电针治疗肝肾阴虚型类风湿关节炎临床疗效及对关节功能的影响

Clinical Efficacy of Electro-Acupuncture in the Treatment of Rheumatoid Arthritis of Yin-Deficiency of Liver and Kidney and Its Influence to Joint Function

目的:探讨电针治疗肝肾阴虚型类风湿关节炎(RA)的临床疗效及对关节功能的影响。方法:选取2016年5月—2018年7月在我院接受治疗的RA患者134例,按入院序号将患者随机分为实验组和对照组,各67例。对照组采用甲氨蝶呤联合来氟米特治疗,实验组在此基础上增加电针治疗,两组均连续治疗4个月。比较两组患者治疗后临床疗效、治疗前后临床症状改善情况、DAS28、关节功能及血清RA相关因子水平,记录不良反应发生情况。结果:治疗后实验组总有效率明显高于对照组(P<0.05);与治疗前比较,治疗后两组患者晨僵时间均明显缩短,关节压痛数、压痛指数及关节肿胀数、肿胀指数均明显降低,且实验组明显低于对照组(P<0.05或P<0.01);与治疗前比较,治疗后两组患者DAS28均明显降低,且实验组明显低于对照组(P<0.01);与治疗前比较,治疗后两组患者Lysholm各项评分均明显升高,且实验组明显高于对照组(P<0.01);与治疗前比较,治疗后两组患者血清CRP、RF及ESR水平均明显降低,且实验组明显低于对照组(P<0.01);实验组总不良反应发生率明显低于对照组(P<0.05)。结论:电针能明显改善肝肾阴虚型RA患者临床症状,降低RA相关因子水平及疾病活动度,改善患者关节功能,提高临床疗效,安全有效,建议临床推广使用。

Objective: To explore the clinical efficacy of electro-acupuncture in the treatment of rheumatoid arthritis(RA) of yin-deficiency of Liver and Kidney and its influence to joint function. Methods: 134 cases of RA were randomly divided into the study group and the control group, with 67 cases in each group. The control group was treated with Methotrexate and Leflunomide;on which basis, the study group was also treated with electro- acupuncture. The two groups were treated continuously for four months. The clinical efficacy after the treatment, the improvement of clinical symptoms, DAS28, joint function and serum RA related factors before and after the treatment were compared between the two groups, and the incidence of adverse reactions was recorded. Results: After the treatment, the total effective rate of the study group was significantly higher than that of the control group( P <0.05). The duration of morning stiffness was significantly shortened, the number of joint tenderness, tenderness index, joint swelling and swelling index were significantly reduced or decreased after the treatment compared to those before the treatment in the two groups, and the improvements in the study group were more significant( P <0.05, P <0.01). DAS28 scores were greatly decreased after the treatment in the two groups, and the decrease in the study group was more significant( P <0.01). The Lysholm scores were significantly increased after the treatment in the two groups, and the increase in the study group was more significant( P <0.01). The serum levels of CRP, RF and ESR were significantly decreased after the treatment in the two groups, and the study group was significantly lower than the control group( P <0.01). The incidence of total adverse reactions in the study group was significantly lower than that of the control group( P <0.05). Conclusion: Electro-acupuncture can significantly improve the clinical symptoms of patients with RA of yin-deficiency of Liver and Kidney, it can reduce the levels of RA related factors and disease activity index, improve the joint function of the patients and improve clinical efficacy. The therapy is safe and effective, which is recommend to use in clinic.