薄氏腹针联合甲氨蝶呤治疗类风湿关节炎的随机对照研究  

BO's Abdominal Acupuncture Combined with Methotrexate to Treat Rheumatoid Arthritis:A Randomized Controlled Trial

作　　者：吕善广[1] 阮晨[1] 杜嘉[1] 张艳艳[1] 廖开森[1] LYU Shanguang;RUAN Chen;DU Jia(Tongde Hospital of Zhejiang Province,Hangzhou(310012),China)

机构地区：[1]浙江省立同德医院,杭州310012

出　　处：《浙江中医药大学学报》2021年第8期842-848,共7页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药科技计划项目(2019ZB026)。

摘　　要：[目的]研究薄氏腹针联合甲氨蝶呤治疗类风湿关节炎的疗效,为该方法的临床推广提供依据。[方法]将符合类风湿关节炎诊断标准的120例患者,随机分为腹针治疗组(A组)、传统针刺组(B组)和西药组(C组),每组各40例。A组采用薄氏腹针疗法配合口服甲氨蝶呤治疗,B组采用传统针刺配合口服甲氨蝶呤治疗,C组予以口服甲氨蝶呤治疗,治疗3个疗程(12周)后,观察各组中医症候评分(关节屈伸不利、关节疼痛、关节肿胀、晨僵),及血清血沉(erythrocyte sedimentation rate,ESR)、类风湿因子(rheumatoid factor,RF)、C反应蛋白(C reactive protein,CRP)水平,并评价临床疗效。[结果]治疗后A、B、C三组患者有效率分别为92.1%、81.1%、64.9%,A、B组有效率明显高于C组(P<0.05);A组与B组比较,A组有效率高于B组(P<0.05)。治疗后三组患者关节屈伸不利、关节疼痛、关节肿胀、晨僵评分较治疗前均降低(P<0.05),且A、B两组各症候评分均明显低于C组(P<0.001);其中屈伸不利和关节疼痛评分比较,A组明显低于B组(P<0.05),在关节肿胀和晨僵评分方面组间差异无统计学意义(P>0.05)。治疗后三组ESR、RF及CRP水平较治疗前均明显降低(P<0.05),且A、B两组各指标水平均明显低于C组(P<0.001);RF水平方面,A组明显低于B组(P<0.05),ESR和CRP比较差异无统计学意义(P>0.05)。[结论]薄氏腹针联合甲氨蝶呤治疗类风湿关节炎具有良好的临床疗效,能有效改善患者临床症状,降低ESR、RF及CRP水平,且优于传统针刺联合甲氨蝶呤治疗,值得临床应用及推广。[Objective]To observe the curative effect of BO's abdominal acupuncture combined with methotrexate in the treatment of rheumatoid arthritis(RA),and provide a basis for the clinical promotion of this method.[Methods]Patients meeting the diagnostic criteria for RA were randomly divided into abdominal acupuncture treatment group(group A),traditional acupuncture group(group B)and western medicine group(group C),with 40 cases in each group.Group C was treated with oral methotrexate alone,group A was treated with BO's abdominal acupuncture on the basis of group C,and group B was treated with traditional acupuncture on the basis of group C.After 3 courses(12 weeks),the traditional Chinese medicine(TCM)symptom index scores of each group(joint flexion and extension,joint pain,joint swelling,morning stiffness)and serum erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),C reactive protein(CRP)levels were detected,and the clinical efficacy was evaluated.[Results]After treatment,the effective rates of patients in groups A,B and C were 92.1%,81.1%,and 64.9%,respectively.The effective rates of group A and group B were significantly higher than that of group C(P<0.05);compared with group B,group A was more effective(P<0.05).After treatment,the scores of the three groups of joint flexion and extension,joint pain,joint swelling,and morning stiffness were all lower than before treatment(P<0.05).The symptom scores of groups A and B were significantly lower than those of group C(P<0.001).Compared with group B,the scores of joint flexion and extension and joint pain after treatment in group A were significantly lower(P<0.05),and there was no significant difference in the scores of joint swelling and morning stiffness(P>0.05).After treatment,the levels of ESR,RF and CRP in the three groups were significantly lower than those before treatment(P<0.05).The levels of each index in groups A and B were significantly lower than those in group C(P<0.001),and in terms of RF level,group A was significantly lower than group B(P<0.05),and t

关 键 词：薄氏腹针 甲氨蝶呤 类风湿关节炎 临床研究 随机对照试验 血沉 类风湿因子 C反应蛋白 

分 类 号：R245.9[医药卫生—针灸推拿学]