温针灸对类风湿关节炎患者关节超声表现及血清CCL19、ANGPTL2的影响  

Effect of Warm Needling Moxibustion on the Ultrasonic Manifestation of Joints and Serum CCL19 and ANGPTL2 in Patients with Rheumatoid Arthritis

作　　者：阮玲娟[1] 杨筱绯 陈春燕[1] RUAN Lingjuan;YANG Xiaofei;CHEN Chunyan(Zhejiang Anji County People’s Hospital,Huzhou 313300,China)

机构地区：[1]浙江省安吉县人民医院,湖州313300

出　　处：《上海针灸杂志》2022年第1期77-82,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：湖州市科学技术局公益性技术应用研究项目(2018GY46)。

摘　　要：目的观察温针灸对类风湿关节炎患者关节超声表现及血清趋化因子配体19(CCL19)、血管生成素样蛋白2(ANGPTL2)的影响。方法将64例类风湿关节炎患者随机分为对照组31例、观察组33例。对照组予甲氨蝶呤联合叶酸治疗,观察组在此基础上予温针灸治疗。比较两组治疗前后关节压痛和肿胀个数、晨僵时间、疾病活动性评分(DAS28)、血清红细胞沉降率(ESR)、血清C-反应蛋白(CRP)、腕关节滑膜厚度、滑膜血流信号分级及血清CCL19、ANGPTL2水平,并比较两组临床疗效。结果观察组总有效率高于对照组(P<0.05);治疗后,两组关节压痛数、关节肿胀数、晨僵时间、DAS28评分、血清ESR、血清CRP均降低(P<0.05),观察组均低于对照组(P<0.05);两组腕关节滑膜厚度均减小(P<0.05),观察组小于对照组(P<0.05);对照组腕关节滑膜血流无明显变化(P>0.05),观察组滑膜血流改善(P<0.05),且优于对照组(P<0.05);两组血清CCL19、ANGPTL2水平均降低(P<0.05),观察组低于对照组(P<0.05)。结论温针灸治疗类风湿关节炎疗效显著,可缓解患者临床症状,改善疾病活动度,降低ESR、CRP水平,减小腕关节滑膜厚度,减少腕关节滑膜血流,这可能与其降低血清CCL19、ANGPTL2水平有关。Objective To observe the effect of warm needling moxibustion on the ultrasonic manifestation of joints and serum C-C motif chemokine ligand 19(CCL19)and angiopoietin like protein 2(ANGPTL2)in patients with rheumatoid arthritis.Method Sixty-four patients with rheumatoid arthritis were randomized to a control group(31 cases)and an observation group(33 cases).The control group was given methotrexate and folic acid and the observation group,warm needling moxibustion in addition.The number of pressure pain joints,the number of swelling joints,morning stiffness duration,the disease activity score-28(DAS28),erythrocyte sedimentation rate(ESR),serum C-reactive protein(CRP),synovial thickness and synovial blood flow signal grading of wrist joints,and serum CCL19 and ANGPTL2 levels were compared between the two groups before and after treatment.The clinical therapeutic effects were also compared between the two groups.Result The total efficacy rate was higher in the experimental group than in the control group(P<0.05).After treatment,the number of pressure pain joints,the number of swelling joints,morning stiffness duration,the DAS28 score,ESR and serum CRP decreased in the two groups(P<0.05)and were lower in the observation group than in the control group(P<0.05);the synovial thickness of wrist joints decreased in the two groups(P<0.05)and was lower in the observation group than in the control group(P<0.05);the synovial blood flow of wrist joints did not change significantly in the control group(P>0.05),and it improved in the observation group(P<0.05)and was better than in the control group(P<0.05);serum CCL19 and ANGPTL2 levels decreased in the two groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).Conclusion Warm needling moxibustion has a marked therapeutic effect on rheumatoid arthritis.It can relieve the clinical symptoms,improve disease activity,decrease ESR and CRP levels and reduce the synovial thickness and blood flow of wrist joints in the patients.All this may be related to

关 键 词：温针疗法 针药并用 关节炎 类风湿 关节超声 趋化因子配体19 血管生成素样蛋白2 

分 类 号：R246.2[医药卫生—针灸推拿学]