基于倾向值匹配的温针灸对类风湿关节炎疗效和炎症因子的影响  

Effect of Warm Needling Moxibustion Based on Propensity Value Matching on Curative Effect and Inflammatory Factors of Rheumatoid Arthritis

作　　者：黄云慧 李坤[1] 牛慧芳[2] 郭飞 冯艳广[1] 魏琴[1] HUANG Yunhui;LI Kun;NIU Huifang;GUO Fei;FENG Yanguang;WEI Qin(Department of Rheumatology and Immunology,Xinxiang First People’s Hospital,Xinxiang Henan 453000,China;Xinxiang Medical University,Xinxiang Henan 453003,China;The Second Affiliated Hospital of Xinxiang Medical University,Xinxiang Henan 453002,China)

机构地区：[1]新乡市第一人民医院风湿免疫科,河南新乡453001 [2]新乡医学院,河南新乡453003 [3]新乡医学院第二附属医院,河南新乡453002

出　　处：《河南医学高等专科学校学报》2021年第3期276-280,共5页Journal of Henan Medical College

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191306);北京医卫健康公益基金会医学科学研究基金项目(YWJKJJHKYJJ-B20366AN)。

摘　　要：目的探讨温针灸对类风湿关节炎(rheumatoid arthritis,RA)疗效和炎症因子的影响。方法调取新乡市第一人民医院HIS系统中2016年8月—2019年12月住院治疗和定期随访治疗的RA患者病例,按照治疗方法分为对照组(采用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合氨甲蝶呤注射液治疗)和观察组(在对照组基础上联合温针灸治疗)。本研究回顾性收集符合纳入研究标准的患者400例,采用倾向值匹配方法,对观察组和对照组进行1:1匹配,70%的病例匹配成功,观察组和对照组,各140例,对匹配后的新数据库进行统计分析。分析患者的病例信息,包括人口学信息、治疗方案、血沉(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)、血管内皮生长因子(VEGF)和白细胞介素1β(IL^(-1)β)等。结果治疗后观察组压痛指数、肿胀指数、ESR、关节疾病活动指数28(DAS28)、CRP、RF、VEGF、IL^(-1)β均较对照组改善,差异有统计学意义(P<0.05);观察组上述各指标较治疗前均有改善,差异有统计学意义(P<0.05);对照组除压痛指数外,其他各指标较治疗前均有改善,差异有统计学意义(P<0.05);2组患者不良反应发生率(14.28%vs 15.00%)比较,差异无统计学意义(P>0.05)。结论温针灸对RA患者疗效较好,可降低患者的ESR、CRP、RF、VEGF、IL^(-1)β等指标水平。Objective To explore the effect of warm needle moxibustion on the curative effect of rheumatoid arthritis and inflammatory factors.Methods The cases of rheumatoid arthritis patients in the HIS system of Xinxiang First People’s Hospital from August 2016 to December 2019 were collected for hospitalization and regular follow-up treatment,and were divided into control groups according to treatment methods(using recombinant human tumor necrosis factor II)Receptor-antibody fusion protein combined with methotrexate injection treatment)and observation group(combined with warm acupuncture treatment on the basis of the control group).This study retrospectively collected 400 patients who met the criteria for inclusion in the study.Using the propensity value matching method,the observation group and the control group were matched 1∶1,70%of the cases were successfully matched.The observation group and the control group,140 cases each,Perform statistical analysis on the new database after matching.Analyze the patient’s case information,including demographic information,treatment plan,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid factor(RF),vascular endothelial growth factor(VEGF)and interleukin 1β(IL^(-1)β)Wait.Results After treatment,the observation group’s tenderness index,swelling index,ESR,DAS28,CRP,RF,VEGF,IL^(-1)βwere improved compared with the control group,and the difference was statistically significant(P<0.05);the observation group’s indicators were improved compared with before treatment,The difference was statistically significant(P<0.05);in the control group,except for the tenderness index,all other indicators were improved compared with before treatment,and the difference was statistically significant(P<0.05);the incidence of adverse reactions between the two groups was compared,the difference was No statistical significance(P>0.05).Conclusion Warm needling moxibustion has a good effect on patients with rheumatoid arthritis,and can reduce the patients’ESR,CRP,RF,VEGF,IL^(-1

关 键 词：类风湿关节炎 温针疗法 重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白 倾向值匹配 氨甲蝶呤 

分 类 号：R593.21[医药卫生—内科学]