文章摘要
吕善广,阮晨,杜嘉,等.薄氏腹针联合甲氨蝶呤治疗类风湿关节炎的随机对照研究[J].浙江中医药大学学报,2021,45(8):842-848.
薄氏腹针联合甲氨蝶呤治疗类风湿关节炎的随机对照研究
DOI: 10.16466/j.issn1005-5509.2021.08.006
DOI:10.16466/j.issn1005-5509.2021.08.006
中文关键词: 薄氏腹针  甲氨蝶呤  类风湿关节炎  临床研究  随机对照试验  血沉  类风湿因子  C反应蛋白
英文关键词: BO's abdominal acupuncture  methotrexate  rheumatoid arthritis  clinical research  randomized controlled trial  erythrocyte sedimentation rate  rheumatoid factor  C reactive protein
基金项目:浙江省中医药科技计划项目(2019ZB026)
作者单位
吕善广 浙江省立同德医院 杭州 310012 
阮晨 浙江省立同德医院 杭州 310012 
杜嘉 浙江省立同德医院 杭州 310012 
张艳艳 浙江省立同德医院 杭州 310012 
廖开森 浙江省立同德医院 杭州 310012 
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中文摘要:
      [目的]研究薄氏腹针联合甲氨蝶呤治疗类风湿关节炎的疗效,为该方法的临床推广提供依据。[方法]将符合类风湿关节炎诊断标准的120例患者,随机分为腹针治疗组(A组)、传统针刺组(B组)和西药组(C组),每组各40例。A组采用薄氏腹针疗法配合口服甲氨蝶呤治疗,B组采用传统针刺配合口服甲氨蝶呤治疗,C组予以口服甲氨蝶呤治疗,治疗3个疗程(12周)后,观察各组中医症候评分(关节屈伸不利、关节疼痛、关节肿胀、晨僵),及血清血沉(erythrocyte sedimentation rate,ESR)、类风湿因子(rheumatoid factor,RF)、C反应蛋白(C reactive protein,CRP)水平,并评价临床疗效。[结果]治疗后A、B、C三组患者有效率分别为92.1%、81.1%、64.9%,A、B组有效率明显高于C组(P<0.05);A组与B组比较,A组有效率高于B组(P<0.05)。治疗后三组患者关节屈伸不利、关节疼痛、关节肿胀、晨僵评分较治疗前均降低(P<0.05),且A、B两组各症候评分均明显低于C组(P<0.001);其中屈伸不利和关节疼痛评分比较,A组明显低于B组(P<0.05),在关节肿胀和晨僵评分方面组间差异无统计学意义(P>0.05)。治疗后三组ESR、RF及CRP水平较治疗前均明显降低(P<0.05),且A、B两组各指标水平均明显低于C组(P<0.001);RF水平方面,A组明显低于B组(P<0.05),ESR和CRP比较差异无统计学意义(P>0.05)。[结论]薄氏腹针联合甲氨蝶呤治疗类风湿关节炎具有良好的临床疗效,能有效改善患者临床症状,降低ESR、RF及CRP水平,且优于传统针刺联合甲氨蝶呤治疗,值得临床应用及推广。
英文摘要:
      [Objective] To observe the curative effect of BO's abdominal acupuncture combined with methotrexate in the treatment of rheumatoid arthritis(RA), and provide a basis for the clinical promotion of this method. [Methods] Patients meeting the diagnostic criteria for RA were randomly divided into abdominal acupuncture treatment group(group A), traditional acupuncture group(group B) and western medicine group(group C), with 40 cases in each group. Group C was treated with oral methotrexate alone, group A was treated with BO's abdominal acupuncture on the basis of group C, and group B was treated with traditional acupuncture on the basis of group C. After 3 courses(12 weeks), the traditional Chinese medicine(TCM) symptom index scores of each group(joint flexion and extension, joint pain, joint swelling, morning stiffness) and serum erythrocyte sedimentation rate(ESR), rheumatoid factor(RF),C reactive protein(CRP) levels were detected, and the clinical efficacy was evaluated. [Results] After treatment, the effective rates of patients in groups A, B and C were 92.1%, 81.1%, and 64.9%, respectively. The effective rates of group A and group B were significantly higher than that of group C(P<0.05); compared with group B, group A was more effective(P<0.05). After treatment, the scores of the three groups of joint flexion and extension, joint pain, joint swelling, and morning stiffness were all lower than before treatment(P<0.05). The symptom scores of groups A and B were significantly lower than those of group C(P<0.001). Compared with group B, the scores of joint flexion and extension and joint pain after treatment in group A were significantly lower(P<0.05), and there was no significant difference in the scores of joint swelling and morning stiffness(P>0.05). After treatment, the levels of ESR, RF and CRP in the three groups were significantly lower than those before treatment(P<0.05). The levels of each index in groups A and B were significantly lower than those in group C(P<0.001), and in terms of RF level, group A was significantly lower than group B(P<0.05), and there was no significant difference in ESR and CRP(P>0.05). [Conclusion] BO's abdominal acupuncture has good clinical effects, can effectively relieve the clinical symptoms of patients with RA, reduce ESR, RF and CRP levels, and is better than traditional acupuncture combined with methotrexate, which is worth promoting.
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