刺络拔罐疗法联合四妙散治疗急性痛风性关节炎的疗效观察  

Observations on the Efficacy of Pricking-cupping Bloodletting Therapy plus Simiao Powder for Acute Gouty Arthritis

作　　者：郑卜通 张光彩[1] 周晓晖[1] 冯琦钒 陆志夫 ZHENG Bu-tong;ZHANG Guang-cai;ZHOU Xiao-hui;FENG Qi-fan;LU Zhi-fu(Hainan Hospital of Traditional Chinese Medicine,Haikou 570000,China;Haikou Hospital of Traditional Chinese Medicine,Haikou 570216,China)

机构地区：[1]海南省中医院,海口570000 [2]海口市中医医院,海口570216

出　　处：《上海针灸杂志》2021年第9期1129-1134,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(8166150465);海南省自然科学基金面上项目(819MS47)。

摘　　要：目的观察刺络拔罐疗法联合加味四妙散治疗急性痛风性关节炎的临床疗效。方法将96例湿热痹阻型急性痛风性关节炎随机分为对照组和观察组,每组48例。对照组采用单纯西药治疗,观察组在对照组治疗基础上采用刺络拔罐疗法联合加味四妙散治疗。观察两组治疗前后血清超氧化物歧化酶(SOD)、白介素(IL)-17、红细胞沉降率(ESR)、前列腺素E2(PGE2)、尿酸(UA)和关节液中转化生长因子(TGF)-β1、基质金属蛋白酶(MMP)-3及症状积分变化,并比较两组临床疗效。结果两组治疗后血清IL-17、ESR降低,SOD升高,差异有统计学意义(P<0.05);观察组治疗后血清IL-17、ESR低于对照组,SOD高于对照组,差异有统计学意义(P<0.05)。两组治疗后血清PGE2、UA均降低(P<0.05),观察组血清PGE2、UA低于对照组(P<0.05)。两组治疗后关节液TGF-β1、MMP-3降低(P<0.05);观察组低于对照组(P<0.05)。两组治疗后主要症状(关节红肿、疼痛)和次要症状(口干、便秘)积分均降低(P<0.05),观察组症状积分低于对照组(P<0.05)。观察组总有效率为97.9%,高于对照组的79.2%(P<0.05)。观察组不良反应总发生率为12.5%,低于对照组的31.3%(P<0.05)。结论在西药治疗基础上,刺络拔罐疗法联合加味四妙散有助于减轻炎症反应,改善临床症状。Objective To observe the clinical efficacy of pricking-cupping bloodletting therapy plus modified Simiao powder for acute gouty arthritis.Method Ninety-six patients with acute gouty arthritis of damp-heat blockage type were randomized to control and observation groups,with 48 cases in each group.The control group received western drug therapy and the treatment group,pricking-cupping bloodletting therapy plus modified Simiao powder in addition.Serum superoxide dismutase(SOD),interleukin-17(IL-17),erythrocyte sedimentation rate(ESR),prostaglandin E2(PGE2)and uric acid(UA)and synovial transforming growth factor-β1(TGF-β1)and matrix metalloproteinase-3(MMP-3)were measured and the symptom score was recorded in the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Result Serum IL-17 and ESR decreased and SOD increased in the two groups after treatment with statistically significant differences(P<0.05).After treatment,serum IL-17 and ESR were lower and SOD was higher in the observation group than in the control group with statistically significant differences(P<0.05).After treatment,serum PGE2 and UA decreased in the two groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After treatment,synovial TGF-β1 and MMP-3 decreased in the two groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After treatment,the primary symptom(joint redness,swelling and pain)scores and secondary symptom(dry mouth and constipation)scores decreased in the two groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).The total efficacy rate was 97.9%in the observation group,which was higher than 79.2%in the control group(P<0.05).The total incidence of adverse reactions was 12.5%in the observation group,which was lower than 31.3%in the control group(P<0.05).Conclusion On the basis of western drug therapy,pricking-cupping bloodletting therapy plus modified Simiao powder helps to reduce in

关 键 词：放血疗法 刺络拔罐疗法 四妙散 关节炎 痛风性 炎性因子 

分 类 号：R246.2[医药卫生—针灸推拿学]