温针灸配合中药熏蒸治疗类风湿关节炎疗效观察

Therapeutic Observation of Warm Needling plus Chinese Medicinal Fumigation for Rheumatoid Arthritis

目的观察温针灸配合中药熏蒸治疗寒湿痹阻型类风湿关节炎的临床疗效。方法将53例寒湿痹阻型类风湿关节炎患者随机分为治疗组27例和对照组26例。对照组采用常规药物治疗,治疗组在对照组治疗基础上采用温针灸配合中药熏蒸治疗。观察两组治疗前后关节疼痛VAS评分、关节症状指标、中医症候量化评分及健康评估积分(HAQ)变化情况,检测两组治疗前后类风湿因子(RF)、血沉(ESR)及C反应蛋白(CRP),并采用美国风湿病协会标准(ACR20)评定两组患者有效率。结果两组治疗后关节疼痛VAS评分、各项关节症状指标、中医症候量化评分及HAQ与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后关节疼痛VAS评分、关节肿胀度、关节疼痛数目、晨僵持续时间、中医症候量化评分及HAQ与对照组比较,差异具有统计学意义(P<0.05)。两组治疗后ESR及CRP水平与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后ESR及CRP水平与对照组比较,差异具有统计学意义(P<0.05)。治疗组总有效率为74.1%,对照组为57.7%,两组比较差异具有统计学意义(P<0.05)。结论温针灸配合中药熏蒸是一种治疗寒湿痹阻型类风湿关节炎的有效方法。

Objective To observe the clinical efficacy of warm needling plus Chinese medicinal fumigation in treating rheumatoid arthritis（RA） due to cold-dampness. Method Fifty-three patients with RA due to cold-dampness were randomized into a treatment group of 27 cases and a control group of 26 cases. The control group was intervened by conventional medication, while the treatment group was by warm needling plus Chinese medicinal fumigation in addition to the medication used in the control group. The Visual Analogue Scale（VAS）, joint symptom parameters, Score of Quantified Syndrome of Traditional Chinese Medicine, Health Assessment Questionnaire（HAQ）, rheumatoid factor（RF）, erythrocyte sedimentation rate（ESR）, and C-reactive protein（CRP） were observed before and after treatment, and the effective rate was evaluated by using the criteria stipulated by the American College of Rheumatology（ACR20）. Result The VAS scores, joint symptom parameters, scores of quantified syndrome of traditional Chinese medicine, and HAQ were significantly changed after treatment in both groups（P〈0.05）. After treatment, the VAS score, joint swelling score, painful joint count, morning stiff duration, Score of Quantified Syndrome of Traditional Chinese Medicine, and HAQ in the treatment group were significantly different from that in the control group（P〈0.05）. The ESR and CRP levels were markedly changed after treatment in both groups（P〈0.05）. After treatment, the ESR and CRP levels in the treatment group were significantly different from that in the control group（P〈0.05）. The total effective rate was 74.1% in the treatment group versus 57.7% in the control group, and the difference was statistically significant（P〈0.05）. Conclusion Warm needling plus Chinese medicinal fumigation is an effective method in treating RA due to cold-dampness.