补肾强骨除痹汤联合艾灸阿是穴对肝肾不足证类风湿关节炎的作用

Effects of Bushen Qianggu Chubi Decoction combined with moxibustion at Ashi point on rheumatoid arthritis of liver-kidney deficiency type

目的 观察补肾强骨除痹汤联合艾灸阿是穴治疗肝肾不足证类风湿关节炎(rheumatoid arthritis, RA)的疗效。方法 选取90例肝肾不足证RA患者,简单随机分为观察组(n=45)和对照组(n=45)。2组均口服甲氨蝶呤片(methotrexate, MTX),对照组在此基础上联合艾灸阿是穴治疗,观察组在对照组治疗的基础上联合应用补肾强骨除痹汤,2组均持续治疗30 d。治疗后,比较2组的临床疗效、中医证候评分、关节肿胀个数、关节压痛个数、晨僵时间、关节活动度和住院时间;采用酶联免疫吸附法(enzyme-linked immuno sorbent assay, ELISA)检测并比较2组患者风湿因子(rheumatoid factor, RF)和血沉(erythrocyto sedimentation rate, ESR)水平;采用疼痛视觉评估量表(visual analogue scale, VAS)比较2组患者的疼痛情况,采用匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)评价2组患者的睡眠质量。结果 治疗后,观察组治疗总有效率(95.56%)显著高于对照组(82.22%),P<0.05;观察组患者关节僵硬、腰膝酸软和肿胀刺痛中医证候评分低于对照组(P<0.05);观察组患者关节肿胀个数和关节压痛个数显著少于对照组(P<0.05),晨僵时间和住院时间短于对照组(P<0.05);观察组患者RF和ESR水平低于对照组(P<0.05);观察组患者VAS评分、PSQI评分和欧洲抗风湿联盟提出的28个关节疾病活动性评分(28 disease activity scores, DAS28)均低于对照组(P<0.05)。结论 补肾强骨除痹汤联合艾灸阿是穴治疗RA患者有良好的临床疗效,可有效缓解患者的临床症状。

Objective To observe the curative effect of Bushen Qianggu Chubi Decoction combined with moxibustion at Ashi point on rheumatoid arthritis(RA) of liver-kidney deficiency type.Methods According to simple random grouping method, 90 patients with RA of liver-kidney deficiency type were enrolled and divided into observation group(n=45) and control group(n=45). The both groups were given oral methotrexate(MTX). On this basis, the control group was treated with moxibustion at Ashi point, while the observation group was treated with Bushen Qianggu Chubi Decoction on the basis of control group. All were continuously treated for 30 days. After treatment, the clinical curative effect, scores of traditional Chinese medicine(TCM) syndromes, number of swelling and tenderness joints, morning stiffness time, range of motion and hospitalization time between the 2 groups were compared. The levels of rheumatism factor(RF) and erythrocyte sedimentation rate(ESR) in the 2 groups were detected and compared by enzyme-linked immunosorbent assay(ELISA). The pain status was compared between the 2 groups by visual analogue scale(VAS). The sleep quality in both groups was evaluated by Pittsburgh sleep quality index(PSQI).Results After treatment, the total response rate of treatment in observation group was significantly higher than that in control group(95.56% vs. 82.22%)(P<0.05). The scores of TCM syndromes(joint stiffness, soreness and weakness of waist and knees, swelling and pricking) in observation group were lower than those in control group(P<0.05). The number of swelling and tenderness joints in observation group was significantly less than that in control group(P<0.05). The morning stiffness time and hospitalization time were shorter than those in control group(P<0.05). The levels of RF and ESR in observation group were lower than those in control group(P<0.05), the scores of VAS, PSQI and 28 disease activity scores(DAS28) were lower than those in control group(P<0.05).Conclusion The clinical curative effect of Bushen Qianggu Chubi Decoction combined with moxibustion at Ashi point is good on RA patients, which can effectively relieve their clinical symptoms.