针药并用对活动期类风湿关节炎患者日常生活能力的影响

Effect of Combined Use of Acupuncture and Medicine on the Activities of Daily Living in Patients with Active-stage Rheumatoid Arthritis

目的观察健脾固肾针法对活动期类风湿关节炎患者日常生活能力的影响。方法将80例活动期类风湿关节炎患者随机分为针药组和西药组,每组40例,西药组主要采用慢作用抗风湿药,针药组在西药治疗基础上,同时联合健脾固肾针法,针刺每星期治疗5次,以30 d为1个疗程,两组治疗3个疗程,比较两组关节肿痛指数、晨僵时间、双手平均握力及健康生活指数(HAQ),观察ESR、CRP、RF实验室指标。结果针药组患者晨僵时间、双手平均握力、关节压痛指数、关节肿胀指数均较治疗前有显著改善(P<0.01),在关节压痛及双手平均握力方面较西药组明显改善(P<0.05),西药组各症状指标较治疗前亦有显著改善(P<0.01,P<0.05)。在健康生活指数(HAQ)评分方面,针药组与西药组均有明显改善(P<0.01,P<0.05)。与治疗前比较两组ESR、CRP均有明显下降(P<0.01,P<0.05),但针药组CRP下降较西药组明显(P<0.05)。结论健脾固肾针法配合西药治疗活动期类风湿关节能有效改善患者日常生活能力,提高生活质量。

Objective To investigate the effect of spleen and kidney-reinforcing acupuncture on the activities of daily living in patients with active-stage rheumatoid arthritis. Methods Eighty patients with active-stage rheumatoid arthritis were randomly allocated to acupuncture plus medicine and Western drug groups, 40 cases each. The Western drug group was mainly treated with slow-acting anti-rheumatic drugs. The acupuncture plus medicine group was treated with kidney-reinforcing acupuncture in addition to Western drug treatment. Acupuncture was given 5 times a week, 30 days as a course. The articular swelling pain indices, morning stiffness times, mean hand grip strengths and the Health Assessment Questionnaire （HAQ） scores were compared between the two groups after 3 courses of treatment. Laboratory indices ESR, CRP and RF were examined, Results Morning stiffness time, mean hand grip strength, the articular tenderness index and the articular swelling pain index improved in the acupuncture plus medicine group of patients after treatment （P〈0.01）. Articular tenderness and mean hand grip strength improved more compared with the Western drug group （P〈0.05）. The symptom indices also improved significantly in the Western drug group after treatment （P〈0.01, P〈0.05）. The Health Assessment Questionnaire （HAQ） score improved significantly in both acupuncture plus medicine and Western drug groups （P〈0.01,P〈0.05）. ESR and CRP decreased markedly in both groups after treatment （P〈0.01,P〈0.05）. But CRP decreased more in the acupuncture plus medicine group than in the Western drug group （P〈0.05）. Conclusion Spleen and kidney-reinforcing acupuncture plus Western drug treatment can effectively improve the activities of daily living and the quality of life in patients with active-stage rheumatoid arthritis.