悬灸联合甲氨蝶呤治疗早期类风湿关节炎疗效及对外周血炎症指标、氧化应激的影响

Therapeutic Effect of Suspended Moxibustion plus Methotrexate on Early Rheumatoid Arthritis and Its Impact on Peripheral Blood Inflammation Indicators and Oxidative Stress

目的观察基于"热证可灸"理论的悬灸联合甲氨蝶呤治疗早期类风湿关节炎(RA)的临床疗效及对外周血炎症指标、氧化应激的影响。方法将符合纳入标准的70例早期RA患者随机分为观察组35例和对照组35例,观察组给予悬灸联合甲氨蝶呤治疗,对照组给予甲氨蝶呤治疗。两组治疗前后以28处关节疾病活动度积分(DAS-28)评分、血清指标[C反应蛋白(CRP)、血沉(ESR)、类风湿因子(RF)],外周血中性粒细胞/淋巴细胞比率(NLR)、血小板/淋巴细胞比率(PLR)和红细胞分布宽度(RDW)及氧化应激指标超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)和丙二醛(MDA)评价治疗效果。结果治疗组总有效率为94.3%,对照组为82.9%,观察组高于对照组(P<0.05);两组治疗后DAS-28及血清ESR、CRP和RF水平均明显降低(P<0.01),观察组低于对照组(P<0.05);两组治疗后氧化应激指标SOD、GSH-Px水平明显上升(P<0.05),MDA水平下降(P<0.05),观察组优于对照组(P<0.01);两组治疗后外周血NLR、PLR和RDW水平均比治疗前下降(P<0.01),观察组NLR低于对照组(P<0.05)。结论基于"热证可灸"理论的悬灸联合甲氨蝶呤治疗早期RA的临床疗效肯定,能有效改善临床症状、血清相关指标,提高机体抗氧化损伤能力,有效防止疾病的进一步发展。

Objective To investigate the clinical efficacy of"heat syndrome can be moxibusted"theoty-based suspended moxibustion plus methotrexate for early rheumatoid arthritis(RA)and its impact on peripheral blood inflammation indicators and oxidative stress.Method Seventy patients with early RA were randomized to an observation group(35 cases)and a control group(35 cases).The observation group was treated with suspended moxibustion plus methotrexate and the control group,with methotrexate alone.The therapeutic effect was evaluated using the 28-joint Disease Activity Score(DAS28)score,serum indicators[C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and rheumatoid factor(RF)],peripheral blood neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),red cell distribution width(RDW),oxidative stress indicators superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px),and malondialdehyde(MDA)in the two groups before and after treatment.Result The total efficacy rate was 94.3%in the treatment group and 82.9%in the control group.It was higher in the treatment group than in the control group(P<0.05).After treatment,the DAS28 score and serum ESR,CRP and RF levels decreased significantly in the two groups(P<0.01)and was lower in the observation group than in the control group(P<0.05).After treatment,oxidative stress indicators SOD and GSH PX levels increased significantly(P<0.05)and MDA levels decreased significantly(P<0.05)in the two groups and improved more in the observation group than in the control group(P<0.01).Peripheral blood NLR,PLR and RDW decreased in the two groups after treatment compared with before(P<0.01),NLR levels was lower in the observation group than in the control group(P<0.05).Conclusion"Heat syndrome can be moxibusted"theoty-based suspended moxibustion plus methotrexate has clinically a definite therapeutic effect on early RA.It can effectively relieve the clinical symptoms,ameliorate serum related indicators and peripheral blood,improve the ability to prevent oxidative damage and effectively arrest further development of disease.