温针法治疗类风湿性关节炎的临床研究及对IL-6、TNF-a的影响  

Therapeutic Observation of Needle Warming Moxibustion for Rheumatoid Arthritis

作　　者：杨红 吴群[2] 毛珍[3] 

机构地区：[1]新疆维吾尔自治区克拉玛依市天山路街道社区卫生服务中心,新疆克拉玛依834000 [2]湖北省武汉市中心医院,湖北武汉430022 [3]湖北中医药大学针灸骨伤学院,湖北武汉430022

出　　处：《云南中医学院学报》2016年第5期35-39,共5页Journal of Yunnan University of Traditional Chinese Medicine

基　　金：武汉市科技攻关项目(WX16B22)

摘　　要：目的观察温针法治疗类风湿性关节炎的疗效及对IL-6及TNF—α的调节作用。方法将60例患者随机分成2组，每组30例，一组用温针灸（针刺组），另一组用甲氨蝶呤联合双氯芬酸钠（药物组），观察患者治疗前，第1个疗程（1-2周），第2个疗程（3～4周）中关节压痛数，关节肿胀数，疼痛强度，双手平均握力，晨僵时间，生活质量评分（HAQ）变化情况，以及治疗前后IL-6及TNF—α含量变化。结果2组在改善各临床症状（关节压痛数，关节肿胀数，疼痛强度，双手平均握力，晨僵时间，提高患者生活质量上均有很好的疗效（P〈0．01），针刺组总有效率80％，药物组总有效率73．3％，二者疗效差异无统计学意义（P〉0．05）。针刺组在第1个疗程结束时在疗效优于药物组（P〈0．05）。2组治疗后患者血清IL-6及TNF—α含量均较治疗前有所下降（P〈0．01），组间比较差异无统计学意义（P〉0．05）。结论（1）温针法和甲氨蝶呤在对类风湿性关节炎的治疗上均有较好的临床疗效，针刺组起效快，能显著缩短治疗疗程。（2）温针灸治疗类风湿性关节炎的机制可能与其能调节体内IL-6及TNF—α的水平有关。Objective To evaluate the clinical efficacy of needle warming moxibustion in the treatment of rheumatoid arthritis, and their regulatory effect on IL-6 and TNF-α. Methods 60 patients with rheumatoid arthritis were randomly divided into acupuncture group and drug group. The treatment period was 4 week. Tender joint count, handgrip strength, morning stiffness time, the quality of life（HAQ） scores before, the end of the first（ 1-2 week after treatment） and second（3-4 week after treatment） course were evaluated. IL-6 and TNF-α levels before and after treatment were measured. Results Both groups had significant improvement of rheumatoid arthritis int the ender joint count, handgrip strength, morning stiffness time, the quality of life （P〈0.01）. The total effective rates of the acupuncture group and drug group were 80% and 73.3%, respectively, which showed no significant difference between the groups （P〉0.05）. The acupuncture group had better efficacy than acupuncture group at the end of the first course （P〈 0.05 ）. SIL-6 and TNF-α levels decreased in both group after treatment （P〈0.01）. Conclusion Both needle warming moxibustion and methotrexate have good results for rheumatoid arthritis, and acupuncture treatment may shorten the course of treatment. The mechanism of needle warming moxibustionfor rheumatoid arthritis may be through regulating IL-6 and TNF-α.

关 键 词：温针法 类风湿性关节炎 甲氨蝶呤 IL-6 TNF-A 

分 类 号：R246.1[医药卫生—针灸推拿学]