摘要
Objective： To compare differences of acupotomy loosing combined with medication treatment, electroacupuncture combined with medication treatment and simple medication treatment in effects on rheumatoid arthritis patients with elbow joint stiffness and investigate the anti-inflammatory mechanism of the acupotomy loosing.Methods： A total of 60 cases of rheumatoid arthritis（RA） patients with elbow joint stiffness were randomly assigned into the group receiving acupotomy loosing（group A）, group with electroacupuncture（group B） and the one undergoing medication treatment（group C） with 20 cases for each group. Based on the medication treatment, all patients underwent continuous oral administration with Methotrexate（MTX）, Leflunomide（LEF） and Bitongding capsules for 3 weeks. And no other treatments were given to group C. In addition to medications treatment, the electroacupuncture was performed in group B. The acupoints of Tianzhu（天柱 BL 10）,DAzhui（大椎 GV 14）; Fengchi（风池 GB 20）,Quchi（曲池 LI 11）,Quze（曲泽 PC 3）,Chize（尺泽 LU 5）, Shousanli（手三里 LI 10）, Xiaohai（小海 SI 8）, Shaohai（少海 HT 3）, Tianjing（天井 TE 10）,Qinglengyuan（清冷渊 TE 11） and Hegu（合谷 LI 4） in the affected side were selected. A pair of electrodes were connected to LI 11 and LI 10, and another pair of electrodes were connected to PC 3 and LU 5, and the continuous wave with frequency of 2 Hz was designed, the needle retention for 30 min was performed, and the acupuncture was performed for 6 times per week with 3 weeks for one course,and there was one course totally. Besides the medication treatment, group A underwent the acupotomy loosing therapy. The tender point in lateral elbow joint, etc. were taken as the treatment point, and 6-8 treatment points being taken for each time, and longitudinal dredging and transverse exfoliation were conducted for 2-3 times with the acupotomy. The treatment was given for one time per week with three weeks for one c
目的：对比针刀松解术联合基础治疗、电针针刺联合基础治疗及单纯基础治疗对类风湿肘关节僵硬患者的疗效差异,探讨针刀松解术的抗炎机制。方法：将60例类风湿关节炎肘关节僵硬患者随机分为针刀组、电针组与药物治疗组,每组各20例。所有患者均以药物治疗为基础,连续3周口服甲氨蝶呤（Methotrexate,MTX）,来氟米特（Leflunomide,LEF）及痹痛定胶囊。药物组不再予其他治疗。电针组在药物治疗的基础上,采用电针针刺。穴取天柱,大椎,患侧风池、曲池、曲泽、尺泽、手三里、小海、少海、天井、清冷渊、合谷。曲池、手三里接一对电极,曲泽、尺泽接一对电极,连续波,频率2 Hz,留针30 min,每周针刺6次,3周为一疗程,共治疗1个疗程。针刀组在药物治疗的基础上,采用针刀松解术治疗。取肘关节外侧的压痛点为治疗点,每次取6至8个点,纵疏横剥两三刀。每周治疗1次,3周为一疗程,共治疗1个疗程。观察并检测3组患者治疗前及治疗结束后2周时的患肘最大主动伸直位角度、最大主动屈曲位角度和活动范围的变化,检测患肘关节液中IL-6、IL-10及TNF-α的含量。结果：（1）与治疗前比较,3组患者患肘最大主动伸直位角度变小、最大主动屈曲位角度变大,活动范围增宽,差异具有统计学意义（均P〈0.05）。治疗结束后2周,与药物组比较,电针组与针刀组患肘最大主动伸直位角度较小、最大主动屈曲位角度较大,活动范围较宽,差异具有统计学意义（均P〈0.05）。与电针组比较,针刀组患者患肘最大主动伸直位角度较小、最大主动屈曲位角度较大,活动范围较宽,差异具有统计学意义（均P〈0.05）。（2）与治疗前比较,3组患者TNF-α、IL-6含量降低,IL-10升高,差异具有统计学意义（均P〈0.05）。在治疗结束后2周时,与药物组比较,电针组与针刀组中TNF-α、IL-6含量较低,IL-10含量较高,差
基金
Supported by 2014 Wuhan clinical medical research project:WZ14C01~~
