndrome,the humiditytoxin syndrome the heat-toxin arthralgia syndrome,the phlegm-toxin arthralgia syndrome,the stasis-toxin arthralgia syndrome and the deficiency-toxin arthralgia syndrome.During syndrome differentiation and typing,mainly selected the wind-dampness dispelling Chinese herbal medicine with certain toxicity and assisted in other treatments.Results:Clinical remission in 216 cases,improvement in 242 cases,ineffectiveness in 22 cases,the effective rate was 95.2% ;in terms of Chinese medicine syndrome,clinical remission in 230 cases,remarkable effectiveness in 144 cases,effectiveness in 87 cases,ineffectiveness in 19 cases,the total effective rate was 96.0%.Conducted follow-ups of 216 cases with clinical remission,130 cases had no recurrence.After treatment,comparing with those before treatment,the time of morning stiffness,index of joint pain,index of joint swelling,handgrip strength and dysfunction of joint were all improved,and the levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and rheumatoid factor(RF)were decreased respectively,differences being significant(P < 0.01).Conclusion:The therapy of counteracting toxin with toxin has both good long-termand short-termclinicaleffect in treating rheumatoid arthritis.