长蛇灸治疗类风湿关节炎:随机对照研究  

Long-snake moxibustion for rheumatoid arthritis:a randomized controlled trial

作　　者：张伟[1] 陈明人[1] 胡锦玉[1] 

机构地区：[1]江西中医药大学附属医院针灸科,南昌330006

出　　处：《中国针灸》2016年第7期694-698,共5页Chinese Acupuncture & Moxibustion

基　　金：江西省科技支撑计划项目:20142BBG70085

摘　　要：目的：观察长蛇灸、温针灸和西药治疗类风湿关节炎的临床疗效差异并探讨其作用机制。方法：将120例患者随机分为长蛇灸组、温针灸组及西药组,每组40例。长蛇灸组予长蛇灸疗法,于大椎至腰俞穴的督脉处行药物隔姜铺灸,每月治疗1次,治疗2个月;温针灸组穴取大椎、肝俞、脾俞、肾俞、至阳、命门、腰阳关为主,每次取4~5穴行温针灸,每穴灸3壮,隔日治疗1次,治疗2个月;西药组口服甲氨蝶呤,每次10mg,顿服,每周1次,若关节压痛度评分或关节肿胀度评分达6分,加用双氯芬酸钠,每次25mg,每日3次,共服用2个月。观察3组患者治疗前后症状评分、体征评分、疼痛视觉模拟评分（VAS）,及血清类风湿因子（RF）、血沉（ESR）、C反应蛋白（CRP）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）含量等变化。结果：3组皆可显著改善类风湿关节炎患者的症状、体征、VAS评分以及血清RF、ESR、CRP、IgM、IgG的含量（均P〈0.01）,且长蛇灸组疗效显著优于温针灸组及西药组（P〈0.05,P〈0.01）。结论：长蛇灸疗法治疗类风湿关节炎临床疗效显著,其疗效优于温针灸及西药甲氨蝶呤,可以更好地降低免疫应答,减轻疾病程度。Objective To observe the clinical efficacy differences among long-snake moxibustion,warm needling and western medication on rheumatoid arthritis and explore its effect mechanism.Methods One hundred and twenty patients were randomized into a long-snake moxibustion group,a warm needling group and a western medication group,40 cases in each one.In the long-snake moxibustion group,the long-snake moxibustion was used.The ginger-isolated moxibustion was applied along the governor vessel,from Dazhui（GV 14）to Yaoshu（GV 2）,once a month,for 2months.In the warm needling group,the main points included Dazhui（GV 14）,Ganshu（BL 18）,Pishu（BL 20）,Shenshu（BL 23）,Zhiyang（GV 9）,Mingmen（GV 4）and Yaoyangguan（GV 3）.The warm needling technique was used at 4to 5points each time,and 3moxa cones were required at each points.The treatment was given once every two days,for 2months.In the western medication group,methotrexate was prescribed for oral administration,10 mg each time,once a week.If the joint pain score or joint swelling score was up to 6,diclofenac sodium was combined,25 mg each time,3times a day,for 2months.The symptom score,physical sign score,the visual analogue scale（VAS）score,levels of rheumatoid factor（RF）,erythrocyte sedimentation rate（ESR）and C-reactive protein（CRP）,immunoglobulin M（IgM）and immunoglobulin G（IgG）were observed before and after treatment in the patients of the three groups.Results The treatments relieved the symptoms and physical signs of rheumatoid arthritis and improved VAS score and the levels of serum RF,ESR,CRP,IgM and IgG in all of the three groups（all P〈0.01）.The efficacy in the long-snake moxibustion group was significantly better than that in the warm needling group and the western medication group（P〈0.05,P〈0.01）.Conclusion The long-snake moxibustion achieves the significant clinical efficacy on rheumatoid arthritis,better than warm needling therapy and methotrexate.This therapy much better reduces immune response and alleviat

关 键 词：类风湿关节炎 长蛇灸 温针灸 甲氨蝶呤 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]