中药熏蒸联合艾灸治疗活动期类风湿性关节炎临床研究

Clinical Study of Chinese Herbal Fumigation Combined with Moxibustion for Rheumatoid Arthritis at Active Stage

目的:观察中药熏蒸联合艾灸治疗活动期类风湿性关节炎(Rheumatoid arthritis,RA)患者的临床疗效。方法:将90例寒湿痹阻证RA患者随机分为对照组和观察组各45例。对照组予塞来昔布胶囊和甲氨蝶呤片口服,适量双氯芬酸二乙胺乳胶剂外用。观察组在对照组治疗的基础上给予中药熏蒸和艾灸治疗。疗程均为4周。治疗前后各评价1次疾病活动性评分,采用28个关节数的疾病活动度(DAS28)评价;检测治疗前后类风湿因子(RF)、血沉(ESR)、C-反应蛋白(CRP)水平及简化的疾病活动性指数(SDAI)评分;统计2组临床疗效。结果:观察组临床疗效优于对照组,差异有统计学意义(Z=2.178,P<0.05)。治疗后观察组疾病活动情况轻于对照组,差异有统计学意义(Z=2.158,P<0.05)。治疗后2组患者的DAS28评分、SDAI评分明显下降,ESR、CRP和RF水平降低(P<0.01),且观察组上述指标低于对照组(P<0.01)。结论:中药熏蒸联合艾灸进一步的减轻了活动期RA寒湿痹阻证患者的肿、疼痛等症状,减轻了炎性反应指标,抑制了疾病活动程度,临床疗效优于单纯的西医治疗,值得临床使用。

Objective:To observe the clinical effect of Chinese herbal fumigation combined with moxibustion for rheumatoid arthritis(RA) at active stage.Methods:A total of 90 cases of RA patients of cold-dampness obstruction type were randomly divided into the control group and the observation group,45 cases in each group.The control group was given oral administration of celecoxib capsules and methopterin tablets,and external treatment of diclofenac diethylammonium gel;the observation group was additionally treated with Chinese herbal fumigation combined with moxibustion based on the treatment of the control group.Both groups were treated for four weeks.The disease activity scores were evaluated once before and after treatment respectively by disease activity score in 28 joints(DAS28);the levels of rheumatoid factor(RF),erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) as well as the scores of simplified disease activity index(SDAI) before and after treatment were detected;the clinical effect in the two groups were counted.Results:The clinical effect in the observation group was better than that in the control group,the difference being significant(Z=2.178,P <0.05).After treatment,the disease activity in the observation group was better than that in the control group,the difference being significant(Z=2.158,P <0.05).After treatment,the scores of DAS28 and SDAI in the two groups were significantly decreased,and the levels of ESR,CRP and RF were decreased(P<0.01);the above indexes in the observation group were lower than those in the control group(P<0.01).Conclusion:The therapy of Chinese herbal fumigation combined with moxibustion for RA patients of cold-dampness obstruction type at active stage further alleviates the symptoms of swelling and pain as well as the indexes of inflammatory response,inhibits the disease activity,and has better clinical effect than that of simple western treatment,which is worthy of clinical promotion.