冬病夏治穴位贴敷治疗类风湿关节炎的随机、盲法、安慰剂对照研究

摘要

目的 观察冬病夏治穴位贴敷治疗类风湿关节炎(RA)的效果.方法 采用前瞻性、随机、盲法、安慰剂对照的方法,将2012年7月~2013年8月在中国中医科学院广安门医院接受三伏贴治疗的70例RA患者随机分为治疗组和对照组,在中西医常规治疗的同时,治疗组给予冬病夏治穴位贴敷,对照组采用安慰剂贴敷,两组均于夏季三伏天贴敷治疗3次,共贴敷治疗2年,贴敷治疗前后观察中医证候及症状的改善.结果两组治疗后第1年、第2年中医证候疗效比较差异均无统计学意义(P>0.05).两组治疗后第1年、第2年对畏寒肢冷的改善效果比较差异有高度统计学意义(P<0.01).两组治疗后第1年、第2年关节痛视觉模拟评分(VAS)及晨僵VAS评分比较差异均无统计学意义(P>0.05);两组治疗后第1年疲乏VAS评分比较差异无统计学意义(P>0.05),治疗后第2年疲乏VAS评分比较差异有统计学意义(P<0.05).与本组治疗前比较,两组关节痛、疲乏、晨僵VAS评分的改善差异均有高度统计学意义(P<0.01).本组内第2年与第1年比较,关节痛VAS评分和疲乏VAS评分的改善差异均有高度统计学意义(P<0.01),晨僵VAS评分的改善差异无统计学意义(P>0.05).结论 冬病夏治穴位贴敷治疗类风湿关节炎可有效改善畏寒肢冷、疲乏、关节痛、晨僵等症状.%Objective To observe the efficacy of winter diseases treated in summer acupoint application therapy in the treatment of rheumatoid arthritis (RA). Methods By using a randomized blinded placebo-controlled design, 70 patients with RA receiving acupoint application therapy in Guangˊanmen Hospital, China Academy of Chinese Medical Sciences from July 2012 to August 2013 were randomly divided into treatment group and control group. On basis of conventional therapy of traditional Chinese and Western medicine, the treatment group was given winter diseases treated in summer acupoint application therapy, the control group was given placebo application, both groups were treated for 3 times at summer canicular days, total 2 years. The improvement of syndrome and symptom of Chinese medicine before and after treatment was observed. Results The efficacy of Chinese medicine syndrome after treatment for 1, 2 years between the two groups had no significant differences (P>0.05). The cold extremities after treatment for 1, 2 years between the two groups had highly significant differences (P<0.01). There were no significant differences of joint pain visual analogue scale (VAS) and morning stiffness VAS score after treatment for 1, 2 years between the two groups (P> 0.05). There was no significant difference of fatigue VAS score after treatment for 1 year between the two groups (P> 0.05), while there was significant difference of fatigue VAS score after treatment for 2 years between the two groups (P<0.05). The VAS scores of joint pain, fatigue, and morning stiffness in the two groups were improved significantly compared with those before treatment (P< 0.01). The VAS scores of joint pain and morning stiffness after treatment for 2 years were improved significantly compared with those after treatment for 1 year (P< 0.01). There was no significant difference of morning stiffness VAS score after treatment for 2 years compared with those after treatment for 1 year (P>0.05). Conclusion Winter diseases treated in summer acupoint application therapy in the treatment of rheumatoid arthritis can significantly improve cold extremities, fatigue, joint pain and morning stiffness and other symptoms.