巨刺法联合耳穴贴压及塞来昔布胶囊治疗湿热蕴结型急性单侧痛风性关节炎的疗效观察

Observation on the Curative Effect of Opposing Needling Combined with Auricular Point Pressing and Celecoxib Caspules in the Treatment of Acute Unilateral Gouty Arthritis with Damp Heat Accumulation Type

【目的】观察巨刺法联合耳穴贴压及塞来昔布胶囊治疗湿热蕴结型急性单侧痛风性关节炎的临床疗效。【方法】将110例湿热蕴结型急性单侧痛风性关节炎患者随机分为观察组和对照组,每组各55例,2组患者均给予塞来昔布胶囊口服与耳穴贴压的基础治疗,对照组在基础治疗的同时给予常规针刺治疗,观察组在基础治疗的同时给予巨刺法治疗,均连续治疗14 d。治疗14 d后,评价2组患者的临床疗效,观察2组患者治疗前后临床症状和体征总积分(TSS)、中医证候评分的变化情况,以及血尿酸(BUA)、血沉(ESR)水平、C反应蛋白(CRP)的情况。比较2组患者治疗前后关节超声评分的变化情况。【结果】(1)研究过程中,观察组脱落1例(治疗期间口服其他影响疗效药物),剔除1例(数据不全);对照组脱落2例(自行退出),剔除1例(数据不全)。最终观察组53例、对照组52例纳入疗效统计。(2)治疗后,2组患者的TSS评分、中医证候积分以及关节超声评分均明显改善(P<0.05),且观察组在改善TSS评分、中医证候积分以及关节超声评分方面均明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗后,2组患者的BUA、ESR、CRP水平均明显改善(P<0.05),且观察组在改善BUA、ESR、CRP水平方面均明显优于对照组,差异均有统计学意义(P<0.05)。(4)观察组总有效率为92.45%(49/53),对照组为76.92%(40/52)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】巨刺法联合耳穴贴压及塞来昔布胶囊治疗湿热蕴结型急性单侧痛风性关节炎,能明显改善患者的症状和体征,有效降低患者的BUA、ESR、CRP水平,疗效显著。

Objective To observe the clinical efficacy of opposing needling combined with auricular point pressing and Celecoxib Caspules on acute unilateral gouty arthritis of damp heat accumulation type. Methods A total of110 patients with acute unilateral gouty arthritis of damp heat accumulation type were randomly divided into the observation group and the control group,with 55 cases in each group. The patients in the two groups were given basic treatment of oral use of Celecoxib Capsules and auricular point pressing. The control group was treated with conventional acupuncture on the basis of basic treatment,while the patients in the observation group was treated with opposing needling on the basis of basic treatment. Both treatment lasted for 14 consecutive days. After 14 days of treatment, the clinical efficacy of two groups was evaluated, and the changes of total score of clinical total symptom score(TSS),traditional Chinese medicine(TCM)syndrome scores,blood urinary acid(BUA),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were observed before and after treatment. The changes of joint ultrasound scores were compared between the two groups before and after treatment. Results(1)During the study,the one case fell off in the observation group(oral administration of other drugs affecting curative effect during the treatment),and one case was eliminated(data incomplete);two cases fell off in the control group(self-exited),and one case was eliminated(incomplete data). Finally,53 cases in the observation group and52 cases in the control group were included in the curative effect statistics.(2)After treatment,TSS score,TCM syndrome scores and joint ultrasonic score of two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving TSS score, TCM syndrome scores and joint ultrasound score,the differences being statistically significant(P<0.05).(3)After treatment,BUA,ESR and CRP levels in the two groups being significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving BUA,ESR and CRP levels,the differences being statistically significant(P<0.05).(4)The total effective rate was 92.45%(49/53)in the observation group and 76.92%(40/52)in the control group,and the therapeutic effect of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05). Conclusion Opposing needling combined with auricular point pressing and Celecoxrb Capsules has significant effect in improving the symptoms and signs of patients with acute unilateral gouty arthritis of damp heat accumulation type and reducing the levels of BUA,ESR and CRP.