桂枝芍药知母汤加减联合补肾祛瘀针刺法治疗类风湿性关节炎临床研究

Clinical Study of Using Modified Guizhi Shaoyao Zhimu Decoction Combined with Tonifying Kidney and Dispelling Stasis Acupuncture Method in the Treatment of Rheumatoid Arthritis

目的:观察补肾祛瘀针刺法联合桂枝芍药知母汤加减治疗类风湿性关节炎的临床疗效。方法:选取我院2013年7月~2014年10月收治的142例类风湿性关节炎患者作为研究对象,采取随机双盲法将患者分为实验组(71例)和对照组(71例),对照组患者采取甲氨蝶呤治疗,实验组患者则采取补肾祛瘀针刺法联合桂枝芍药知母汤加减治疗,观察两组患者治疗效果及不良反应情况,对比两组患者治疗前后关节肿胀数、关节压痛数、晨僵时间、C反应蛋白(CRP)、血沉(ESR),并采取视觉模拟量表(VAS)及匹茨堡睡眠质量指数量表(PSQI)分别评估患者治疗前后关节疼痛程度及睡眠质量。结果:经治疗后发现,实验组治疗总有效率为97.18%,对照组为87.32%,实验组总有效率显著高于对照组,P<0.05,差异具有统计学意义;治疗前两组患者关节肿胀数、关节压痛数、晨僵时间、CRP、ESR、VAS、PSQI对比无差异(P>0.05),治疗后各组数据显示患者均有所改善,且实验组改善程度显著优于对照组,P<0.05,差异具有统计学意义;实验组未见不良反应,对照组出现1例恶心,1例口干,对症处理后好转,两组不良反应对比差异无统计学意义(P>0.05)。结论:补肾祛瘀针刺法联合桂枝芍药知母汤加减治疗类风湿性关节炎效果佳,患者症状及体征明显改善,关节功能恢复好,疼痛轻,睡眠质量佳,具有极高临床应用价值。

Objective： To explore the clinical value of using Guizhi Shaoyao Zhimu Decoction combined with tonifying kidney and dispelling stasis acupuncture method in the treatment of rheumatoid arthritis. Methods： Selected 142 cases of patients with rheumatoid arthritis as the research object from July 2013 to October 2013, adopting random double blind method, the patients were divided into experimental group （71 cases） and controlled group （71 cases） and the controlled group in patients treated with methotrexate, the experimental group patients were treated with kidney and dispelling stasis method of acupuncture combined with Guizhi Shaoyao Zhimu Decoction, to observe therapeutic effect and adverse reaction of the two groups of patients, compared two groups of patients before and after treatment, deadlocked of morning of joint swelling, joint tenderness, count time, c-reactive protein （CRP） and blood sedimentation （ESR）, and take the visual analog scale （VAS） and Pittsburgh sleep quality index scale （PSQI） , respectively, to assess patients before and after treatment the degree of joint pain and sleep quality. Results： Found af- ter treatment, the total effective rate of the treatment group was 97. 18%, the controlled group was 87. 32%, the total effective rate of the experimental group was significantly higher than the controlled group, P 〈 0. 05, the difference was statistically signif- icant; two groups of patients before treatment, deadlocked of morning of joint swelling, joint tenderness, count time, CRP, ESR, VAS, PSQI contrast no difference （P 〉 0. 05）, and each data showed that patients were improved after treatment, and the de- gree of the experimental group improved significantly better than the controlled group, P 〈 0. 05, the difference was statistically significant; no adverse reaction, controls in 1 case of nausea, 1 case of dry mouth, improved after symptomatic treatment, two groups of adverse reactions to contrast difference was no statistical significance （ P 〉 0. 05 ）. Conclusion ： Guizhi Shaoyao Zhimu Decoction combined with tonifying kidney and dispelling stasis acupuncture method, the effect of treatment of rheumatoid arthritis, significantly improve patients with symptoms and signs, joint function is good, pain is light, good quality sleep, with very high value of clinical application.