早期中医临床干预与类风湿性关节炎发病率关系的前瞻性队列研究  

A Prospective Cohort Study on the Relationship Between Early TCM Clinical Intervention and the Incidence of Rheumatoid Arthritis

作　　者：孙玮琦 杨美凤[2] 吕永飞[3] SUN Wei-qi;YANG Mei-feng;LV Yong-fei(Department of Acupuncture and Massage for Rehabilitation of Rheumatism Pain,Puyang Hospital of Traditional Chinese Medicine,Puyang Henan 45700;Department of Rheumatology,Puyang Traditional Chinese Medicine Hospital,Puyang Henan 457001;Department of Cardiology,Puyang Traditional Chinese Medicine Hospital,Puyang Henan 457001)

机构地区：[1]濮阳市中医院针灸推拿康复风湿疼痛科,河南濮阳457000 [2]濮阳市中医院风湿科,河南濮阳457000 [3]濮阳市中医院心内科,河南濮阳457000

出　　处：《世界中西医结合杂志》2020年第8期1519-1523,1527,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：濮阳市科技计划项目(1805065)。

摘　　要：目的采取前瞻性队列研究方式,探讨早期中医临床干预与类风湿性关节炎发病率之间的关系。方法选取2018年1月-2019年3月濮阳市中医院风湿科门诊、针推康复科病区门诊或住院患者,观察所有可能或可疑类风湿性关节炎病人,将符合标准而入选的126例患者作为受试对象,经患者自愿选择,分为治疗组及对照组,每组63例。治疗组给予补肾温阳周天灸法,并口服补肾祛寒治尫汤加减进行治疗;对照组给予空白汤药(即白水加焦糖色素)治疗,临床观察4周。观察两组患者随访时发生类风湿性关节炎的情况并进行对比,同时比较两组患者临床干预前后关节各指数指标情况和关节基线指标情况,以及干预后的体征改善情况。结果观察组发病情况总概率明显低于对照组(χ~2=29.584,P=0.000)。治疗后,观察者关节压痛指数、关节肿胀指数、关节功能指数均明显低于对照组,膝骨性关节炎新药临床研究指导原则(GPCRND-KOA)评分、关节周径、髋膝关节骨性关节炎(WOMAC)评分均明显低于对照组(P <0.001);观察组各项症状治疗总有效率明显高于对照组(χ~2=5.942,P=0.015),差异具有统计学意义。结论早期中医临床干预可以预先降低可疑患者的类风湿性关节炎的发病率,并可改善其关节功能和体征,阻断关节炎的恶性发展,降低关节的肿胀程度,值得临床借鉴。Objective A prospective cohort study was conducted to explore the relationship between early traditional Chinese medicine(TCM)clinical intervention and the incidence of rheumatoid arthritis.Methods The sample was selected from January 2018 to March 2019,in the Fuyang City Hospital of Traditional Chinese Medicine,Rheumatology Clinic,Needle Push Rehabilitation Department outpatient or inpatient.All patients with possible or suspected rheumatoid arthritis were selected and 126 patients were selected according to the criteria.The patients were selected as subjects and divided into treatment group and control group by voluntarily selected patients,with 63 cases in each group.The treatment group was given the Bushen moxibustion method of Bushen Wenyang Zhoutian,and the treatment of oral tonifying phlegm and cold phlegm and blood stasis was added.The control group was treated with blank decoction and clinical observation for 4 weeks.The incidence of rheumatoid arthritis in the follow-up period was observed and compared between the two groups.The index of the joint index and the baseline index of the joint before and after the clinical intervention were compared between the two groups,and the improvement of the signs after the intervention.Results The total probability of onset of the observation group was 55.56%,which was significantly lower than that of the control group(96.83%)(χ2=29.584,P=0.000).After treatment,the joint tenderness index,joint swelling index and joint function index of the observers were all observed.Compared with the control group,the GPCRND-KOA score,joint circumference and WOMAC osteoarthritis index were significantly lower than the control group(P<0.001).The total effective rate of treatment of the symptoms in the observation group was significantly higher(92.06%).In the control group(76.19%)(χ2=5.942,P=0.015).Conclusion Early clinical intervention of TCM can prematurely reduce the incidence of rheumatoid arthritis in suspicious patients,improve joint function and signs,block the malignant deve

关 键 词：类风湿性关节炎 发病率 前瞻性队列研究 

分 类 号：R289[医药卫生—方剂学]