腹针配合口服甲氨蝶呤片治疗类风湿关节炎疗效观察  

Efficacy Observation of Abdominal Acupuncture Combined with Oral Administration of Methotrexate Tablets for Rheumatoid Arthritis

作　　者：吕善广[1] 杜嘉[1] 阮晨[1] 曲建鹏[2] 余涛 LÜShan-guang;DU Jia;RUAN Chen;QU Jian-peng;YU Tao(Tongde Hospital of Zhejiang Province,Hangzhou 310012,China;Zhejiang Hospital,Hangzhou 310030,China;Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310007,China)

机构地区：[1]浙江省立同德医院,杭州310012 [2]浙江医院,杭州310030 [3]杭州市中医院,杭州310007

出　　处：《上海针灸杂志》2021年第12期1431-1436,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：浙江省中医药科技计划项目(2019ZB026)。

摘　　要：目的观察腹针配合口服甲氨蝶呤片治疗类风湿关节炎(RA)的临床疗效及其对红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)水平和生活质量的影响。方法将96例RA患者随机分为A组、B组和C组,每组32例。A组采用腹针配合口服甲氨蝶呤片治疗,B组采用常规针刺配合口服甲氨蝶呤片治疗,C组采用单纯口服甲氨蝶呤片治疗。观察3组治疗前后血清ESR、CRP、RF水平及各项生活质量评分的变化情况,并比较3组总有效率及不良反应发生率。结果A组总有效率为93.5%,B组为81.3%,C组为63.3%,A组总有效率明显高于B组和C组(P<0.05),且B组总有效率明显高于C组(P<0.05)。3组治疗后血清ESR、CRP、RF水平与同组治疗前比较,差异均具有统计学意义(P<0.05)。A组和B组治疗后血清ESR、CRP、RF水平均显著低于C组(P<0.05)。A组和B组治疗后生理功能、心理功能及社会功能评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。A组治疗后生理功能及社会功能评分明显低于B组(P<0.05)。A组在治疗过程中不良反应发生率为3.2%,B组为3.1%,C组为10.0%,A组和B组不良反应发生率明显低于C组(P<0.05)。结论腹针配合口服甲氨蝶呤片治疗RA疗效确切,能有效降低血清炎症因子水平,改善患者临床症状,并提高其生活质量。Objective To observe the clinical efficacy of abdominal acupuncture plus oral administration of methotrexate(MTX)tablets in treating rheumatoid arthritis(RA)and its effects on the levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and rheumatoid factor(RF)and quality of life(QOL).Method Ninety-six RA patients were randomized into group A,group B and group C,with 32 cases in each group.Group A was treated with abdominal acupuncture plus oral administration of MTX tablets,group B was treated with ordinary acupuncture plus oral administration of MTX,and group C received oral administration of MTX alone.The levels of serum ESR,CRP and RF and the QOL score in the three groups were observed before and after treatment.The total effective and adverse reaction rates were compared among the three groups.Result The total effective rate was 93.4%in group A,81.3%in group B,and 63.3%in group C.The total effective rate was significantly higher in group A than in groups B and C(P<0.05),and significantly higher in group B than in group C(P<0.05).The levels of serum ESR,CRP and RF significantly changed after treatment in the three groups(P<0.05).After treatment,the levels of serum ESR,CRP and RF were notably lower in groups A and B than in group C(P<0.05).The scores of physiological function,psychological function,and social function significantly changed after treatment in groups A and B(P<0.05).After treatment,the scores of physiological function and social function were significantly lower in group A than in group B(P<0.05).The adverse reaction rate was 3.2%in group A,3.1%in group B,and 10.0%in group C.The adverse reaction rate was markedly lower in groups A and B than in group C(P<0.05).Conclusion Abdominal acupuncture plus oral administration of MTX is effective in treating RA.It can effectively down-regulate the serum levels of inflammatory factors,improve the clinical symptoms,and enhance the QOL.

关 键 词：针刺疗法 腹针 关节炎 类风湿 红细胞沉降率 类风湿因子 C反应蛋白 针药并用 

分 类 号：R246.1[医药卫生—针灸推拿学]