温针灸配合西药治疗寒湿痹阻型类风湿关节炎临床观察

Treatment of rheumatoid arthritis (type of cold-dampness obstruction) with warm needling combining Western medicinal

目的观察温针灸配合西药治疗寒湿痹阻型类风湿关节炎的疗效。方法将100例寒湿痹阻型类风湿关节炎患者随机分为治疗组50例、对照组50例。对照组采用西医常规治疗,口服塞来昔布胶囊、来氟米特片;治疗组在西医常规治疗的基础上,加用温针灸治疗。观察2组中医证候疗效、中医临床症状积分、疼痛视觉模拟评分法(VAS)评分、血沉(ESR)、C-反应蛋白(CRP)。结果治疗组50例中,临床痊愈20例(40%),显效19例(38%),有效9例(18%),无效2例(4%),总有效率为96%;对照组50例中,临床痊愈15例(30%),显效10例(20%),有效12例(24%),无效13例(26%),总有效率为74%。2组疗效比较,经秩和检验,Z=-7.557,P<0.05,说明治疗组疗效优于对照组。中医临床症状积分2组治疗后较本组治疗前均降低(P<0.05),治疗组治疗前后差值与对照组比较差异有统计学意义(P<0.05),治疗组优于对照组。VAS评分2组治疗后较本组治疗前均降低(P<0.05),治疗组治疗前后差值与对照组比较差异有统计学意义(P<0.05),治疗组优于对照组。ESR2组治疗后较本组治疗前均降低(P<0.05),2组治疗前后差值比较差异无统计学意义(P>0.05)。CRP2组治疗后较本组治疗前均降低(P<0.05),2组治疗前后差值比较差异无统计学意义(P>0.05)。结论温针灸配合西药治疗寒湿痹阻型类风湿关节炎有较好的临床疗效。

Objective To observe the curative effect of warm needling combining routine treatment of Western medicinal on rheumatoid arthritis （type of cold-dampness obstruction）. Methods The patients （n=100） were randomly divided into treatment group and control group （each n=50）. The control group was given routine treatment of Western medicine （oral celecoxib capsules and leflunomide tablets）, and treatment group was given warm needling besides of routine treatment of Western medicine. The curative effect on TCM syndromes, integrals of TCM symptoms, scores of visual analogue scale （VAS）, erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） were observed in two groups. Results In treatment group, there were 20 cases cured （40%）, 19 with obvious effect （38%）, 9 with effect （18%） and 2 without effect （4%）, and the total effective rate was 96%. In control group, there were 15 cases cured （30%）, 10 with obvious effect （20%）, 12 with effect （24%） and 13 without effect （26%）, and the total effective rate was 74% （Z=-7.557, P〈0.05）. The integrals of TCM symptoms and scores of VAS all decreased in two groups after treatment （P〈0.05, P〈0.05）, and the difference in the comparison before and after treatment was statistically significant between treatment group and control group （P〈0.05, P〈0.05）. ESR and CRP all decreased in two groups after treatment （P〈0.05）, and the difference in the comparison before and after treatment was not statistically significant between treatment group and control group （P〉0.05, P〉0.05）. Conclusion Warm needling combining routine treatment of Western medicinal has a good curative effect on rheumatoid arthritis （type of cold-dampness obstruction）.