调督通脉针灸法辅助甲氨蝶呤及对乙酰氨基酚治疗类风湿性关节炎患者的疗效观察  

Observation of the Application Effect of Tiaodu Tongmai Acupuncture Therapy in Combination with Methotrexate and Acetaminophen for Rheumatoid Arthritis

作　　者：张秀荣[1] 崔欣美[1] 赵海燕[2] 戴缙[3] 付佳新 王博[1] ZHANG Xiu-rong;CUI Xin-mei;ZHAO Hai-yan;DAI Jin;FU Jia-xin;WANG Bo(Department of Rheumatology and Immunology,the Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150016;Department of Rheumatology and Immunology,The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150000;Department of Massage,The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150000)

机构地区：[1]黑龙江中医药大学附属第四医院风湿免疫科,黑龙江哈尔滨150016 [2]黑龙江中医药大学附属第二医院风湿免疫科,黑龙江哈尔滨150000 [3]黑龙江中医药大学附属第二医院推拿科,黑龙江哈尔滨150000

出　　处：《世界中西医结合杂志》2024年第1期120-124,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：黑龙江省中医药科研项目(ZHY2022-206)。

摘　　要：目的探究调督通脉针灸法辅助甲氨蝶呤、对乙酰氨基酚在类风湿性关节炎(Rheumatoid arthritis,RA)中的应用效果。方法选取2022年1月—2022年12月期间黑龙江中医药大学附属第四医院RA患者100例,按照随机数字表法分为对照组和研究组,每组各50例。对照组口服甲氨蝶呤,针对疼痛难忍者临时给予对乙酰氨基酚片,研究组在对照组基础上采取调督通脉针灸法。治疗3个月后,观察比较两组患者临床疗效、安全性,治疗前后中医证候积分、疼痛程度(Visual Analogue Scale/Score,VAS)及疾病活动度(Disease Activity Score 28,DAS28)评分、实验室指标[类风湿因子(Rheumatoid factor,RF)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)、抗环瓜氨酸肽抗体(Anti-cyclic citrulline peptide antibody,抗CCP抗体)、血沉(Erythrocyte sedimentation rate,ESR)]水平。结果(1)中医证候积分:治疗后两组患者晨僵、屈伸不利、关节疼痛、关节肿胀积分均较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。(2)临床疗效:治疗后研究组临床总有效率94.00%(47/50)高于对照组80.00%(40/50),差异有统计学意义(P<0.05)。(3)疼痛程度及疾病活动度:治疗后两组患者VAS、DAS28分值较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。(4)实验室指标:治疗后两组患者RF、CRP、TNF-α、抗CCP抗体、ESR水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。(5)安全性:治疗期间,两组患者均未发生血尿常规、肝肾功能异常,且研究组不良反应发生率8.00%(4/50)与对照组4.00%(2/50)比较,差异无统计学意义(P>0.05)。结论采取调督通脉针灸法辅助甲氨蝶呤、对乙酰氨基酚对RA患者实施干预,可减轻患者临床症状,缓解疼痛程度及疾病活动度,调�Objective To explore the application effect of Tiaodu Tongmai acupuncture in combination with methotrexate and acetaminophen for rheumatoid arthritis(RA).Method A total of 100 RA patients treated at the Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2022 to December 2022 were selected and divided into a control group and a study group according to simple random number table method,with 50 patients in each group.The control group was given methotrexate orally,and acetaminophen tablets were temporarily given in cases of severe pain.The study group was treated with Tiaodu Tongmai acupuncture therapy on the basis of the treatment provided to the control group.After 3 months of treatment,clinical efficacy,treatment safety,Traditional Chinese Medicine(TCM)syndrome scores,visual analogue scale/score(VAS)for pain intensity,disease activity score 28(DAS28),and laboratory indicators[rheumatoid factor(RF),C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-α),anti-cyclic citrulline peptide antibody(anti-CCP antibody),and erythrocyte sedimentation rate(ESR)]were observed and compared before and after treatment.Results(1)TCM syndrome scores:After treatment,the scores of morning stiffness,poor flexion and extension,joint pain,and joint swelling in the two groups decreased compared to before treatment(P<0.05),and the syndrome scores in the study group were lower than those in the control group(P<0.05).(2)Clinical efficacy:After treatment,the study group exhibited a significantly higher total effective rate of 94.00%(47/50)compared to the control group′s rate of 80.00%(40/50)(P<0.05).(3)Pain intensity and disease activity:After treatment,VAS and DAS28 scores of the two groups were significantly lower than before treatment(P<0.05),with the study group having lower scores than the control group(P<0.05).(4)Laboratory indicators:After treatment,the levels of RF,CRP,TNF-α,anti-CCP antibody and ESR in the two groups were decreased compared with those before treatment(P<0.05),with the stu

关 键 词：调督通脉针灸法 甲氨蝶呤 对乙酰氨基酚 类风湿性关节炎 

分 类 号：R593.22[医药卫生—内科学] R245[医药卫生—临床医学]