针灸治疗类风湿关节炎临床及机制研究进展

Research progress in clinical and mechanism of acupuncture and moxibustion in the treatment of rheumatoid arthritis

针刺可改善类风湿关节炎(RA)患者疼痛、关节僵硬等临床症状, 改善类风湿因子、超敏C反应蛋白、ESR等临床指标, 并通过抑制病灶局部关节滑膜细胞增殖及软骨细胞凋亡、抑制肥大细胞炎症反应, 以及脾脏、腘窝淋巴结等上游免疫器官炎症细胞浸润, 调节T细胞极化平衡, 改善RA炎症状态。临床多取足太阳膀胱经、足阳明胃经、足太阴脾经、督脉等治疗, 选穴以足三里、阳陵泉、大椎、曲池等温经散寒通络的穴位为主。近年研究表明, 针药联用的治疗策略值得临床推广。

It is found that acupuncture can significantly improve the clinical symptoms of rheumatoid arthritis(RA)such as pain and joint stiffness,and improve rheumatoid factor,high-sensitivity CRP,ESR and other clinical indicators.It can inhibit the proliferation of synovial cells,the apoptosis of chondrocytes,and regulate polarization balabce of mononuclear macrophages,T cells,as well as inhibit the inflammatory function of multiple immune cells,in order to improve inflammation state of RA joints.In clinical treatment of RA,bladder meridian,stomach meridian,spleen meridian,and Governor Vessel are mostly selected.Acupoints with the efficacy of warming meridian,dispelling coldness and dredging collaterals were commonly selected such as Zusanli(ST36),Yanglinquan(GB34),Dazhui(GV14),Quchi(LI11).Several researches have proved that combined therapy of acupuncture and medicine is worthy promotion in clinic.