针刀松解术联合常规西药治疗类风湿关节炎腕关节病变22例临床观察

Clinical Observation on 22 Cases of Rheumatoid Arthritis Wrist Joint Disease Treated by Acupotomy Combined with Conventional Western Medicine

目的:观察针刀松解术联合口服非甾体抗炎药、改善病情抗风湿药治疗类风湿关节炎腕关节病变的临床疗效。方法:将44例类风湿关节炎腕关节病变的门诊患者随机分为治疗组和对照组,每组22例。对照组给予西药依托考昔、甲氨蝶呤、叶酸、来氟米特治疗,治疗组在对照组的基础上加针刀松解术。2组均治疗3个月。观察2组临床疗效,以及治疗前后Cooney腕关节评分、实验室指标等。结果:治疗组显效5例,有效13例,无效4例,总有效率为81.81%;对照组显效2例,有效11例,无效9例,总有效率为59.19%。2组比较,差异有统计学意义(P<0.05)。治疗后,2组患者Cooney腕关节评分升高,类风湿因子(RF)、红细胞沉降率(ESR)、C反应蛋白(CRP)、抗环瓜氨酸肽抗体(抗CCP抗体)降低(P<0.05);且治疗组RF、CRP、ESR、抗CCP抗体均优于对照组(P<0.05)。结论:针刀松解术治疗类风湿关节炎引起的腕关节病变优于口服西药;针刀松解术可以有效缓解腕关节的临床症状,进而提高患者的生活质量。

Objective:To observe the clinical efficacy of acupotomy combined with oral nonster-oidal anti-inflammatory drugs and anti rheumatic drugs in the treatment of rheumatoid arthritis.Methods:Forty-four outpatients with rheumatoid arthritis wrist disease were randomly divided into a treatment group and a control group,with 22 cases in each group.The control group was treated with etoposide tablets,methotrexate,folic acid and leflunomide,and the treatment group was treated with acupotomy on the basis of the treatment as that for the control group.Both groups were treated for 3 months.The clinical efficacy,Cooney wrist score before and after treatment and laboratory indexes of the two groups were observed.Results:In the treatment group,5 cases were significantly effective,13 cases were effective,4 cases were ineffective,and the total effective rate was 81.81%;In the control group,2 cases were significantly effective,11 cases were effective and 9 cases were ineffective.The total effective rate was 59.19%.The difference between the two groups was statistically significant(P<0.05).After treatment,Cooney wrist score increased,rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and anti cyclic citrullinated peptide antibody(anti CCP antibody)decreased in both groups(P<0.05);RF,CRP,ESR and anti CCP antibodies in the treatment group were better than those in the control group(P<0.05).Conclusion:Acupotomy is better than western medicine in the treat-ment of wrist joint disease caused by rheuma-toid arthritis,which can effectively alleviate the clinical symptoms of wrist joint,and then improve the quality of life of patients.