热补针法治疗类风湿关节炎临床疗效及对机体氧化应激的影响

Clinical Efficacy of Hot Needling Acupuncture for Rheumatoid Arthritis and Its Effects on Oxidative Stress

目的观察热补针法治疗类风湿关节炎(RA)风寒湿阻证患者临床疗效及对血浆氧化应激指标的影响。方法采用随机数字表法将68例患者分为热补针法组和西药组各34例。西药组予依托考昔片、来氟米特片、甲氨蝶呤片,餐后服。热补针法组在西药组基础上行热补针法,每日1次,连续5 d,疗程间休息2 d。2组均治疗4周,治疗后3个月随访。采用视觉模拟评分法(VAS)评价疼痛程度,检测血浆谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)及丙二醛(MDA)水平,评价临床疗效。结果热补针法组治疗后及治疗后3个月总有效率分别为91.2%(31/34)、88.3%(30/34),西药组分别为76.5%(22/34)、70.6%(24/34),热补针法组均优于西药组(P<0.05)。与本组治疗前比较,2组治疗后及治疗后3个月VAS评分明显降低,血浆GSH-Px、SOD水平升高,MDA水平降低(P<0.05);2组治疗后及治疗后3个月比较,热补针法组VAS评分低于西药组,GSH-Px、SOD、MDA水平改善优于西药组(P<0.05)。结论热补针法治疗RA风寒湿阻证患者疗效显著,可明显减轻疼痛症状,提高机体抗氧化损伤能力。

Objective To observe the clinical efficacy of hot needling acupuncture for the treatment of patients of rheumatoid arthritis(RA) with wind-cold dampness syndrome and its effects on expressions of plasma oxidative stress indices. Methods Totally 68 patients with RA were divided into hot needling acupuncture group and Western medicine group according to random number table method, with 34 cases in each group. Western medicine group took etoricoxib tablets, leflunomide tablets and methotrexate tablets, orally taken after meals. Hot needling acupuncture group received hot needling acupuncture on the basis of the Western medicine group, once a day for 5 d, with two days rest between courses. Both groups were treated for 4 weeks and followed up three months after treatment. The degree of pain was evaluated by visual analog scale(VAS), and plasma GSH-Px, SOD and MDA levels were measured. Clinical efficacy was evaluated. Results The total effective rates after treatment and three months after treatment were 91.2%(31/34) and 88.3%(30/34) in the hot needling acupuncture group, and 76.5%(22/34) and 70.6%(24/34) in the Western medicine group, and hot needling acupuncture group was superior to the Western medicine group(P<0.05). Compared with before treatment, the VAS scores of the two groups were significantly lower after treatment and three months after treatment, and the plasma GSH-Px and SOD levels were higher than those before treatment, and the MDA level decreased(P<0.05). Comparing after treatment and three months after treatment, the VAS score of the hot needling acupuncture group was lower than that of the Western medicine group, and the GSH-Px, SOD and MDA levels were better than the Western medicine group(P<0.05). Conclusion Hot needling acupuncture has confirmed efficacy for the treatment of patients of RA with wind-cold dampness syndrome, which can significantly reduce pain symptoms and improve the anti-oxidative ability of RA patients.