合谷刺配合化脓灸治疗类风湿性关节炎活动期疗效观察

Observation on therapeutic effect of muscular needling combined with scarring moxibustion on active stage of rheumatoid arthritis

目的:观察合谷刺配合化脓灸治疗类风湿性关节炎(RA)活动期的疗效。方法:将60例RA患者随机分为合谷刺组和西药组,各30例。合谷刺组选曲池、三阴交等穴合谷刺,配合大椎、足三里等穴化脓灸治疗;西药组口服双氯灭痛,肌注甲氨喋呤治疗,观察两组疗效、治疗前后主要症状体征、血沉和类风湿因子情况。结果:合谷刺组总有效率为76.7%,西药组总有效率为73.3%,两组比较差异无统计学意义(P>0.05)。两组患者治疗后在临床症状、体征及血沉方面较治疗前有明显改善(P<0.01,P<0.05),但两组治疗后比较,差异均无统计学意义(均P>0.05),西药组不良反应较合谷刺组更为明显。结论:合谷刺可明显缓解RA活动期症状及体征,疗效与口服西药相当,不良反应发生率较西药明显降低,是治疗RA的安全有效方法。

Objective To observe the therapeutic effect of muscular needling combined with scarring moxibustion on active stage of rheumatoid arthritis （RA）. Methods Sixty cases of RA were randomly divided into a muscular needling group and a medication group, 30 cases in each group. The muscular needling group was treated by muscular needling on Quchi （LI11）, Sanyinjiao （SP 6）, etc. combined with scarring moxibustion on Dazhui （GV14）, Zusanli （ST 36） etc. , while the medication group was treated by oral administration of Diclofenac sodium and intramuscular injection of Methotrexate. The therapeutic effects, main symptoms and signs, erythrocyte sedimentation rate （ESR） and rheumatoid factor were observed in two groups before and after treatment. Results The total effective rate of muscular needling group was 76.7%, and that of medication group was＇ 73.3%, there was no significant difference between two groups （P〉0.05）. The clinical symptoms, signs, and ESR of two groups were improved obviously compared with those before treatment （P〈0.01, P〈0.05）, however there were no significant differences between the two groups after treatment （all P〉0.05）. The adverse reactions of medication group were more eminent compared to the muscular needling group. Conclusion Muscular needling can obviously relieve the symptoms and signs of active stage rheumatoid arthritis and the effect is equivalent to oral administration of western medicine, the incidence of adverse reactions in the muscular needling group is obviously lower than that of western medication. Muscular needling is a safe and effective method for treatment of RA.