摘要
目的 观察针刺联合甲氨蝶呤治疗类风湿关节炎(rheumatoid arthritis, RA)的临床疗效及对关节功能及红细胞沉降率(erythrocyte sedimentation rate, ESR)、C反应蛋白(C-reactive protein, CRP)水平的影响。方法 将86例RA患者随机分为观察组与对照组,每组43例。两组均予甲氨蝶呤治疗,观察组另予针刺治疗。观察两组治疗前后视觉模拟量表(visual analog scale, VAS)评分、28个关节疾病活动度评分(disease activity score-28, DAS-28)评分、关节功能[晨僵时间、28个关节肿胀数(28-swollen joint count, SJC28)、28个关节压痛数(28-tender joint count, TJC28)及双手握力]、炎性细胞因子CRP、抗环瓜氨酸肽(anti-cyclic citrullinated peptide antibody, anti-CCP)抗体及类风湿因子(rheumatoid factor, RF)]水平、血液流变学[ESR、D-二聚体(D-Dimer, D-D)和纤维蛋白原(fibrinogen, FBG)]的变化,并比较两组临床疗效和不良事件情况。结果 观察组的总有效率为95.4%,高于对照组的79.1%(P<0.05)。两组治疗后VAS评分、DAS-28评分、晨僵时间、SJC28、TJC28、CRP、anti-CCP抗体、RF、ESR、D-D及FBG水平均较治疗前降低(P<0.05),观察组低于对照组(P<0.05);两组治疗后双手握力较治疗前升高(P<0.05),观察组高于对照组(P<0.05);两组不良事件发生率比较差异无统计学意义(P>0.05)。结论 针刺联合甲氨蝶呤对RA患者疗效确切,能显著改善关节功能和疼痛程度,降低炎症反应和血液流变学,安全性较高。
Objective To observe the clinical effect of acupuncture combined with methotrexate in the treatment of rheumatoid arthritis(RA)and its effect on joint function and erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels.Method A total of 86 patients with RA were randomly divided into the observation group and the control group,with 43 cases in each group.Both groups were treated with methotrexate,and the observation group was treated with acupuncture in addition.The changes of visual analog scale(VAS)score,disease activity score-28(DAS-28)score,joint function[morning stiffness time,28-swollen joint count(SJC28),28-tender joint count(TJC28)and grip strength of both hands],inflammatory cytokines[CRP,anti-cyclic citrullinated peptide antibody(anti-CCP)and rheumatoid factor(RF)levels,hemorheology[ESR,D-Dimer(D-D),and fibrinogen(FBG)],and the clinical efficacy and adverse events were compared between the two groups.Result The total effective rate of the observation group was 95.4%,which was higher than 79.1%of the control group(P<0.05).After treatment,the VAS score, DAS-28 score, morning stiffness time, SJC28, TJC28, CRP, anti-CCP antibody, RF, ESR, D-D and FBG levels in the two groups were lower than those before treatment (P<0.05), and those in the observation group were lower than those in the control group (P<0.05);The grip strength of both hands after treatment was higher than that before treatment in both groups (P<0.05), and it was higher in the observation group than in the control group (P<0.05);the difference in the incidence rate of adverse events between the two groups was not statistically significant (P>0.05). Conclusion Acupuncture combined with methotrexate is effective in the treatment of RA, which can significantly improve joint function and pain, reduce inflammatory response and hemorheology, and has high safety.
作者
刘小静
王红
刘振华
曲萌
张磊
刘旭
郭晓艳
刘洋
LIU Xiaojing;WANG Hong;LIU Zhenhua;QU Meng;ZHANG Lei;Liu Xu;GUO Xiaoyan;LIU Yang(The 82nd Group Army Hospital,PLA Army,Baoding 071000,China)
出处
《上海针灸杂志》
CSCD
2024年第1期76-80,共5页
Shanghai Journal of Acupuncture and Moxibustion
关键词
针刺疗法
针药并用
关节炎
类风湿
关节功能
血液流变学
炎症因子
Acupuncture therapy
Acupuncture-medication combined
Arthritis,rheumatoid
Joint function
Hemorheology
Inflammatory factors
