广义估计方程评估调督通脉针灸法治疗不同年龄临床前类风湿关节炎的效果  

Effect of Tiaodu Tongmai acupuncture therapy on rheumatoid arthritis at different ages by generalized estimating equation

作　　者：张秀荣[1] 崔欣美[1] 赵海燕[2] 戴缙[3] 付佳新 王博[1] Zhang Xiurong;Cui Xinmei;Zhao Haiyan;Dai Jin;Fu Jiaxin;Wang Bo(Department of Rheumatology and Immunology,The Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150077,Heilongjiang Province,China;Department of Rheumatology and Immunology,The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,Heilongjiang Province,China;Department of Tuina,The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,Heilongjiang Province,China)

机构地区：[1]黑龙江中医药大学附属第四医院风湿免疫科,黑龙江省哈尔滨市150077 [2]黑龙江中医药大学附属第二医院风湿免疫科,黑龙江省哈尔滨市150001 [3]黑龙江中医药大学附属第二医院推拿科,黑龙江省哈尔滨市150001

出　　处：《中国组织工程研究》2024年第35期5584-5590,共7页Chinese Journal of Tissue Engineering Research

基　　金：黑龙江省中医药科研项目(ZHY2022-206),项目负责人:张秀荣。

摘　　要：背景:针灸在类风湿关节炎中的治疗效果尚存在争议。因此,该研究旨在通过广义估计方程评估调督通脉针灸法治疗不同年龄临床前类风湿关节炎患者的效果,为针灸在类风湿关节炎中的应用提供依据。目的:基于广义估计方程探讨调督通脉针灸法对不同年龄临床前类风湿关节炎患者的影响。方法:选取2023年1-9月收治的123例临床前类风湿关节炎患者为研究对象,根据治疗方法不同分为研究组(n=64)和对照组(n=59),研究组给予调督通脉针灸治疗,对照组给予乙酰氨基酚片治疗。采用倾向性评分匹配法调整基线均衡性,比较两组患者临床疗效和治疗前后细胞因子水平,建立广义估计方程模型评估调督通脉针灸法治疗不同年龄临床前类风湿关节炎患者的效果。结果与结论:(1)治疗0 d,研究组和对照组在关节疼痛、C-反应蛋白方面存在显著差异(P<0.05);治疗4周,两组患者在目测类比评分、关节疼痛、C-反应蛋白、红细胞沉降率方面存在显著差异(P<0.05);治疗8周,两组患者在目测类比评分、C-反应蛋白、红细胞沉降率方面存在显著差异(P<0.05);治疗12周,两组患者在目测类比评分、C-反应蛋白、红细胞沉降率方面存在显著差异(P<0.05)。(2)研究组治疗后总有效率为93.75%,对照组为79.17%,研究组患者临床疗效显著优于对照组(P<0.05)。(3)研究组治疗后在白细胞介素6、干扰素γ、巨噬细胞迁移抑制因子、类风湿因子IgA、类风湿因子IgM、基质金属蛋白酶3、基质金属蛋白酶9、抗环状瓜氨酸抗体方面与治疗前相比差异显著(P<0.05);对照组治疗后在白细胞介素6、干扰素γ、类风湿因子IgA、类风湿因子IgM、基质金属蛋白酶3、基质金属蛋白酶9、抗环状瓜氨酸抗体方面与治疗前相比差异显著(P<0.05);研究组治疗后在白细胞介素6、干扰素γ、巨噬细胞迁移抑制因子、类风湿因子IgA、类风湿因子IgM、基BACKGROUND:Rheumatoid arthritis is a chronic autoimmune disease characterized by joint pain,swelling,and dysfunction.Acupuncture,as a traditional medical treatment,has proved its effectiveness and safety in many diseases.However,the efficacy of acupuncture in the treatment of rheumatoid arthritis remains controversial.Therefore,the purpose of this study is to evaluate and explore the effect of Tiaodu Tongmai acupuncture in the treatment of preclinical rheumatoid arthritis of different ages through the generalized estimating equation,and to provide a basis for the application of acupuncture in rheumatoid arthritis.OBJECTIVE:To investigate the effect of Tiaodu Tongmai acupuncture therapy on preclinical rheumatoid arthritis(pre-RA)patients at different ages based on generalized estimating equation.METHODS:A total of 123 patients with preclinical rheumatoid arthritis treated from January to September 2023 were selected as the study objects and divided into study group(n=64)and control group(n=59)according to different treatment methods.The study group was given Tiaodu Tongmai acupuncture treatment,and the control group was given acetaminophen tablets.The baseline balance was adjusted by propensity score matching method.The clinical efficacy and cytokine levels before and after treatment between the two groups were compared.The generalized estimating equation model was established to evaluate the efficacy of Tiaodu Tongmai acupuncture therapy on preclinical rheumatoid arthritis patients at different ages.RESULTS AND CONCLUSION:(1)After 0 days of treatment,there were significant differences in joint pain and C-reactive protein expression between study and control groups(P<0.05).After 4 weeks of treatment,there were significant differences in visual analogue scale scores,joint pain,C-reactive protein and erythrocyte sedimentation rate between the two groups(P<0.05).After 8 weeks of treatment,there were significant differences in visual analogue scale scores,C-reactive protein and erythrocyte sedimentation rate between t

关 键 词：广义估计方程 针灸 调督通脉针灸法 类风湿关节炎 临床前类风湿关节炎 年龄分级 疗效 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R593.22