| 沈狄,何维英,童培建.齐刺结合滞针操作治疗类风湿性关节炎的疗效观察[J].浙江中西医结合杂志,2019,29(8): |
| 齐刺结合滞针操作治疗类风湿性关节炎的疗效观察 |
| Clinical effect of total glucosides of paeony combined with methotrexate in treatment of rheumatoid arthritis |
| 投稿时间：2018-11-02 修订日期：2019-07-06 |
| DOI： |
| 中文关键词: 类风湿性关节炎 齐刺法 滞针 |
| 英文关键词:Rheumatoid arthritis Methotrexate Total glucosides of paeony Clinical effect |
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| 中文摘要: |
| 目的：观察齐刺结合滞针操作与普通针刺法治疗类风湿性关节炎（rheumatoid arthritis ,RA）的疗效差异。方法：将60例门诊RA患者随机分为观察组30 例、对照组 30例，两组取穴相同，以督脉穴、背腧穴及局部取穴为主，主要为百会、风池、大椎、身柱、至阳、曲池、阳池、阳陵泉、三阴交、足三里，犊鼻、膝阳关、肾俞、脾俞、秩边，局部取穴以病痛部位为主，观察组以三针齐刺，局部穴位以齐刺结合滞针操作。对照组采用普通针灸针治疗，两组均隔两日治疗一次，4周为一疗程，观察两组RA患者治疗前后关节肿胀、压痛情况、关节疼痛视觉模拟评分（VAS）及美国健康问卷评分（HAQ），以及抗环瓜氨酸抗体( 抗CCP抗体)、C反应蛋白（CRP）、血沉（ESR）实验室指标，并进行掌指关节及趾跖关节高频超声检查，参照美国风湿病学会（ACR）标准评价两组疗效差异。结果：两组RA患者在关节压痛数、肿胀数，炎性指标、关节疼痛VSA评分及HAQ评分均有所改善（P<0.01），上述数据中观察组评分均优于对照组（P<0.05），两组患者关节滑膜炎均有所升高（P<0.01），而观察组治疗前后差异小于对照组（P<0.05），观察组的ACR2018（62.09），ACR506（20.69）均优于对照组的10（35.71），1（3.57）（P<0.01，P<0.05）。结果：齐刺结合滞针操作与普通针刺均能治疗类风关炎症，齐刺结合滞针操作效果优于普通针刺。 |
| 英文摘要: |
| OBJECTIVE: To explore the value of total glucosides of paeony and methotrexate in the treatment of rheumatoid arthritis. METHODS: 132 patients diagnosed as rheumatoid arthritis were selected and divided into 66 cases in combination group and single drug group. The combined group was treated with total glucoside and methotrexate, the single drug group was treated with methotrexate alone, and 66 healthy volunteers were taken as the control group. The clinical data was compared among 3 groups. RESULTS: The myocardial enzyme spectrum index of patients with rheumatoid arthritis was significantly higher than that of the control group (P<0.05), and the myocardial enzyme spectrum index decreased after treatment (P<0.05). The reduction degree of the combined group was significantly higher than that of the single drug group (P<0.05). The clinical manifestation showed that the combined group was better than the single drug group, and the difference was statistically significant (P<0.05). The scores of DAS28 and VAS in the combined group were significantly lower than those in the single drug group (P<0.05). The improvement of laboratory indexes such as ESR, CCP and RF in the combined group was higher than that in the single drug group (P<0.05). The total effective rate of the combined group was higher than that of the single drug group, and the incidence of adverse reactions was lower than that of the single drug group (P<0.05). CONCLUSIONS: Combined application of total glucosides of paeony and methotrexate in treating rheumatoid arthritis in clinic has good effect and low side effects, which is conducive to the recovery of patients' function. |
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