温针灸配合乌头麻黄治痹汤治疗类风湿性关节炎湿寒痹阻证的效果  

Effect of Warm Acupuncture and Moxibustion Combined with Wutou Mahuang Zhibi Decoction on Dampness-Cold Obstruction Syndrome of Rheumatoid Arthritis

作　　者：沙书娅 仵永旗 SHA Shuya;WU Yongqi(Department of Traditional Chinese Medicine,Henan Chest Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省胸科医院中医科,河南郑州450000

出　　处：《河南医学研究》2024年第14期2619-2622,共4页Henan Medical Research

摘　　要：目的观察温针灸配合乌头麻黄治痹汤治疗类风湿性关节炎(RA)湿寒痹阻证的效果及对巨噬细胞极化和血清风湿相关因子水平的影响。方法选取河南省胸科医院于2022年1月至2023年6月收治的100例RA患者,采用随机数字表法分为两组,每组50例。西药组接受常规西药治疗,中医联合组在西药组基础上接受温针灸配合乌头麻黄治痹汤治疗。统计两组疗效和治疗期间严重并发症发生率,检测两组类风湿因子(RF)、转化生长因子-β(TGF-β)等血清相关因子及巨噬细胞极化相关指标水平,评估两组RA症状评分、美国特种外科医院(HSS)评分等相关评分的差异。结果中医联合组总有效率为94.00%,高于西药组的80.00%(P<0.05)。两组经治疗RF、B细胞趋化因子CXC配体13(CXCL13)、抗环瓜氨酸肽(CCP)抗体较前降低,中医联合组更低(P<0.05);两组经治疗TGF-β较前升高,中医联合组更高(P<0.05)。两组经治疗M1型巨噬细胞、M1/M2较前降低,中医联合组更低(P<0.05);两组经治疗M2型巨噬细胞较前升高,中医联合组更高(P<0.05)。两组经治疗中医证候积分、RA症状评分、RA病情评价量表(DAS28)评分较前降低,中医联合组更低(P<0.05);两组经治疗HSS评分较前升高,中医联合组更高(P<0.05)。100例患者均未发生严重不良反应。结论温针灸配合乌头麻黄治痹汤治疗RA湿寒痹阻证可调节巨噬细胞极化及RF、TGF-β等因子的表达,减轻症状,提高疗效。Objective To observe the effect of warm acupuncture and moxibustion combined with Wutou Mahuang Zhibi decoction on dampness-cold obstruction syndrome of rheumatoid arthritis(RA)and its influence on the polarization of macrophages and the level of serum rheumatism related factors.Methods A total of 100 RA patients admitted to Henan Chest Hospital from January 2022 to June 2023 were selected and divided into two groups by random number table method,with 50 patients in each group.The western medicine group was given conventional western medicine treatment,and the traditional Chinese medicine combined group was given warm acupuncture and moxibustion combined with Wutou Mahuang Zhibi decoction on the basis of the western medicine group.The efficacy of the two groups and the incidence of serious complications during treatment were analyzed.The levels of serum related factors such as rheumatoid factor(RF),transforming growth factor-β(TGF-β)and macrophage polarization were detected between the two groups.The differences of RA symptom score,Hospital for Special Surgery(HSS)score and other related scores were evaluated between the two groups.Results The total effective rate of the traditional Chinese medicine combined group was 94.00%,which was higher than 80.00%of the western medication group(P<0.05).After treatment,RF,B cell chemokine CXC ligand 13(CXCL13)and anti-cyclic citrullinated peptide(CCP)antibody were lower than before in the two groups,and those in the traditional Chinese medicine combined group were lower than those in the western medication group(P<0.05).After treatment,TGF-βwas increased compared before treatment in the two groups,and it was higher in the traditional Chinese medicine combined group than that in the western medication group(P<0.05).After treatment,the M1 macrophages and M1/M2 in the two groups were lower than those before treatment,and those in the traditional Chinese medicine combined group were lower than those in the western medication group(P<0.05).Two groups after the treatment of typ

关 键 词：温针灸 湿寒痹阻证 乌头麻黄治痹汤 类风湿性关节炎 巨噬细胞极化 疗效 

分 类 号：R242[医药卫生—中医临床基础]