蜂针疗法治疗类风湿关节炎的临床随机对照研究

Clinical Randomized Study of Bee-sting Therapy for Rheumatoid Arthritis

目的:观察蜂针疗法治疗类风湿关节炎(RA)的临床疗效,及其促进西药减量及稳定病情的作用。方法:100例RA患者随机分为两组,蜂针疗法加西药治疗组(蜂针治疗组)50例,西药对照组50例。西药对照组口服甲氨喋呤(MTX,每周1次,每次7.5mg)、柳氮磺吡啶片(每天3次,每次0.5g)、美洛昔康片(莫比可,每天2次,每次7.5mg);蜂针治疗组在口服上述西药的同时,加用蜂针疗法,根据RA发病部位,以局部取阿是穴为主,配合辨证取穴,疗程3个月。观察临床疗效,治疗前后症状、体征变化,及西药用量、不良反应和治疗后3个月病情复发情况。结果:蜂针治疗组的总有效率优于西药对照组(P<0.05);在改善症状和体征(关节疼痛度、肿胀度、压痛度、活动度、握力、晨僵)的积分方面,与治疗前及对照组治疗后比较差异有显著性(P<0.05,0.01);蜂针治疗组的美洛昔康及MTX的用量、病情复发率和不良反应发生率明显少于西药对照组(P<0.05,0.01)。结论:蜂针疗法加西药治疗RA的疗效优于单独西药治疗,蜂针疗法不良反应少,具有促进西药减量、减少病情复发率和稳定病情的作用。

Objective To observe the clinical effect of bee-sting （venom） therapy in the treatment of rheumatoid arthritis （RA）. Methods One hundred RA patients were randomly divided into medication （control） group and bee-venom group, with 50 cases in each. Patients of control group were treated with oral administration of Methotrexate （MTX,7.5 mg/w）, Sulfasalazine （0.5 g,t. i. d. ）, Meloxicam （Mobic,7.5 mg, b. i. d. ） ; and those of bee-venom group treated with Bee-sting of Ashipoints and the above-mentioned Western medicines. Ashi-points were selected according to the position of RA and used as the main acupoints,supplemented with other acupoints according to syndrome differentiation, The treatment was given once every other day and all the treatments lasted for 3 months. Results Compared with pre-treatment, scores of joint swelling degree, joint activity, pain, and pressing pain, joint-swelling number, grasp force, 15 m-walking duration, morning stiff duration in bee-venom group and medication group were improved significantly （P〈0.05, 0.01 ）. Comparison between two groups showed that after the therapy, scores of joint swelling, pain and pressing pain, joint-swelling number and morning stiff duration, and the doses of the administered MTX and Mobic in bee-venom group were all significantly lower than those in medication group （P〈0.05, 0.01 ）; whereas the grasp force in been-venom group was markedly higher than that in medication group （P〈0, 05）, In addition, the relapse rate of bee-venom group was obviously lower than that of medication group （P〈0, 05; 12% vs 32% ）. Conclusion Combined application of bee-venom therapy and medication is superior to simple use of medication in relieving RA, and when bee- sting therapy used, the commonly-taken doses of western medicines may be reduced, and the relapse rate gets lower. [KEY WORDS] Rheumatoid arthritis; Bee-sting; Medication