加味桂枝附子汤联合艾灸治疗类风湿关节炎疗效研究  

Curative effect study on modified Guizhi Fuzi decoction combined with moxibustion on rheumatoid arthritis

作　　者：何娅娜[1] 陈新宇[1] 罗云涛 邓旭 蔡虎志[1] 沈宏荣[1] HE Yana;CHEN Xinyu;LUO Yuntao;DENG Xu;CAI Huzhi;SHEN Hongrong(The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《陕西中医》2023年第11期1562-1565,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：湖南省科学技术厅重点领域研发计划项目(2019SK2321);湖南省卫生健康委员会科研立项课题(202214055139);湖南省发展和改革委员会创新引导专项(湘发改投资2019-412号);全国名老中医药专家陈新宇传承工作室建设项目[国中医药人教函(2022)75号];湖南省研究生科研创新项目(QL20210176)。

摘　　要：目的:探讨加味桂枝附子汤联合艾灸治疗类风湿关节炎(RA)疗效及对血清白细胞介素-21(IL-21)、Wnt信号通路关键抑制因子Dickkopf-1(DKK-1)的影响。方法:选取80例RA患者随机分为对照组、联合组,各40例。对照组给予加味桂枝附子汤,联合组给予加味桂枝附子汤联合艾灸治疗。比较两组中医证候积分、临床疗效、晨僵时间、压痛关节数(TJC)、肿胀关节数(SJC)、关节功能评分、视觉模拟评分(VAS)、风湿性关节炎活动度评分(DAS28)、血清IL-21、血清DKK-1、不良反应。结果:与治疗前比较,两组治疗后晨僵、关节疼痛、关节肿胀评分、晨僵时间、TJC、SJC、WOMAC评分、VAS评分、DAS28评分、血清IL-21、DKK-1水平均下降,且治疗后联合组上述指标均低于对照组,差异有统计学意义(均P<0.05)。联合组总有效率92.50%高于对照组72.50%,差异有统计学意义(P<0.05)。两组患者便秘、失眠、皮肤瘙痒等不良反应发生率比较,差异无统计学意义(均P>0.05)。结论:加味桂枝附子汤联合艾灸治疗RA可有效改善患者临床症状,提高关节功能,减轻疼痛,降低血清IL-21、DKK-1水平,安全性较高。Objective:To explore curative effect of modified Guizhi Fuzi decoction combined with moxibustion on rheumatoid arthritis(RA)and its influences on serum interleukin-21(IL-21)and Dickkopf-1 a key suppressor of Wnt signaling pathway(DKK-1).Methods:80 patients with RA were randomly divided into control group and combined group,40 cases in each group.The control group were treated with modified Guizhi Fuzi decoction,and the combined group treated with modified Guizhi Fuzi decoction combined with moxibustion.TCM syndrome score,clinical efficacy,time of morning stiffness,tenderness joint count(TJC),swelling joint count(SJC),joint function score,visual analog score(VAS),rheumatoid arthritis activity score(DAS28),and the levels of serum IL-21 and DKK-1,adverse reactions of the two groups were compared.Results:Compared with before treatment,the scores of morning stiffness,joint pain and joint swelling,time of morning stiffness,TJC,SJC,WOMAC score,VAS score,DAS28 score,the levels of serum IL-21 and DKK-1 in the two groups were obviously reduced after treatment,and the above indexes in the combination group were lower than those in the control group,difference statistically significant(all P<0.05).The total effective rate of the combined group 92.50%was obviously higher than that in the control group 72.50%,difference statistically significant(P<0.05).There were no obvious difference in the incidence of adverse reactions such as constipation,insomnia,skin itching between the two groups,difference not statistically significant(all P>0.05).Conclusion:Modified Guizhi Fuzi decoction combined with moxibustion can effectively improve clinical symptoms of RA patients enhance joint function relieve pain and reduce serum IL-21 and DKK-1 levels better security.

关 键 词：类风湿关节炎 加味桂枝附子汤 艾灸 白细胞介素-21 Wnt信号通路关键抑制因子Dickkopf-1 中医证候积分 不良反应 

分 类 号：R593.22[医药卫生—内科学]