温经散寒通络汤联合针灸治疗寒湿型类风湿性关节炎临床观察

Clinical Observation of the Treatment of Rheumatoid Arthritis of Cold⁃Dampness Type with Decoction for Warming Meridians and Dispersing Cold and Dredging Collaterals Combined with Acupuncture and Moxibustion

目的:观察温经散寒通络汤联合针灸治疗寒湿型类风湿性关节炎(rheumatoid arthritis,RA)的临床疗效。方法:选取寒湿型RA患者114例,按照随机数字表法分为对照组和观察组,各57例。对照组给予氨甲蝶呤片口服治疗,观察组在对照组治疗的基础上加用温经散寒通络汤联合针灸治疗。观察两组治疗前后中医证候评分、血沉(erythrocyte sedimentation rate,ESR)、类风湿因子(rheumatoid factor,RF)、C反应蛋白(C reactive protein,CRP)、白细胞介素(interleukin,IL)-1、IL-6和肿瘤坏死因子(tumor necrosis factor,TNF)-α、28个关节疾病活动度评分(28 joint disease activity score,DAS28)、疾病活动指数简表(simplified disease activity index,SDAI)评分、健康评估问卷(the health assessment questionnaire,HAQ)评分变化情况及临床疗效。结果:观察组治疗后中医证候评分、DAS28评分、SDAI评分、HAQ评分均低于对照组,差异有统计学意义(P<0.05);观察组治疗后CRP、ESR、RF水平低于对照组,差异有统计学意义(P<0.05);观察组治疗后IL-1、IL-6和TNF-α水平均低于对照组,差异有统计学意义(P<0.05);观察组有效率为96.49%,对照组有效率为80.70%,观察组有效率高于对照组,差异有统计学意义(P<0.05)。结论:温经散寒通络汤联合针灸可改善RA患者相关症状,提高临床疗效,降低疾病活动指标和炎症相关指标。

Objective:To observe the clinical efficacy of Decoction for Warming Meridians and Dispersing Cold and Dredging Collaterals combined with acupuncture and moxibustion on rheumatoid arthritis(RA)with cold⁃dampness syndrome.Methods:A total of 114 RA patients with cold⁃dampness syndrome were selected and randomly divided into the control group and the observation group,with 57 ca⁃ses in each group.The control group was treated with Methotrexate Tablets orally,while the observation group was treated with Decoction for Warming Meridians and Dispersing Cold and Dredging Collaterals combined with acupuncture and moxibustion on the basis of the control group.Then the changes in TCM syndrome score,erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),C reactive protein,erythrocyte sedimentation rate(RF)before and after treatment in the two groups.CRP,interleukin(IL⁃1),IL⁃6,and tumor necrosis factor(TNF)⁃α,28 joint disease activity score(DAS28),simplified disease activity index(SDAI)score,the health assess⁃ment questionnaire(HAQ)score of the two groups before and after treatment and clinical efficacy were observed.Results:After treat⁃ment,the TCM syndrome score,DAS28 score,SDAI score and HAQ score in the observation group were lower than those in the control group,and all the differences were statistically significant(P<0.05);The levels of CRP,ESR and RF in the observation group were lower than those in the control group,and all the differences were statistically significant(P<0.05);The levels of IL⁃1,IL⁃6 and TNF⁃αin the observation group were lower than those in the control group,and all the differences were statistically significant(P<0.05).The effective rate of the observation group was 96.49%,and that of the control group was 80.70%.The effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Decoction for Warming Meridians and Dispersing Cold and Dredging Collaterals combined with acupuncture and moxibustion can improve the symp⁃toms of RA patients,and clinical efficacy,and reduce disease activity indexes and inflammation⁃related indexes.