桂枝芍药知母汤联合火鍉针治疗类风湿关节炎寒湿痹阻证临床观察

Clinical observation of Guizhi Shaoyao Zhimu Decoction combined with huochi needle in the treatment of rheumatoid arthritis caused by blockage of cold and dampness

目的:观察桂枝芍药知母汤联合火鍉针治疗寒湿痹阻型类风湿关节炎的临床疗效。方法:选取82例符合纳入标准的类风湿关节炎患者,随机分为治疗组(41例)、对照组(41例)。对照组予口服甲氨蝶呤片,治疗组予口服桂枝芍药知母汤加减联合火鍉针点按患处。比较两组中医证候积分、疼痛视觉模拟(VAS)评分、红细胞沉降率(ESR)、类风湿因子(RF)、C反应蛋白(CRP)水平以及临床疗效。结果:(1)治疗后,治疗组总有效率为95.12%,对照组为78.05%,两组总有效率比较差异有统计学意义(P<0.05)。(2)治疗后两组各项中医证候积分及总积分较治疗前明显降低,差异有统计学意义(P<0.05),且治疗组明显低于对照组(P<0.01)。(3)两组患者治疗后VAS评分均较治疗前明显降低,且治疗组显著低于对照组(P<0.05)。(4)两组患者治疗后ESR、RF、CRP均较前降低(P<0.05),治疗组明显低于对照组(P<0.05)。结论:桂枝芍药知母汤联合火鍉针治疗寒湿痹阻型类风湿关节炎疗效显著,中医外治法和内治法巧妙结合,临床认可度高,值得推广。

Objective:To observe the clinical effect of Guizhi Shaoyao Zhimu Decoction combined with huochi needle in the treatment of rheumatoid arthritis caused by blockage of cold and dampness.Methods:82 patients with rheumatoid arthritis who met the inclusion criteria were randomly divided into treatment group(41 cases)and control group(41 cases).The patients in the control group took Methotrexate Tablets orally,and the patients in the treatment group took modified Guizhi Shaoyao Zhimu Decoction combined with huochi needle to press the affected area.Results:(1)After treatment,the total effective rate was 95.12%in the treatment group and 78.05%in the control group,and there was statistically significant difference in the total effective rate between the two groups(P<0.05).(2)After treatment,the TCM syndrome scores and total scores of the treatment group were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The TCM syndrome scores and total scores of the treatment group were significantly lower than those of the control group(P<0.01).(3)The visual analogue scores(VAS)of the two groups after treatment were significantly lower than those before treatment,and the VAS score of the treatment group was significantly lower than that of the control group(P<0.05).(4)The erythrocyte sedimentation rate(ESR),rheumatoid factors(RF)and C-reactive protein(CRP)of the two groups after treatment were lower than those before treatment(P<0.05),and ESR,RF and CRP in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion:Guizhi Shaoyao Zhimu Decoction combined with huochi needle has a significant effect in the treatment of rheumatoid arthritis caused by blockage of cold and dampness.The clever combination of external treatment and internal treatment of traditional Chinese medicine has a high degree of clinical recognition and is worthy of promotion.