超声评分法评价艾灸治疗活动期类风湿关节炎临床研究  

Clinical Study on Evaluation of Moxibustion Therapy for Rheumatoid Arthritis at Active Stage by 7-joint Ultrasound Score

作　　者：王丹 陈延强[2] 梁春燕 莫秋艳 李宏一 刘雪玲[1] WANG Dan;CHEN Yanqiang;LIANG Chunyan;MO Qiuyan;LI Hongyi;LIU Xueling(Department of Ultrasound,The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning Guangxi 530023,China;Department of Rheumatology and Immunology,The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning Guangxi 530023,China)

机构地区：[1]广西中医药大学第一附属医院超声科,广西南宁530023 [2]广西中医药大学第一附属医院风湿免疫科,广西南宁530023

出　　处：《新中医》2023年第22期171-175,共5页New Chinese Medicine

基　　金：国家自然科学基金项目(81860825);广西中医药适宜技术开发与推广项目(GZSY21-22);广西壮族自治区中医药管理局自筹课题(GZZC2020028)。

摘　　要：目的:运用7关节超声评分法(US7)评价艾灸治疗活动期类风湿关节炎(RA)的临床疗效。方法:将42例活动期RA患者随机分为观察组和对照组各21例。对照组予以常规抗风湿药物(DMARDs)治疗,观察组在对照组治疗方案的基础上予艾灸足三里、肾俞和阿是穴治疗,2组均治疗4周。比较分析2组治疗前后的临床疗效、血清学指标及超声参数评分。结果:临床疗效总有效率观察组90.5%,对照组61.9%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组US7评分包括关节腔积液、滑膜增生评分、滑膜血流评分均降低,差异均有统计学意义(P<0.05),且观察组上述指标均低于对照组,差异均有统计学意义(P<0.05)。2组骨皮质及软骨损伤评分比较,差异均无统计学意义(P>0.05)。治疗后,观察组类风湿DAS28评分、血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)水平均降低,差异均有统计学意义(P<0.05);对照组DAS28评分低于治疗前,差异有统计学意义(P<0.05),观察组DAS28评分低于对照组,差异有统计学意义(P<0.05),2组CRP、RF指标比较,差异均无统计学意义(P>0.05)。结论:艾灸联合DMARDs治疗可减轻活动期RA患者关节滑膜炎,抑制疾病活动度,临床疗效优于单纯DMARDs治疗。US7可为其提供客观影像学依据。Objective:To evaluate the clinical effect of moxibustion therapy for rheumatoid arthritis(RA)at active stage by 7-joint ultrasound score(US7).Methods:A total of 42 RA patients at active stage were randomly divided into the observation group and the control group,with 21 cases in each group.The control group was treated with routine disease-modifying antirheumatic drugs(DMARDs),and the observation group was treated with moxibustion at Zusanli point(ST 36),Shenshu point(BL 23),and Ashi points based on the treatment of the control group.Both groups were treated for 4 weeks.The clinical effects,serological indicators,and ultrasound parameter scores were compared and analyzed between the two groups before and after treatment.Results:The total effective rate was 90.5%in the observation group and 61.9%in the control group,the difference being significant(P<0.05).After treatment,the US7 scores including scores of joint effusion,synovial hyperplasia,and synovial blood flow in the two groups were decreased,differences being significant(P<0.05),and the above indicators in the observation group were lower than those in the control group,differences being significant(P<0.05).There was no significant difference being found in the comparison of scores of cortical and cartilage injuries between the two groups(P>0.05).After treatment,the DAS28 score,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and rheumatoid factor(RF)levels in the observation group were decreased,differences being significant(P<0.05).The DAS28 score in the control group was lower than that before treatment,the difference being significant(P<0.05),and the DAS28 score in the observation group was lower than those in the control group,differences being significant(P<0.05).There was no significant differences being found in the comparison of CRP and RF between the two groups(P>0.05).Conclusion:Moxibustion combined with DMARDs can alleviate joint synovitis in RA patients at active stage,inhibit disease activity,whose clinical effect is superior to that

关 键 词：类风湿关节炎 活动期 艾灸 7关节超声评分法 

分 类 号：R593.22[医药卫生—内科学]