摘要
目的观察电针足三里和关元穴辅助治疗类风湿关节炎(rheumatoid arthritis,RA)的临床疗效及对患者关节功能、关节压痛指数、红细胞沉降率、类风湿因子和炎症因子的影响。方法将112例RA患者用随机数字表法分为对照组和观察组,每组56例。对照组采用常规西医治疗,观察组在对照组治疗基础上予电针足三里和关元穴治疗。比较两组临床疗效和不良反应发生情况,观察两组治疗前后关节功能、关节肿胀指数、关节压痛指数、RA患者病情评价(disease activity score 28,DAS28)评分以及红细胞沉降率、类风湿因子、炎症因子[C-反应蛋白(C-reactive protein,CRP)、白介素-1β(interleukin-1β,IL-1β)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]水平的变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,两组关节功能(关节僵硬、疼痛和日常活动)评分、DAS28评分、关节肿胀指数和关节压痛指数以及红细胞沉降率、类风湿因子、CRP、TNF-α和IL-1β水平均低于治疗前(P<0.05),且观察组上述观察指标均低于对照组(P<0.05)。对照组1例出现咽部梗阻感,疑为甲氨蝶呤所致;有2例出现消化道不适症状。观察组2例出现针刺后皮下血肿,1例出现消化道不适症状。结论在常规西医治疗基础上,电针足三里和关元穴辅助治疗RA可提高临床疗效,有助于改善患者关节功能和关节压痛,降低红细胞沉降率、类风湿因子和炎症因子水平。
Objective To observe the clinical efficacy of electroacupuncture at Zusanli(ST36)and Guanyuan(CV4)in the adjuvant treatment of rheumatoid arthritis(RA)and its effect on joint function,joint tenderness index,erythrocyte sedimentation rate(ESR),rheumatoid factor(RF)and inflammatory factor.Method A total of 112 patients with RA were randomly divided into a control group and an observation group,with 56 cases in each group.The control group was treated with conventional Western medicine,and the observation group was treated with electroacupuncture at Zusanli and Guanyuan on the basis of the treatment of the control group.The clinical efficacy and adverse reactions of the two groups were compared.The joint function,joint swelling index,joint tenderness index and disease activity score 28(DAS28)score,as well as ESR,RF and inflammatory factors[C-reactive protein(CRP),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)]levels were observed before and after treatment in the two groups.Result The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the scores of joint function(joint stiffness,pain and daily activities),DAS28 score,joint swelling index,joint tenderness index,and the levels of ESR,RF,CRP,TNF-α and IL-1β 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).In the control group,1 patient had pharyngeal obstruction which was suspected to be caused by methotrexate,and 2 patients had gastrointestinal symptoms.In the observation group,2 cases had subcutaneous hematoma after acupuncture,and 1 case had gastrointestinal discomfort.Conclusion On the basis of conventional Western medicine treatment,electroacupuncture at Zusanli and Guanyuan can improve the clinical efficacy of RA,help to improve joint function and joint tenderness,and reduce ESR,RF and inflammatory factor levels.
作者
王晓云
高宇
文培培
刘益兵
WANG Xiaoyun;GAO Yu;WEN Peipei;LIU Yibing(Zhengzhou Orthopedics Hospital,Henan,Zhengzhou 450052,China)
出处
《上海针灸杂志》
CSCD
2024年第4期428-433,共6页
Shanghai Journal of Acupuncture and Moxibustion
基金
国家自然科学基金项目(81601368)
河南省医学科技攻关计划(联合共建)项目(LHGJ20191139)。
关键词
针刺疗法
电针
关节炎
类风湿
关节功能
关节压痛
类风湿因子
炎症因子
Acupuncture therapy
Electroacupuncture
Arthritis,Rheumatoid
Joint function
Joint tenderness
Rheumatoid factor
Inflammatory factors
