热补针法联合甲氨蝶呤治疗早期 类风湿关节炎的临床研究  

Clinical Study of Heat-Reinforcing Needling Combined with Methotrexate in Treatment of Early RA

作　　者：张宏涛[1] 张星华[1] 任超展[1] 张广军 井维尧 ZHANG Hongtao;ZHANG Xinghua;REN Chaozhan;ZHANG Guangjun;JING Weiyao(Gansu Provincial Hospital of TCM,Lanzhou 730050,China;Lanzhou Hospital of Traditional Chinese Medicine,Lanzhou 730050,China;Gansu University of Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃省中医院,甘肃兰州730050 [2]兰州市中医院,甘肃兰州730050 [3]甘肃中医药大学,甘肃兰州730000

出　　处：《针灸临床杂志》2023年第10期38-42,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：甘肃省自然科学基金,编号:22JR5RA637;国家中医药管理局甘肃郑氏针法学术流派传承工作室项目,编号:2305135901。

摘　　要：目的:观察热补针法联合甲氨蝶呤对早期类风湿关节炎(RA)的临床疗效。方法:64例符合诊断标准的RA患者采用随机数字表法分为热补针法组32例和西药组32例。西药组口服甲氨蝶呤片,每次5 mg,每周1次;热补针法组在西药组的基础上施加热补针法,隔日1次,每周3次。两组均治疗12周,评定两组临床疗效,治疗前后中医症状总评分、关节疾病活动指数(DAS28),检测血清C-反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)及抗环瓜氨酸肽(CCP)抗体水平。结果:热补针法组总有效率为90.62%(29/32),高于西药组的75.00%(24/32),差异具有统计学意义(P<0.05)。两组中医症状总评分、DAS28指数、CRP、ESR、RF及抗CCP抗体水平均低于治疗前,差异具有统计学意义(P<0.05),且热补针法组均低于西药组,差异具有统计学意义(P<0.05)。结论:热补针法联合甲氨蝶呤治疗风湿痹阻型早期类风湿关节炎疗效显著,且缩短了疗程,减少了西药的使用。Objective:To observe clinical efficacy of heat-reinforcing needling combined with Methotrexate in treatment of early rheumatoid arthritis(RA).Methods:64 cases of early RA met the diagnostic criteria were randomly divided into the heat-reinforcing needling group(n=32)and the western medication group(n=32).The western medication group was treated with Methotrexate Tablet,5 mg,once a week;on which basis,the heat-reinforcing needling group was also treated with heat-reinforcing needling method,once every other day,three times a week.After 12 weeks of treatment,clinical efficacy was compared between the two groups.The total score of TCM symptoms and DAS28 index,as well as the contents of CRP,ESR,RF and anti-CCP antibody were detected before and after the treatment in the two groups.Results:The total effective rate was 90.62%(29/32)in the heat-reinforcing needling group,which was significantly higher than 75.00%(24/32)in the western medication group(P<0.05).The total score of TCM symptoms,DAS28 index,as well as the levels of CRP,ESR,RF and anti-CCP antibody were significantly decreased after the treatment compared with those before the treatment(P<0.05),which were lower in the heat-reinforcing needling group than those in the western medication group(P<0.05).Conclusion:The combination of heat-reinforcing needling and Methotrexate has a significant therapeutic effect in treatment of early RA of wind-dampness blockage syndrome,it can shorten the course of treatment and reduce the adverse reactions of the western medication.

关 键 词：热补针法 风湿痹阻型 早期类风湿关节炎 

分 类 号：R246.2[医药卫生—针灸推拿学]