温和艾灸治疗寒湿痹阻型类风湿关节炎的疗效及对免疫学的影响

Effects of Mild Moxibustion on Curative Efficacy of Cold Dampness Blockage Type Rheumatoid Arthritis and Clinical Immune Index

目的:探讨温和艾灸寒湿痹阻型类风湿关节炎(RA)的疗效和对免疫学的影响。方法:选取2014年12月至2016年11月成都市新都区人民医院收治的寒湿痹阻型类风湿关节炎患者176例作为研究对象,按入组先后顺序平均分为对照组和观察组,每组88例,对照组常规西医治疗,观察组在对照组基础上加用温和艾灸治疗,观察不同方法治疗3个月后的疗效、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、免疫球蛋白G(Ig G)、免疫球蛋白G(Ig A)、免疫球蛋白M(Ig M)、补体C3、补体C4水平等免疫学指标和中医症状积分、不良反应。结果:对照组临床痊愈率15. 91%、总有效率78. 41%,观察组临床痊愈率23. 86%、总有效率89. 77%,观察组优于对照组(P <0. 05);治疗前2组ESR、CRP、RF、Ig A、Ig G、Ig M、C3、C4水平比较,差异无统计学意义(P <0. 05);治疗3个月后较治疗前以上指标2组差异有统计学意义(P <0. 05),治疗3个月后观察组以上指标优于对照组(P <0. 05);治疗前2组休息痛、晨僵持续时间、关节肿胀指数、HAQ指数、DAS28评分比较,差异无统计学意义(P> 0. 05);治疗3个月后较治疗前以上评分2组均显著下降,差异有统计学意义(P <0. 05),治疗3个月后观察组以上评分显著优于对照组,差异有统计学意义(P <0. 05)。对照组腹痛腹泻、恶心呕吐、畏寒乏力、过敏性皮疹、脱发、口腔溃疡发生率分别为17. 05%、23. 86%、9. 09%、25%、5. 68%、12. 5%,观察组分别为10. 23%、13. 64%、6. 82%、11. 36%、3. 41%、3. 41%,观察组在腹痛腹泻、恶心呕吐、过敏性皮疹、口腔溃疡发生率上显著低于对照组,差异有统计学意义(P <0. 05)。结论:温和艾灸能提高寒湿痹阻型类风湿关节炎免疫功能,改善症状,提高疗效,且不良反应小。

Objective:To investigate the effects of mild moxibustion on curative efficacy cold dampness blockage type rheumatoid arthritis(RA)and on clinical immune index.Methods:A total of 176 cold dampness blockage type rheumatoid arthritis patients treated in Chengdu Xindu District People′s Hospital from December 2014 to November 2016 were selected and divided into the control group and the observation group according to the order with 88 cases in each group.The control group received conventional western medicine treatment,and the study group was treated with mild moxibustion on the basis of the same treatment in the control group.After 3 months treatment,the clinical efficacy,erythrocyte sedimentation rate(ESR),C reactive protein(CRP),rheumatoid factor(RF),immunoglobulin G(IgG),immunoglobulin G(IgA),immunoglobulin G(IgM)and the effects of complement C3,C4 content of immune index and TCM symptom score and adverse reaction of different treatments were compared.Results:The clinical cure rate and total clinical efficacy in the control group were 15.91%and 78.41%.The clinical cure rate and total clinical efficacy in the observation were 23.86%and 89.77%.The study group was superior to the control group(P<0.05).Before the treatment,there was no significant difference among the immune indicators including the levels of ESR,CRP,RF,IgA,IgG,IgM,C3,C4 between the 2 groups(P>0.05).After 3 months of treatment,there was significant difference in the above indexes of the 2 groups before and after treatment(P<0.05).Compared with before treatment,the above indexes of the observation group were superior to those of the control group(P<0.05).Before the treatment,the difference of the symptom scores such as rest pain,morning stiffness duration and the swelling index,HAQ index,DAS28 score in the 2 groups was not statistically significant(P>0.05).After 3 months of treatment,compared with before treatment,the scores of the 2 groups were significantly decreased,and there was significant difference(P<0.05).After 3 months of treatment,the above scores in the study group were superior to those of the control group(P<0.05).The incidence rates of adverse reactions,such as abdominal pain and diarrhea,nausea and vomiting,chills,fatigue,allergic rash,alopecia,oral ulcer in the control group were 17.05%,23.86%,9.09%,25%,5.68%,12.5%,and the above incidence rate in the observation group were 10.23%,13.64%,6.82%,11.36%,3.41%,3.41%.The incidence rates of diarrhea,nausea and vomiting,abdominal pain allergic rash,oral ulcer in the observation group was significantly lower than those of the control group(P<0.05).Conclusion:Mild moxibustion can improve the immune function against arthritis with cold dampness blockage syndrome,rheumatoid improve symptoms and the curative efficacy,which also has less adverse reactions.