温针灸治疗类风湿关节炎的疗效观察及对炎症因子的影响  

Clinical Efficacy of Warm Needling for Rheumatoid Arthritis and Its Effects on Inflammatory Factors

作　　者：徐丹[1] 董巡[1] XU Dan;DONG Xun(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学附属医院,沈阳110032

出　　处：《上海针灸杂志》2021年第10期1228-1233,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：目的观察温针治疗类风湿关节炎(RA)患者的临床疗效及对患者血清炎症因子水平的影响。方法将112例成年RA患者随机分为温针组和对照组,每组56例。对照组予口服甲氨蝶呤片治疗,温针组在此治疗基础上联合温针治疗。连续治疗3个月后,比较两组患者临床疗效、中医证候积分、28个关节疾病活动性评分(DAS28)、7个关节超声评分(US7)以及血清炎症因子[肿瘤坏死因子(TNF)-α、前列腺素E2(PGE2)、白细胞介素(IL)-6]水平。结果温针组总有效率为94.6%,明显高于对照组的82.1%,差异具有统计学意义(P<0.05)。治疗后,两组中医证候积分、DAS28评分、US7评分均较治疗前明显降低(P<0.05),且温针组治疗后优于对照组(P<0.05)。治疗后,两组患者血清TNF-α、IL-6、PGE2水平均较治疗前明显降低(P<0.05),且温针组治疗后优于对照组(P<0.05)。结论在药物治疗基础上,温针治疗RA可有效改善临床症状与关节活动度,下调血清炎症因子水平,抑制炎症反应,控制病情进展。Objective To observe the clinical efficacy of warm needling in treating rheumatoid arthritis(RA) and its effects on the levels of serum inflammatory factors. Method A total of 112 adult RA patients were randomized into a warm needling group and a control group, with 56 cases in each group. The control group was treated with oral administration of Methotrexate(MTX), while the warm needling group was given additional warm needling treatment.After treatment of 3 consecutive months, clinical efficacy, symptom score of traditional Chinese medicine(TCM),28-joint disease activity score(DAS28), 7-joint ultrasound score(US7) and the levels of serum inflammatory factors [tumor necrosis factor(TNF)-α, prostaglandin E2(PGE2) and interleukin(IL)-6] in the two groups were compared. Result The total effective rate was 94.6% in the warm needling group, higher than 82.2% in the control group, and the between-group difference was statistically significant(P<0.05). After treatment, the TCM symptom score, DAS28 score and US7 score all decreased notably in both groups(P<0.05), and the warm needling group was superior to the control group(P<0.05). The levels of serum TNF-α, IL-6 and PGE2 dropped significantly after intervention in both groups(P<0.05), and the warm needling group was superior to the control group(P<0.05).Conclusion Based on Western medicine treatment, warm needling can effectively improve the clinical symptoms and joint range of motion, regulate the levels of serum inflammatory factors, inhibit inflammatory reactions and control the disease progression in the treatment of RA.

关 键 词：针灸疗法 温针疗法 针药并用 关节炎 类风湿 炎症因子 

分 类 号：R246.2[医药卫生—针灸推拿学]