芪桂蠲痹饮配合温针灸法治疗类风湿关节炎(寒湿痹阻型)60例临床观察  

Clinical observation of Qigui Juanbi decoction combined with warm acupuncture and moxibustion in treating 60 cases of rheumatoid arthritis(cold-dampness obstruction type)

作　　者：宋潇 徐庆 赵海娟 张明珠 张雅茹 SONG Xiao;XU Qing;ZHAO Haijuan;ZHANG Mingzhu;ZHANG Yaru

机构地区：[1]黑龙江省中医药科学院,黑龙江哈尔滨150000 [2]黑龙江省中医医院南岗院区,黑龙江哈尔滨150000

出　　处：《中医临床研究》2024年第15期79-83,共5页Clinical Journal Of Chinese Medicine

摘　　要：目的:观察芪桂蠲痹饮配合温针灸法治疗类风湿关节炎(Rheumatoid Arthritis,RA)的临床疗效。方法:选取黑龙江省中医医院南岗院区风湿科2021年9月-2022年10月RA(寒湿痹阻型)患者60例作为研究对象,将其随机分成治疗组和对照组各30例,均给予免疫抑制剂和非甾体抗炎药等基础治疗,在此基础上治疗组另予自拟方芪桂蠲痹饮配合温针灸法治疗,对照组予正清风痛宁缓释片,连续治疗2个月后分别比较两组的临床疗效、中医证候评分、类风湿关节炎28项疾病活动度评分(Disease Activity Score-28,DAS28)、视觉模拟评分法(Visual Analogue Scale,VAS)评分及C反应蛋白(C-reactive Protein,CRP)、红细胞沉降率(Erythrocyte Sedimentation Rate,ESR)、类风湿因子(Rheumatoid Factor,RF)等理化指标。结果:治疗组的总有效率(96.7%,29/30)高于对照组(73.3%,22/30),中医证候积分的改善效果好于对照组,差异存在统计学意义(P<0.05);两组DAS28、VAS评分、RF、CRP、ESR水平均降低,且治疗组显著低于对照组(P<0.05)。结论:芪桂蠲痹饮配合温针灸法通过中西医结合的方式针药合用,互为补充,疗效更加明显。此方法用于治疗RA(寒湿痹阻证)能够有效缓解晨僵及关节疼痛等临床症状,明显改善中医证候积分及理化指标,且不良反应少。Objective:To observe the clinical effect of Qigui Juanbi decoction(芪桂蠲痹饮)combined with warm acupuncture and moxibustion on rheumatoid arthritis.Methods:A total of 60 patients with rheumatoid arthritis(cold-dampness obstruction type)from the Rheumatology Department of Nangang Hospital of Heilongjiang Provincial Hospital of Traditional Chinese Medicine from September 2021 to October 2022 were selected as the study subjects,and randomly divided into the treatment group and the control group,with 30 patients in each group.Both groups were given basic treatment such as immunosuppressants and non-steroidal anti-inflammatory drugs.In addition to basic treatment,the treatment group was treated with Qigui Juanbi decoction combined with warm acupuncture and moxibustion,and the control group was treated with Zhengqing Fengtongning sustained-release tablets.After 2 months of continuous treatment,the clinical efficacy,TCM syndrome score,28 joint disease activity score(DAS28),VAS pain score,C-reactive protein(CRP),erythrocyte deposition rate(ESR),rheumatoid factor(RF)and other physicochemical indexes in the two groups were compared respectively.Results:After treatment,the total effective rate in the treatment group(96.7%,29/30)was higher than that in the control group(73.3%,22/30),the difference was statistically significant(P<0.05).The improvement effect of TCM syndrome score in the treatment group was better than that in the control group(P<0.05).The DAS28,VAS score,RF,CRP and ESR levels in the two groups were decreased,and the treatment group was significantly lower than the control group(P<0.05).Conclusion:Qigui Juanbi decoction combined with warm acupuncture and moxibustion is a combination of traditional Chinese medicine and Western medicine to make the therapeutic effect more significant.This method used in the treatment of rheumatoid arthritis(cold-dampness obstruction type)can effectively relieve morning stiffness and joint pain and other clinical symptoms,significantly improve the Chinese medicine symptom s

关 键 词：类风湿关节炎 寒湿痹阻证 芪桂蠲痹饮 温针灸 临床观察 

分 类 号：R274[医药卫生—中医骨伤科学]