灸药结合改善湿热痹阻型类风湿关节炎的临床观察  

Clinical observation on moxibustion combined with Western medicine in improving rheumatoid arthritis due to damp heat affecting bones/joints

作　　者：陈家涟 李爱丽 朱田田 杨东宇 赵中亭 CHEN Jialian;LI Aili;ZHU Tiantian;YANG Dongyu;ZHAO Zhongting(Gansu University of Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]Gansu University of Chinese Medicine,Lanzhou 730000,China

出　　处：《Journal of Acupuncture and Tuina Science》2023年第5期391-397,共7页针灸推拿医学（英文版）

基　　金：国家自然科学基金地区项目,No.81560791,No.82060892;甘肃省高等学校青年博士基金项目,No.2022QB-095;甘肃中医药大学科学研究与创新基金重点项目,No.KCZD2018-3.

摘　　要：目的:观察温和灸联合药物治疗湿热痹阻型类风湿关节炎(RA)的临床疗效,进一步证实“热证可灸”理论的科学性。方法:将78例湿热痹阻型RA患者根据随机数字表法分为观察组和对照组,每组39例。对照组采用西药常规治疗,观察组在对照组用药基础上加用温和灸治疗,每日1次,每2周休息1 d,持续8周,比较两组患者治疗前后腕关节周长、疼痛程度、皮肤颜色和温度及背伸活动度,并观察两组安全性。结果:治疗后观察组总有效率为94.9%,高于对照组的79.5%(P<0.05);证候分类量化指标中两组患者腕关节周长、疼痛程度、皮温及背伸活动度均有改善(P<0.01),且观察组改善情况优于对照组(P<0.05)。治疗后两组腕关节皮肤颜色均有改善(P<0.05),两组皮肤颜色改善情况及不良反应发生情况差异均无统计学意义(P>0.05)。结论:温和灸联合西药治疗湿热痹阻型RA疗效优于单独使用西药治疗,且安全性高,进一步证实了“热证可灸”理论的科学性。Objective:To observe the efficacy of gentle moxibustion combined with Western medicine in treating rheumatoid arthritis(RA)due to damp heat affecting bones/joints to further certificate the scientific nature of the theory that“heat pattern can be treated by moxibustion therapy”.Methods:A total of 78 patients with RA due to damp heat affecting bones/joints were divided into an observation group and a control group using the random number table method,with 39 cases in each group.The control group was treated with regular Western medicine,on the basic of which the observation group was treated with additional gentle moxibustion.Patients in the observation group received gentle moxibustion therapy once a day for 8 weeks with a one-day rest every 2 weeks.The wrist circumference,wrist pain degree,skin color and temperature of the wrist,and range of dorsiflexion motion of the wrist in the two groups of patients were compared before and after treatment under the condition of safety observed.Results:The total effective rate in the observation group was 94.9%,which was higher than the result of 79.5%in the control group(P<0.05).Among the quantitative indicators of syndrome differentiation,the wrist circumference,pain degree,skin temperature,and range of dorsiflexion motion in both groups were significantly improved(P<0.01),and the improvements were more significant in the observation group than in the control group(P<0.05).The skin color of the wrist joint was improved in both groups after treatment(P<0.05),and there was no statistical significance in comparing the improvement of skin color and the occurrence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with Western medicine treatment alone,the combination of gentle moxibustion and Western medicine treatment has significantly better treatment efficacy and shares high safety,which helps to prove the scientific nature of the theory that“heat pattern can be treated by moxibustion therapy”.

关 键 词：灸法 温和灸 关节炎 类风湿 湿热痹阻证 热证可灸 

分 类 号：R246.2[医药卫生—针灸推拿学]