超声引导针刀联合秦息痛治疗类风湿性肩关节炎的临床疗效  

Clinical effect of ultrasound-guided acupotomy combined with Qinxitong in the treatment of rheumatoid shoulder arthritis

作　　者：张婷婷 牛晓庆 李娟 李锐 宋佳 Zhang Tingting;Niu Xiaoqing;Li Juan;Li Rui;Song Jia(Department of Rheumatology and Immunology,Xi'an Fifth Hospital,Xi'an 710082,China;Department of Ultrasound,Xi'an Fifth Hospital,Xi'an 710082,China)

机构地区：[1]西安市第五医院风湿免疫科,西安710082 [2]西安市第五医院超声科,西安710082

出　　处：《国际医药卫生导报》2025年第7期1108-1113,共6页International Medicine and Health Guidance News

基　　金：陕西省中医药管理局科研项目(2021-ZZ-LC014);陕西省重点研发计划(2022SF-266);西安市科技计划(24YXYJ0107、21YXYJ0003)。

摘　　要：目的 分析超声引导针刀联合秦息痛治疗类风湿性肩关节炎的临床疗效。方法 本研究为随机对照试验。选取2021年9月至2023年3月西安市第五医院诊治的120例类风湿性肩关节炎患者,采用随机数字表法分为A、B、C 3组,每组40例。A组男、女各8、32例;年龄(52.43±11.77)岁;病程(55.40±33.89)个月。B组男、女各11、29例;年龄(51.48±11.91)岁;病程(56.25±40.41)个月。C组男、女各10、30例;年龄(53.18±10.47)岁;病程(55.88±41.52)个月。3组均口服甲氨蝶呤片10.0~12.5 mg/次,每周一次;来氟米特片10~20 mg/次,每日一次。A组采取超声引导针刀治疗,每周一次,连续3周。B组采取秦息痛口服,1.08~1.80 g/次,每日两次。C组采取超声引导针刀联合秦息痛治疗,治疗方案与A、B组一致。3组均治疗12周。比较3组患者治疗前、治疗4周后、治疗12周后的视觉模拟评分法(VAS)评分、Constant-Murley肩关节功能评分(CMS)、红细胞沉降率(ESR)、C反应蛋白(CRP)、28个关节疾病活动度-红细胞沉降率(DAS28-ESR)、28个关节疾病活动度-C反应蛋白(DAS28-CRP),临床疗效及不良反应。采用χ^(2)检验、方差分析、广义估计方程进行统计学分析。结果 C组治疗有效率为97.50%(39/40),高于A组的77.50%(31/40)及B组的77.50%(31/40),差异有统计学意义(χ^(2)=8.004,P=0.018)。治疗4周、12周后,3组患者的VAS、ESR、CRP、DAS28-ESR、DAS28-CRP均呈下降趋势,且C组低于A、B组;CMS呈上升趋势,且C组高于A、B组(均P<0.05)。A、B、C组的不良反应发生率分别为12.50%(5/40)、17.50%(7/40)、20.00%(8/40),差异无统计学意义(P>0.05)。结论 超声引导针刀联合秦息痛治疗类风湿性肩关节炎能缓解肩关节疼痛,改善肩关节功能,降低炎症水平及疾病活动度,提升临床疗效,且临床应用安全性较高。Objective To analyze the clinical effect of ultrasound-guided acupotomy combined with Qinxitong in the treatment of rheumatoid shoulder arthritis.Methods This study was a randomized controlled trial.A total of 120 patients with rheumatoid shoulder arthritis treated in Xi'an Fifth Hospital from September 2021 to March 2023 were selected and were divided into group A,B,and C by the random number table method,with 40 cases in each group.Group A included 8 males and 32 females,aged(52.43±11.77)years,with a course of disease of(55.40±33.89)months.Group B included 11 males and 29 females,aged(51.48±11.91)years,with a course of disease of(56.25±40.41)months.Group C included 10 males and 30 females,aged(53.18±10.47)years,with a course of disease of(55.88±41.52)months.All the three groups took methotrexate tablet 10.0-12.5 mg/time,once a week,and leflunomide tablet 10-20 mg/time,once a day.Group A was treated with ultrasound-guided acupotomy once a week for 3 consecutive weeks.Group B took Qinxitong orally,1.08-1.80 g/time,twice a day.Group C was treated with ultrasound-guided acupotomy combined with Qinxitong,and the treatment plan was consistent with group A and B.All the three groups were treated for 12 weeks.The Visual Analogue Scale(VAS)score,Constant-Murley Shoulder Joint Function Score(CMS),erythrocyte sedimentation rate(ESR),C reactive protein(CRP),28 joint disease activity score-erythrocyte sedimentation rate(DAS28-ESR),and 28 joint disease activity score-C reactive protein(DAS28-CRP)were compared among the three groups before treatment,4 weeks after treatment,and 12 weeks after treatment,as well as clinical efficacy and adverse effects.χ^(2) test,analysis of variance,and generalized estimation equation were used for statistical analysis.Results The effective rate of group C was 97.50%(39/40),higher than those of group A[77.50%(31/40)]and B[77.50%(31/40)],with a statistically significant difference(χ^(2)=8.004,P=0.018).After 4 weeks and 12 weeks of treatment,the VAS,ESR,CRP,DAS28-ESR,and DAS28-CRP of the

关 键 词：类风湿性肩关节炎 超声引导针刀 秦息痛 临床疗效 

分 类 号：R684.3[医药卫生—骨科学]