输络结合刺法为主治疗类风湿关节炎疗效观察  

Therapeutic effects on rheumatoid arthritis treated with shu-deep needling and bloodletting techniques

作　　者：陆虞荪 宗蕾 侯文光 曾亮 赵冉 安洋洋 LU Yu-sun;ZONG Lei;HOU Wen-guang;ZENG Liang;ZHAO Ran;AN Yang-yang(Yueyang Integrated Chinese and Western Medicine Hospital Affiliated to Shanghai University of TCM,Shanghai 200437,China)

机构地区：[1]上海中医大学附属岳阳中西医结合医院

出　　处：《中国针灸》2019年第1期49-53,共5页Chinese Acupuncture & Moxibustion

基　　金：上海市进一步加快中医药事业发展三年行动计划资助项目:ZY3-JSFC-1-1023

摘　　要：目的:观察输络结合刺法与常规针刺法治疗类风湿性关节炎(rheumatoid arthritis,RA)的疗效差异。方法:将70例患者随机分为观察组(35例)与对照组(35例,脱落4例)。两组均取大椎、身柱、至阳、筋缩、肝俞、肾俞、秩边、委中、太溪、天宗等穴,观察组于天宗、秩边穴采用输刺,并在肿胀部位采用刺络放血疗法,余穴采用平补平泻手法;对照组均采用平补平泻手法,隔日治疗1次,每周治疗3次,共治疗12周。观察两组患者治疗前后关节压痛个数、肿胀个数、关节疼痛视觉模拟评分(VAS)、美国健康评估问卷(HAQ)评分,以及血沉(ESR)、C反应蛋白(CRP)的变化,并采用美国风湿病学会(ACR)类风湿关节炎好转标准评定两组疗效。结果:两组治疗后关节压痛个数、肿胀个数、VAS评分及HAQ评分均较治疗前改善(均P<0.01),且观察组均优于对照组(均P<0.05);两组治疗后ESR、CRP均较治疗前降低(均P<0.01),但组间比较差异无统计学意义(均P >0.05);观察组ACR20、ACR50达标率分别为94.3%(33/35)、31.4%(11/35),均优于对照组的67.7%(21/31)、6.5%(2/31)(P<0.01,P<0.05)。结论:输络结合刺法与常规针刺法治疗RA均有效,输络结合刺法疗效优于常规针刺法。Objective To observe the difference in the therapeutic effects on rheumatoid arthritis(RA) between the combined shu-deep needling and bloodletting technique and the regular needling technique. Methods A total of 70 patients were randomized into an observation group(35 cases) and a control group(35 cases, 4 cases dropped-out). Dazhui(GV 14), Shenzhu(GV 12), Zhiyang(GV 9), Jinsuo(GV 8), Ganshu(BL 18), Shenshu(BL 23), Zhibian(BL 54), Weizhong(BL 40), Taixi(KI 3) and Tianzong(SI 11), etc. were selected in the two groups. Additionally, in the observation group the shu-deep needling technique was adopted at Tianzong(SI 11) and Zhibian(BL 54), the bloodletting technique at the local swollen area and the even-needling technique at the rest acupoints. In the control group, the even-needling technique was applied to all of the acupoints. Acupuncture treatment was given once every two days, 3 times a week and for 12 weeks totally. The numbers of tender points at the knee joint, the numbers of swollen sites at the knee joint, the visual analogue scale(VAS) score and the American health assessment questionnaire(HAQ) score were observed in the two groups before and after treatment, as well as the changes in erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP). The American College of Rheumatology(ACR) criteria was adopted to evaluate the therapeutic effects of the two groups. Results After treatment, the numbers of tender points, the numbers of swollen sites, VAS score and HAQ score were all improved as compared with those before treatment in the two groups(all P<0.01), and the results in the observation group were better than those in the control group(all P<0.05). After treatment, ESR and CRP levels were all reduced as compared with those before treatment in the two groups(all P<0.01), but there was no significant differences between the two groups(both P >0.05). The standard-reaching rates of ACR 20 and ACR 50 in the observation group were 94.3%(33/35) and 31.4%(11/35) respectively, which were better than 67.7%(2

关 键 词：类风湿关节炎 输刺 刺络放血 疼痛视觉模拟评分法(VAS) 美国健康评估问卷(HAQ)评分 

分 类 号：R246.2[医药卫生—针灸推拿学]