放血疗法治疗急性痛风性关节炎疗效观察及对炎症相关因子的影响  

Observations on the Efficacy of Bloodletting Therapy for Acute Gouty Arthritis and Its Effect on Inflammation-related Factors

作　　者：徐丹[1] 鲁耘曌[2] 董巡[1] XU dan;LU Yun-tan;DONG Xun(Liaoning University of Traditional Chinese Medicine Hospital,Shenyang 110032,China;Shenyang Seventh People’s Hospital,Shenyang 110000,China)

机构地区：[1]辽宁中医药大学附属医院,沈阳110032 [2]沈阳市第七人民医院,沈阳110000

出　　处：《上海针灸杂志》2021年第9期1123-1128,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家“十二五”科技支撑计划项目(2014BAI10B00);辽宁省科技厅项目(2019-ZD-0437)。

摘　　要：目的观察放血疗法治疗急性痛风性关节炎瘀热阻滞证的临床疗效以及对血清炎症因子的影响。方法将106例急性痛风性关节炎瘀热阻滞证患者,随机分为治疗组和对照组,每组53例。对照组采用秋水仙碱片口服治疗,治疗组在此基础上联合三棱针放血治疗。观察两组患者治疗前后中医证候积分、关节疼痛评分、关节肿胀评分变化,检测两组治疗前后血尿酸(UA)、C反应蛋白(CRP)、红细胞沉降率(ESR)以及血清炎症因子[肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、环氧化酶(COX)-2]水平,并比较两组临床疗效。结果治疗组总有效率(94.3%)明显高于对照组(77.4%),差异具有统计学意义(P<0.05)。治疗后两组患者的中医证候积分、关节疼痛评分、关节肿胀评分均较治疗前明显降低(P<0.05),且治疗组优于对照组(P<0.05)。治疗后两组患者的血UA、CRP、ESR与血清TNF-α、IL-1β、COX-2水平均较治疗前明显降低(P<0.05),且治疗组优于对照组(P<0.05)。结论放血疗法联合西药治疗急性痛风性关节炎瘀热阻滞证可有效改善临床症状与关节功能,降低机体血UA、CRP、ESR水平,下调血清炎症因子水平,整体疗效确切。Objective To observe the clinical efficacy of bloodletting therapy for stagnant heat blocking syndrome in acute gouty arthritis and its effect on inflammation-related factors.Method One hundred and six patients suffering from acute gouty arthritis with stagnant heat blocking syndrome were randomized to treatment and control groups,with 53 cases in each group.The control group received oral administration of Colchicine tablets and the treatment group,three-edged needle bloodletting in addition.The Traditional Chinese Medicine(TCM)syndrome score,the joint pain score and the joint swelling score were recorded,and blood uric acid(UA),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)and serum inflammatory factor tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and cyclooxygenase-2(COX-2)levels were measured in the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Result The total efficacy rate was significantly higher in the treatment group(94.3%)than in the control group(77.4%)with a statistically significant difference(P<0.05).After treatment,the TCM syndrome score,the joint pain score and the joint swelling score decreased significantly in the two groups of patients compared with before(P<0.05)and were lower in the treatment group than in the control group(P<0.05).After treatment,blood UA,CRP and ESR and serum TNF-α,IL-1βand COX-2 levels decreased significantly in the two groups of patients compared with before(P<0.05)and were lower in the treatment group than in the control group(P<0.05).Conclusion Bloodletting therapy plus Western medicine can effectively relieve the clinical symptoms,improve joint function,reduce bodily blood UA,CRP and ESR and down-regulate serum inflammatory factor levels and has a definite overall effect in treating acute gouty arthritis with stagnant heat blocking syndrome.

关 键 词：关节炎 痛风性 三棱针疗法 放血疗法 炎症因子 

分 类 号：R246.2[医药卫生—针灸推拿学]