艾灸加刺络放血治疗急性痛风性关节炎的临床疗效

目的:比较传统方法与口服西药治疗急性痛风性关节炎的疗效,为临床治疗该病提供更有效的治疗手段。方法:急性痛风性关节炎患者62例,分为传统组32例和西药组30例。传统组采用患处艾灸加刺络放血治疗;西药组口服秋水仙碱片为主治疗。治疗前后观察2组患者血尿酸水平及疼痛变化。结果:治疗5d后,2组患者血尿酸水平及疼痛程度积分均较治疗前明显下降(P<0.01),与西药组比较传统组更显著(P<0.01)。结论:艾灸加刺络放血治疗急性痛风性关节炎能明显提高临床疗效。

FORTY-EIGHT CASES OF ACUTE GOUTY ARTHRITIS TREATED COMPREHENSIVELY WITH ELECTROACUPUNCTURE AND WARMING MOXIBUSTION

Objective To probe into the effects on acute gouty arthritis treated comprehensively with electroacupuncture (EA) and warming moxibustion. Methods 70 cases were randomized into treatment group (48 cases), in which the EA+warming moxibustion was applied; and controlled group (22 cases), in which, colchicine was prescribed for oral administration. Results The statistical outcomes after 1 course treatment in treatment group: 28 cases were cured (58.33%), 18 cases improved (37.50%) and the total effective rate was 95.83%. In controlled group: 12 cases (54.55%) were cured, 8 cases improved (36.36%) and the total effective rate was 90.91%. The therapeutic effects of two groups were basically consistent, without significant different (P>0.05). But, concerning to side effect, there was no any toxic side effects in the group treated with EA+warming moxibustion, and the occurrence rate in the group treated with colchicine was 40.91%. Conclusion Electroacupuncture+warming moxibustion achieves good therapeutic effects without any side effects.

Fire needling and bloodletting at cleft points in treatment of 35 patients with acute gouty arthritis

Objective To observe the clinical efficacy of fire needling and bloodletting at cleft points for acute gouty arthritis, and to explore its functional mechanism. Methods Thirty-five patients with acute gouty arthritis were enrolled into this study, and fire needling and bloodletting with 10 mL/ time were applied at cleft points of corresponding meridians and collaterals at the affected side. The treatment was conducted for once every other day, and treatment for three consecutive times was needed. Serum uric acid （UA） and pain score were tested in patients before treatment and on the 6th day after treatment, follow-up visit for 3 months was performed in patients who stopped treatment, and recurrence rate was calculated. Results Budzyuski 6-point behavioral rating scale was applied to score pain. T-test was conducted on mean and standard deviation of pain score before treatment （4.09 ＋ 0.82） and after treatment （1.14 ＋ 1.33）, showing that the difference was significant （P〈0.05）; t-test was also conducted on mean and standard deviation of serum UA before treatment [（555.34 ＋ 53.09） pmol/L] and after treatment [（414.23 ＋ 67.04） pmol/L], showing that the difference was significant （P〈0.05）; among the 35 patients with acute gouty arthritis, 14 patients were cured （40.0%）, improvement was found in 19 patients （54.3%）, and effectiveness was found in 33 patients （94.3%）. Based on follow-up visit for 3 months in 33 patients with efficacy, recurrence was found in 3 patients （9.1%）. Conclusion Fire needling and bloodletting at cleft points is an effective method in treatment of acute gouty arthritis with significant analgesic effect, efficacy of reducing serum UA, high cure rate and low recurrence rate, which is worth of being generalized clinically.

Points selection pattern in acupuncture-moxibustion treatment of gouty arthritis:an analysis based on bibliometrics

To discuss the selection pattern of points and meridians in acupuncture-moxibustion treatment of gouty arthritis （GA） by analyzing clinical literatures related to GA, and to provide reference for acupuncture-moxibustion treatment of GA. Methods： Clinical literatures related to GA treated with acupuncture-moxibustion published between January 1981 and July 2017 were collected from Chinese databases. The points, meridians, frequency and treatment methods were analyzed. Results： A total of 78 studies were included. For meridians, the top 5 meridians used were the Spleen Meridian （67 times）, Liver Meridian （59 times）, Stomach Meridian （53 times）, Kidney Meridian （49 times） and Large Intestine Meridian （44 times）. For points selection, the leading 5 points were Taichong （LR 3） （79 times）, Taibai （SP 3） （68 times）, Sanyinjiao （SP 6） （61 times）, Taixi （KI 3） （57 times） and Yinlingquan （SP 9） （55 times）. For major and adjunct points, the 5 most significant major points were Taichong （LR 3） （79 times）, Taibai （SP 3） （68 times）, Sanyinjiao （SP 6） （61 times）, Yinlingquan （SP 9） （37 times） and Taixi （KI 3） （32 times）. The 5 most significant adjunct points were Yanglingquan （GB 34） （31 times）, Fenglong （ST 40） （30 times）, Xuehai （SP 10） （29 times）, Taixi （KI 3） （25 times） and Quchi （LI 11） （21 times）. For treatment methods, the top 5 methods used were acupuncture-moxibustion alone for 15 studies, acupuncture-moxibustion combined with medicina electroacupuncture combined with bloodletting for 5 studies studies, acupuncture combined with medicinal herbs for 11 herbs for 10 studies, acupuncture alone for 7 studies, and Conclusion： The main meridians chosen in acupuncture-moxibustion treatment of GA were the Spleen, Liver, Stomach, Kidney and Large Intestine Meridians, conforming to the syndrome differentiation principle of tonifying spleen and kidney, clearing heat and draining dampness. Points mainly locate at lower limbs and feet around the affected area, which was a reflection of peripheral treatment function of points. The data mining results of meridian and point selection in acupuncture-moxibustion treatment of GA conform to the disease and syndrome differentiation theory and provide references for acupuncture-moxibustion treatment of GA.

Chief physician Zhang Tang-fa＇s experience of acupuncture for gouty arthritis

Skillful in the treatment of gouty arthritis （GA） by integrated therapies of Chinese and Western medicine, chief physician Zhang Tang-fa proposes to ＇deal with the exterior with the needles, and attack the interior with the drugs, by integrated application of acupuncture and herbal medicine＇, in combination with comprehensive intervention of dietetic therapy and health education. In the treatment of GA, he adopts the syndrome differentiation based upon the pathogenic factors, in combination of syndrome differentiation based upon the six meridians, to reinforce and benefit the spleen and kidney, clear away heat and remove dampness as the therapeutic principle. By acupuncture mainly at the acupoints of the Spleen and Liver Meridians, he also proposes to select the acupoints by the theory of Na Zi Fa （earthly branch method） ofZi Wu Liu Zhu （midnight-noon ebb-flow）, and to puncture the surrounding area of the involved joints shallowly by multiple needles as the major needling method, simultaneously with the reinforcing and reducing manipulations based upon the respiration. In the treatment, acupuncture and acupoint-injection are often used. In diet, low purine diet is often suggested. In health education, the patients are often instructed to understand the disease correctly, eliminate fears and cooperate with doctor＇s treatment positively.

Treatment of Acute Gouty Arthritis by Blood-letting Cupping plus Herbal Medicine

Objective:To observe the therapeutic effect of blood-letting cupping plus herbal medicine for acute gouty arthritis.Methods:The 34 cases of acute gouty arthritis were treated by blood-letting cupping plus herbal medicine.Results:21 cases were cured and 13 cases improved.Conclusion:The therapeutic effect of this therapy was satisfactory for gouty arthritis.

Comparative observation of therapeutic effects of acupuncture combined with infrared irradiation and western medicine on acute gouty arthritis

Objective To compare the efficacy difference in treatment of acute gouty arthritis between acupuncture combined with infrared irradiation and Indomethachin, as well as to observe the impacts on liver function. Methods One hundred and sixty cases of gout were randomized into an acupuncture group （80 cases） and an Indomethachin group （80 cases）. In the acupuncture group, acupuncture was applied to Zusanli（足三里 ST 36）, SanyTnjiao （三阴交 SP 6）, Quchi （曲池LI 11）, Xuehai （血海 SP 10）, Yanglingquan （阳陵泉 GB 34） and Ashi points （阿是穴）. Additionally, infrared irradiation was used in the local area. The treatment was given once daily. In the Indomethachin group, Indomethachin was taken orally, 25 mg each time, three times per day. The treatment lasted for 5 days in either group. Separately, before and after treatment, pain severity and the levels of blood uric acid （BUA）, erythrocyte sedimentation rate （ESR）, alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were detected. Additionally, the efficacy and the impacts on liver function were assessed. Results The cured rate was 52.5% （42/80） in the acupuncture group, which was superior to 22.5% （18/80） in the Indomethachin group （P〈0.01）. In the acupuncture group, the analgesic efficacy was better than that in the Indomethachin group （P〈0.01） and the effect on reducing BUA and ERS levels was same as that in the Indomethachin group （all P〉0.05）. After treatment, ALT and AST levels had no changes in the acupuncture group, but they increased apparently in the Indomethachin group （all P〈0.01）. Conclusion Acupuncture combined with infrared irradiation achieves a superior efficacy on acute gouty arthritis as compared with oral medication of Indomethachin and the therapy provides a significant effect on analgesia and does not bring the damage of liver function.