温针灸联合西药治疗急性痛风性关节炎随机平行对照研究  

Randomized Parallel Controlled Study of Warm Acupuncture and Moxibustion combined with Western Medicine in the Treatment of Acute Gouty Arthritis

作　　者：赵坚 莫文聪 翁川川 ZHAO Jian;MO Wencong;WENG Chuanchuan(Department of Integrated Traditional Chinese and Western Medicine,Renkang Hospital,Zhanjiang 524200,Guangdong,China)

机构地区：[1]湛江市雷州仁康医院中西医结合科

出　　处：《实用中医内科杂志》2019年第5期56-58,67,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察温针灸联合西药治疗急性痛风性关节炎疗效。[方法]使用随机平行对照方法,将70例门诊患者按就诊顺序号方法随机分为两组,抬高患肢,避免受累关节负重;少量多次饮水(>2000mL/d);避免高嘌呤食物;禁酒。对照组35例秋水仙碱,首次1mg/次,1次/2h,之后0.5mg/次,48h内最大剂量≤7mg;秋水仙碱不耐受者:吲哚美辛,初始计量50mg/次,1次/6h,症状缓解后,25mg/次,2~3次/d。治疗组35例温针灸,主穴:阿是穴、曲池、合谷、太溪、阴陵泉、三阴交、足三里、太白、太冲,第一趾节肿痛加隐白、太冲;膝关节肿痛加血海、梁丘、犊鼻;肘关节肿痛加尺泽、天井、手三里;踝关节肿痛加昆仑、商丘;腕关节胀痛加外关、阳溪、阳池,针刺得气后,点燃针柄端艾绒,留针20min,防止烫伤,1次/d。西药治疗同对照组。连续治疗10d为1疗程。观测临床表现、血尿酸、疼痛缓解时间、不良反应。治疗1疗程(10d),判定疗效。[结果]治疗组临床痊愈15例,显效10例,有效8例,无效2例,总有效率94.28%;对照组临床临床痊愈10例,显效8例,有效8例,无效9例,总有效率85.33%;治疗组疗效优于对照组(P<0.05)。疼痛缓解时间治疗组短于对照组(P<0.01)。血尿酸水平两组均有降低(P<0.01),治疗组降低多于对照组(P<0.01)。[结论]温针灸联合西药治疗急性痛风性关节炎,疗效满意,无严重不良反应,值得推广。[Objective] To observe the therapeutic effect of warming needle moxibustion combined with western medicine on acute gouty arthritis.[Method] Seventy outpatients were randomly divided into two groups according to the order of visiting. Limbs were elevated to avoid weight-bearing of affected joints, a small amount of drinking water(>2000 mL/d), high purine food avoidance and alcohol prohibition were avoided. In the control group, 35 cases of colchicine were given 1 mg/time, 1 time/2 h for the first time, then0.5 mg/time, the maximum dose within 48 hours was less than 7 mg;in the colchicine intolerance group,the initial dose was 50 mg/time, 1 time/6 h, 25 mg/time, 2~3 times/day after symptom relief. The treatment group consisted of 35 cases of warm acupuncture and moxibustion, with the main points: Ashi point, Quchi,Hegu, Taixi, Yinlingquan, Sanyinjiao, Zusanli, Taibai, Taichong, swelling and pain of the first toe joint plus Yinbai, Taichong;swelling and pain of the knee joint plus Xuehai, Liangqiu, calf nose;swelling and pain of elbow joint plus ruler, patio, hand three li;swelling and pain of ankle joint plus Kunlun, Shangqiu;wrist swelling plus Waiguan, Yangxi, Yangchi, acupuncture. After getting angry, ignite the needle handle end moxa velvet and keep the needle for 20 minutes to prevent scald, once a day. Western medicine treatment was the same as the control group. Continuous treatment for 10 days is a course of treatment. Clinical manifestations,serum uric acid, pain relief time and adverse reactions were observed. One course of treatment(10 days) was used to determine the curative effect.[Result] In the treatment group, 15 cases were cured, 10 cases were markedly effective, 8 cases were effective and 2 cases were ineffective, the total effective rate was 94.28%. In the control group, 10 cases were clinically cured, 8 cases were markedly effective, 8 cases were effective and9 cases were ineffective, the total effective rate was 85.33%. The curative effect of the treatment group was better than that of the con

关 键 词：急性痛风性关节炎 痹症 温针灸 秋水仙碱 吲哚美辛 症状缓解时间 血尿酸 随机平行对照研究 

分 类 号：R589.7[医药卫生—内分泌]