针刺联合三痹汤对痛风性关节炎患者的临床疗效及免疫功能的影响

Clinical Efficacy of Acupuncture Combined with San Bi Decoction for Gouty Arthritis Patients and the Effect on Immune Function

目的观察针刺联合三痹汤加减治疗痛风性关节炎的临床疗效及其对患者免疫功能的影响。方法将纳入的120例痛风性关节炎患者按照完全随机法分为对照组和联合组,每组60例。两组患者均给予基础治疗;对照组予三痹汤加减口服治疗;联合组在对照组的治疗基础上予针刺治疗。观察两组治疗前后血尿酸(UA)、黄嘌呤氧化酶(XOD)、超氧化物歧化酶(SOD)、T淋巴细胞亚群(CD3^(+)、CD8^(+)、CD4^(+)/CD8^(+))、白介素(IL)-8、IL-1及C反应蛋白(CRP)水平的变化。比较两组临床疗效。结果联合组治疗后UA、XOD水平低于对照组(P<0.05),而SOD水平高于对照组(P<0.05)。联合组治疗后CD3^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05),而CD8^(+)水平低于对照组(P<0.05)。联合组治疗后IL-8、CRP及IL-1水平低于对照组(P<0.05)。联合组治疗后疼痛、红肿、活动度及关节功能均优于对照组(P<0.05)。联合组治疗后总有效率高于对照组(P<0.05)。结论针刺联合三痹汤治疗痛风性关节炎临床疗效优于单一三痹汤治疗,可缓解症状,提高患者免疫功能,降低尿酸水平与炎症反应。

Objective To observe the clinical efficacy of acupuncture plus modified San Bi decoction in treating gouty arthritis and its effect on the immune function in patients.Method A total of 120 gouty arthritis patients were recruited and divided into a control group and an integrated group using the complete randomization method,with 60 cases in each group.The two groups of patients were all given basic intervention;the control group was given additional oral administration of San Bi decoction,while the integrated group was given acupuncture based on the intervention given to the control group.The levels of uric acid(UA),xanthine oxidase(XOD),superoxide dismutase(SOD),T lymphocyte subsets(CD3^(+),CD8^(+)and CD4^(+)/CD8^(+)),interleukin(IL)-8,IL-1 and C-reactive protein(CRP)were observed before and after treatment in the two groups.The clinical efficacy was also compared between the two groups.Result After intervention,the levels of UA and XOD were lower(P<0.05)and the level of SOD was higher(P<0.05)in the integrated group than in the control group.The levels of CD3^(+)and CD4^(+)/CD8^(+)were higher(P<0.05)and the level of CD8^(+)was lower(P<0.05)in the integrated group than in the control group after treatment.The levels of IL-8,CRP and IL-1 were lower in the integrated group than in the control group after intervention(P<0.05).The integrated group was superior to the control group comparing pain,swelling,range of motion and joint function after treatment(P<0.05).After intervention,the integrated group had a higher total effective rate compared with the control group(P<0.05).Conclusion Acupuncture plus San Bi decoction can produce more significant clinical efficacy than using San Bi decoction alone;it can mitigate symptoms,enhance the immune function and reduce the level of UA and inflammatory responses in the patients.