除痹汤结合针灸、穴位贴对类风湿性关节炎患者血清生化指标的影响  

Effect of Chubi Decoction Combined with Acupuncture,Moxibustion,and Acupoint Application on Serum Biochemical Indexes of Patients with Rheumatoid Arthritis

作　　者：高远 李冀[1,3] 周梦丹 韩东卫 GAO Yuan;LI Ji;ZHOU Mengdan;HAN Dongwei(Basic Medical College of Heilongjiang University of Chinese Medicine,Harbin 150040,China;College of Pharmacy,Guizhou University of Traditional Chinese Medicine,Guiyang 550025,China;Department of General Medicine,First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;Department of Acupuncture and Moxibustion,Affiliated Hospital of Guizhou Medical University,Guiyang 550001,China)

机构地区：[1]黑龙江中医药大学基础医学院,哈尔滨150040 [2]贵州中医药大学药学院,贵阳550025 [3]黑龙江中医药大学附属第一医院综合内科,哈尔滨150040 [4]贵州医科大学附属医院针灸科,贵阳550001

出　　处：《世界中医药》2022年第24期3538-3542,3548,共6页World Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81904090);中国博士后科学基金面上资助项目(2020M670942)。

摘　　要：目的:探讨除痹汤结合针灸、穴位贴对类风湿性关节炎(RA)患者血清生化指标的影响。方法:选取2020年8月至2021年8月在黑龙江中医药大学附属第一医院接受治疗的RA患者100例作为研究对象,采用随机数字表法分为西药+针灸+穴位贴组与联合除痹汤组,每组50例。西药+针灸+穴位贴组给予西医常规治疗(氨甲蝶呤+来氟米特),同时给予针灸、穴位贴疗法,联合除痹汤组在西药+针灸+穴位贴组的基础上给予除痹汤联合针灸治疗。2组均治疗12周。检测2组治疗前后血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-18(IL-18)、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)、免疫球蛋白(IgG)、红细胞沉降率(ESR);比较2组治疗后的疗效、治疗前后生命质量情况及治疗期间不良反应发生情况。结果:治疗后,与治疗前相比2组血清TNF-α、IL-6、IL-18、hs-CRP、RF、IgG、ESR水平显著降低,联合除痹汤组低于西药+针灸+穴位贴组(P<0.05);2组生理健康总评分(PCS)、心理健康总评分(MCS)评分显著升高,联合除痹汤组高于西药+针灸+穴位贴组(P<0.05)。治疗后,联合除痹汤组总有效率(98.00%)较西药+针灸+穴位贴组(86.00%)显著升高(P<0.05)。治疗期间,联合除痹汤组与西药+针灸+穴位贴组不良反应发生率比较差异无统计学意义(18.00%对比6.00%,P>0.05)。结论:除痹汤结合针灸、穴位贴可有效抑制RA患者机体炎症反应与病情进展,使患者生命质量得到保障,临床疗效显著,安全性良好。Objective:To explore the effect of Chubi Decoction combined with acupuncture,moxibustion,and acupoint application on serum biochemical indexes of patients with rheumatoid arthritis(RA).Methods:A total of 100 patients with RA treated in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from August 2020 to August 2021 were enrolled and divided into a control group(western medicine+acupuncture-moxibustion+acupoint application,n=50)and an observation group(western medicine+acupuncture-moxibustion+acupoint application+Chubi Decoction,n=50)according to the random number table method.All patients underwent routine western medicine treatment(methotrexate+leflunomide),acupuncture-moxibustion,and acupoint application therapy,while those in the observation group received additional Chubi Decoction.Patients in both groups were treated continuously for 12 weeks.Serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-18(IL-18),and high-sensitivity C-reactive protein(hs-CRP)]and rheumatic factors[rheumatoid factor(RF),immunoglobulin(IgG)and erythrocyte sedimentation rate(ESR)]of the two groups were detected before and after treatment.The curative effect after treatment,quality of life before and after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results:After treatment,the levels of serum TNF-α,IL-6,IL-18,hs-CRP,RF,IgG,and ESR in the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).The post-treatment total physical component score(PCS)and total mental component score(MCS)in the two groups were significantly higher than those before treatment,and the observation group was higher than the control group(P<0.05).After treatment,the total effective rate of the observation group was 98.00%,higher than 86.00%of the control group(P<0.05).During treatment,there was no significant difference in the incidence of adverse reactions between the two group

关 键 词：类风湿关节炎 除痹汤 针灸 穴位贴 炎症介质 风湿因子 生命质量 不良反应 

分 类 号：R245[医药卫生—针灸推拿学] R59322[医药卫生—中医临床基础]