千斤拔油针治疗类风湿关节炎临床研究

Clinical Study on Treatment of Rheumatoid Arthritis with Flemingia Oil Needle Acupuncture

目的观察千斤拔油针治疗类风湿关节炎(RA)的临床疗效及可能的作用机制。方法采用随机数字表法将80例RA患者分为对照组及观察组各40例。对照组予甲氨蝶呤片,每次10mg,急性期每周2次,缓解期每周1次,口服;观察组予千斤拔油针,隔日1次,每周3次。2组均连续治疗2个月。比较2组临床疗效,检测2组治疗前后红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)及白细胞介素(IL)-1、IL-6、肿瘤坏死因子(TNF)-α水平,比较2组关节压痛数、关节肿胀数和晨僵持续时间。结果观察组脱落2例,对照组脱落3例。观察组总有效率为89.8%(34/38),对照组为62.2%(24/37),观察组明显优于对照组(P<0.05)。与本组治疗前比较,2组关节压痛数、关节肿胀数、晨僵持续时间明显减少(P<0.05);2组治疗后比较,观察组关节压痛数、关节肿胀数和晨僵时间明显少于对照组(P<0.05)。与本组治疗前比较,2组治疗后ESR、CRP、RF、IL-1、IL-6、TNF-α水平明显下降(P<0.05);2组治疗后比较,观察组ESR、CRP、RF、IL-1、IL-6、TNF-α水平明显低于对照组(P<0.05)。结论千斤拔油针可改善RA患者临床症状,其机制可能与降低炎症因子水平、减轻关节炎症损伤有关。

Objective To observe the clinical efficacy of Flemingia oil needle acupuncture in the treatment of rheumatoid arthritis and possible mechanism of action.Methods Totally 80 patients with rheumatoid arthritis were divided into control group and observation group by random number table method,with 40 cases in each group.The control group was treated with methotrexate tablets,10 mg each time,twice a week in acute phase and once a week in remission phase,orally.The observation group was given Flemingia oil needle acupuncture therapy,once every other day,three times a day.Both groups were treated for successive two months.The clinical efficacy of the two groups were compared.The changes of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid factor(RF),interleukin(IL)-1,IL-6 and tumor necrosis factor(TNF)-αwere detected before and after treatment.The number of joint tenderness,joint swelling and the duration of morning stiffness were evaluated.Results The observation group dropped 2 cases,the control group dropped 3 cases.The total effective rate was 89.8%(34/38)in the observation group and 62.2%(24/37)in the control group.The observation group was significantly better than the control group(P<0.05).Compared with before treatment,the number of joint tenderness,joint swelling and the duration of morning stiffness of both groups decreased significantly(P<0.05);After treatment,the number of joint tenderness,joint swelling and the duration of morning stiffness of the observation group were fewer than the control group(P<0.05).Compared with before treatment,the levels of ESR,CRP,RF,IL-1,IL-6 and TNF-αin the two groups were significantly decreased(P<0.05);The levels of ESR,CRP,RF,IL-1,IL-6 and TNF-αin the observation group were significantly lower than those in the control group(P<0.05).Conclusion Flemingia oil needle acupuncture therapy can improve the clinical symptoms of patients with rheumatoid arthritis,and the mechanism may be related to reducing the level of inflammatory cytokines and alleviating the inflammatory injury of joints.