电针联合穴位注射鹿瓜多肽对类风湿关节炎骨形态发生蛋白及类风湿因子的影响  

Effect of electroacupuncture combined with acupoint injection of deer melon polypeptide on bone morphogenetic protein and rheumatoid factor in rheumatoid arthritis

作　　者：赵凌艳[1] 颜梅[1] 蒲卉 钞艳[1] 郭俐宏[2] 

机构地区：[1]十堰市太和医院附属湖北医药学院内分泌科,442000 [2]十堰市太和医院附属湖北医药学院针灸科,442000

出　　处：《国际中医中药杂志》2016年第7期610-613,共4页International Journal of Traditional Chinese Medicine

摘　　要：目的：观察电针联合穴位注射鹿瓜多肽对类风湿关节炎（rheumatoid arthritis, RA）关节滑膜骨形态发生蛋白（bone morpho-genetic protein Synovial, BMPs）及血清类风湿因子（rheumatoid factor, RF） IgA-RF、IgM-RF的影响。方法将符合入选标准的RA患者246例按入院顺序随机分为2组各123例，对照组采用电针配合药物及超短波理疗，联合治疗组在对照组治疗结束后30 min选择痛点穴位注射鹿瓜多肽注射液。2组均治疗14 d。检测治疗前后BMPs及基质金属蛋白酶-1（matrix metalloproteinase-1, MMP-1）细胞阳性表达率、测定患者ESR及血清类风湿因子IgA-RF、IgM-R百分率，记录患者晨僵时间并计算曼彻斯特大学关节炎指数（Western Ontario and McMaster Universities Osteoarthritis Index, WOMAC）及视觉模拟评分量表（Visual Analog Scale,VAS）分值，评价临床疗效。结果联合治疗组总有效率[82.11%（101/123）比71.55%（88/123），χ2＝12.764]高于对照组（P＜0.05）。与对照组治疗后比较，联合治疗组 ESR[（8.79±1.61）mm/h 比（12.41±2.57）mm/h，t＝3.654]及 IgM-RF[（22.38±5.45）%比（39.57±6.18）%，t＝2.365]、IgA-RF[（32.84±6.57）%比（49.84±4.20）%，t＝2.574]阳性率均明显下降（P＜0.05）；联合治疗组BMPs[（15.43±2.94）比（7.22±1.52），t＝3.914]明显升高，软骨细胞MMP-1[（8.01±1.54）%比（15.34±2.47）%，t＝2.015]阳性表达率降低（P＜0.05）；联合治疗组 WOMAC[（22.36±3.49）分比（30.50±4.11）分，t＝4.021]、VAS[（3.37±0.35）分比（5.75±0.39）分，t＝3.251]评分明显降低（P＜0.05），晨僵时间[（34.32±5.57）min 比（49.84±4.20）min，t＝3.914]明显缩短（P＜0.05）。结论电针联合穴位注射鹿瓜多肽可明显改善RA患者的临床症状，提高临床疗效。ObjectiveTo detect the effect of electroacupuncture combined with acupoint injection of deer melon polypeptide on the bone morpho-genetic protein synovial, BMPs and serum rheumatoid factor IgA-RF, IgM-RF.MethodsA total of 246 patients with Rheumatoid arthritis were divided randomly into control group and combined treatment group, 123 patients in each group. The control group received the treatment of electro-acupuncture, drug and Ultrashort wave therapy, and the combined treatment group continue to receive acupoint injection of deer melon polypeptide after 30 minutes when the treatment of control group was completed. Both groups were treated for 2 weeks. The expression of BMPs, MMP-1 and the ESR, serum rheumatoid factor IgA-RF, IgM-RF were detected. The morning stiffness time, Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） and visual analogue scale （VAS） were recorded for outcome assessment.ResultsCompared with control group after treatment, the positive expression rates of ESR （8.79 ±1.61 mm/hvs.12.41 ± 2.57 mm/h,t=3.654）, IgM-RF （22.38% ± 5.45%vs.39.57% ± 6.18%,t=2.365）, IgA RF （32.84% ± 6.57%vs.49.84% ± 4.20%,t=2.574） in the combined treatment group significantly decreased. Compared with the control group, the expression of BMPs （15.43 ± 2.94vs.7.22 ± 1.52,t=3.914） in the combined treatment group significantly increased, while MMP-1 （8.01% ± 1.54%vs. 15.34% ± 2.47%,t=2.015） in the combined treatment group significantly decreased （P〈0.05）. Compared with control group, the outcomes VAS （3.37 ± 0.35 vs.5.75 ± 0.39, t=3.251）, WOMAC （22.36 ± 3.49vs.30.50 ± 4.11,t=4.021）, and morning stiffness （34.32 ± 5.57 minvs. 49.84 ± 4.20 min,t=3.914） in the combined treatment group significantly decreased （P〈0.05）. The total effect rate （82.11%vs. 71.55%,χ2=12.764） of combined treatment group was significantly higher than control group （P〈0.05）.Conclusion Electroacupuncture combined with acupoint injection of deer and melon p

关 键 词：关节炎 类风湿 电针 穴位注射 鹿瓜多肽 骨形态发生蛋白质类 

分 类 号：R593.22[医药卫生—内科学]