经筋刀联合中医微创针刀镜治疗类风湿关节炎临床疗效观察

Clinical Efficacy Observation of Treatment of Rheumatoid Arthritis with Musculature Knife Combined with Minimally Invasive Acupotomy

目的:观察经筋刀联合中医微创针刀镜治疗类风湿关节炎(rheumatoid arthritis,RA)的疗效。方法:选取2016年6月至2017年6月在潍坊市中医院风湿免疫科住院的类风湿关节炎患者60例,随机分为治疗组和对照组,每组30例。对照组给予西乐葆、甲氨蝶呤、叶酸、云克2套治疗,治疗组在对照组治疗的基础上给予经筋刀联合中医微创针刀镜治疗。结果:与治疗前相比较,两组患者晨僵时间、关节肿胀数、关节压痛数、疼痛VAS评分、医师评价、患者评价、血沉、C反应蛋白均明显改善(P<0.05),且治疗组治疗后优于对照组,差异有统计学意义;治疗组治疗8周后DAS28评分优于对照组,差异有统计学意义(P<0.05)。结论:经筋刀联合中医微创针刀镜治疗类风湿关节炎可以松解粘连的滑膜组织,清除纤维素样坏死,修复关节面,缩短疗程,不仅可以解决局部关节的顽固痹,而且有利于整体病情的控制。

Objective： To observe the clinical curative effect of musculature knife combined with minimally invasive acupotomy on rheumatoid arthritis（ RA）. Methods： A total of 60 patients with RA hospitalized in the Department of Rheumatology of Weifang TCM Hospital from June 2016 to June 2017 were randomly divided into the treatment group and the control group,with 30 cases in each group. The ones in the control group were treated with celecoxib,methotrexate,folic acid,and 2 sets of Yunke. The ones in the treatment group were treated with the musculature knife knife combined with the minimally invasive on acupotomy the basis of the control group. Results： Compared with before the treatment,the two groups＇ morning stiffness time,joint swelling,joint pressure pain,pain VAS score,doctor evaluation,patient evaluation,erythrocyte sedimentation rate and C reactive protein were significantly improved（ P 0. 05）,and the treatment group was better than the control group after treatment,the difference was statistically significant; After 8 weeks＇ treatment,the DAS 28 score of the treatment group was better than that of the control group,and the difference was statistically significant（ P 0. 05）. Conclusion： Musculature knife combined with minimally invasive acupotomy can release synovial tissue,remove fibrinoid necrosis,repair the articular surface and shorten the course of treatment. It can not only solve the obstinate arthralgia of local joints,but also help to control the overall condition of disease.