独活寄生汤加减联合针灸治疗类风湿性关节炎的临床疗效分析

摘要

目的:探讨独活寄生汤加减联合针灸治疗类风湿性关节炎的临床疗效.方法:将符合纳入标准的160例类风湿性关节炎患者随机分为两组,对照组采用美洛昔康联合甲氨蝶呤治疗,观察组采用独活寄生汤加减联合针灸治疗.比较两组患者的临床疗效、症状及体征变化、ESR、CRP、RF指标变化、炎性及免疫因子变化情况.结果:观察组临床有效率为93.75％,明显高于对照组的73.75％,两组间比较有统计学差异(P＜0.05);观察组治疗后关节疼痛、晨僵、关节肿胀指数、握力、20 m步行时间等症状明显较对照组改善,两组间比较有统计学差异(P＜0.05);两组患者治疗前红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)无明显差异(P ＞0.05),观察组治疗后ESR、CRP、RF较对照组明显改善,两组间比较有统计学差异(P＜0.05);两组患者治疗前IL-1、IL-6、TNF-α、ICMAM-1无明显差异(P＞0.05), 观察组治疗后IL - 1、IL -6、TNF - α、ICMAM - 1较对照组明显降低,两组间比较有统计学差异(P＜0.05).结论:独活寄生汤加减联合针灸治疗类风湿性关节炎效果显著,利于症状及体征的持续改善,可抑制机体炎性反应,改善免疫功能,具有积极的临床意义.%Objective: To observe the clinical efficacy of modiefied Duhuo Jisheng decoction combined with acupuncture and moxibustion in the treatment of rheumatoid arthritis (RA). Methods: 160 RA patients were randomly divided into the control group and the observation group; the control group was treated with Meloxicam combined with Methotrexate, whereas the observation group was treated with modified Duhuo Jisheng decoction combined with acupuncture and moxibustion. Clinical efficacy, changes of signs, symptoms, laboratory index, inflammatory and immune factors were compared between two groups. Results: The effective rate in the observation group was 93.75％, which was significantly higher than 73.75％ in the control group, and the difference was significant(P ＜0.05 ). After the treatment, symptoms and signs, such as joint pain, morning stiffness, index of joint swelling, grip strength and walking time of 20m, were greatly improved in the observation compared to those in the control group, which showed significant difference(P ＜0.05). The levels of ESR, RF and CRP showed no significant differences between the two groups before the treatment(P ＞0.05); however, they were improved greatly in the observation group compared to the control group after the treatment(P ＜0.05). The levels of IL - 1, IL -6, TNF - α and ICMAM - 1 showed no significant difference between two groups before the treatment (P ＞ 0.05 ); they became significantly lower in the observation group than those in the control group after the treatment (P ＜ 0.05 ). Conclusion: The therapy of modified Duhuo Jisheng decoction combined with acupuncture and moxibustion has significant effect on RA, it is good for continuous improvement of symptoms and signs, it can inhibit the inflammatory reactions and improve immune function, with a positive clinical significance.