摘要
目的观察穴位贴敷联合火针对踝关节急性痛风性关节炎(acute gouty arthritis,AGA)患者关节恢复情况、血尿酸(uric acid,UA),血沉(erythrocyte sedimentation rate,ESR),C-反应蛋白(C-reactive protein,CRP)的影响及其对关节腔内氧化相关物质[谷胱甘肽过氧化酶(glutathionepPeroxidase,GSH-Px)、超氧化物歧化酶(superoxide dismutase,SOD)、活性氧类物质(reactive oxygen species,ROS)、丙二醛(malondialchehyche,MDA)]的影响,评价临床疗效。方法收集2012年3月-2017年3月治疗于沈阳市骨科医院确诊为踝关节AGA的患者130例,按照随机数字表法分为对照组与干预组,每组65例。对照组患者给予穴位贴敷+常规西医治疗(布洛芬+秋水仙碱+关节腔注射曲安奈德),干预组在此基础上加用火针放血治疗,两组患者连续治疗14 d。治疗前后采用视觉模拟评分(visual analogue scale,VAS)法评估疼痛程度、关节相关症状(疼痛、压痛、胀、活动障碍)、血清学指标(UA、ESR、CRP)及其氧化相关指标的变化,并评估两组患者的临床疗效。结果治疗结束后,观察组患者的治疗有效率高于对照组,但差异无统计学意义(P>0.05);治疗开始后第2、3、7、10天,观察组的疼痛VAS评分均明显低于对照组,差异均有统计学意义(P<0.05);观察组患者的疼痛缓解时间为(3.23±0.78)d,短于对照组的(4.43±1.02)d,差异有统计学意义(P<O.05);治疗结束后观察组患者的关节疼痛、压痛、红肿、活动障碍评分,均低于对照组,差异均有统计学意义(P<O.05)。治疗结束后观察组患者的血清学指标(UA、ESR、CRP)均低于对照组的,差异均有统计学意义(P<0.05)。治疗后观察组GSH-Px、SOD高于对照组,差异有统计学意义(P<0.05),治疗后观察组ROS、MDA低于对照组,差异有统计学意义(P<0.05)。结论踝关节AGA的患者在穴位贴敷的基础上给予火针放血疗法能很好的缓解疼痛程度、缩短恢复时间、减少炎症反应、改善氧化与抗氧化物质平衡,提高临床疗效。
Objective To study the clinical effect of fire-needle treatment on the base of acupoint application and conventional Western medicine treatment.Methods 130 patients with AGA in the ankle joint selected by??were randomly divided into 2 equal groups:control group given conventional Western medicine treatment(colchicine+brufen+intra-articular triamcinolone acetonide)plus point application of Chinese medicine,and intervention group given fire-needle with bleeding in addition.All the patients were treated for 14 days.Visual analogue scale(VAS)was used to evaluate the degree of arthralgia,Peripheral blood samples were collected before and after treatment to detect the uric acid(UA),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP).Joint cavity fluid was collected before and after treatment to examine the activeness of glutathione peroxidase(GSH-Px),superoxidc dismutase(SOD),malondialchehyche(MDA).,and reactive oxygen species(ROS).The clinical effects were evaluated,joint condition(arthralgia,tenderness,joints swollen,and articular activity obstacle).Results 108 patients adhered to the treatment with data in line with the study.The clinical effect of the intervention group was 32.43%,notsiguificantly higher thanthat of the control group(30.77%,P>0.05).On the second,third,seventh,and tenth days of treatment,the VAS pain scores of the intervention group were all significantly lower than those of the control group(all P<0.05).In addition,the remission time of the inervention group was significantly shorter than that of the control group(P<0.05).The scores of arthralgia,tenderness,joints swolling,and articular activity obstacle at any time point after treatment of the intervntion group were all significantly lower than tose of the control group(all P<0.05).The levels of UA,ESR,and CRP after treatment of the intervention group were all significantly lower than those of the control group(all P<0.05).The activity levels of GSH-Px and SOD of the intervention group were both significantly higher than those of the control group all P<0.05),but the activity levels of ROS and in observation group were lower than those in control group(both P<0.05).Conclusion On the base of Western medicine treatment and acupoint application,fire-needle treatment further eases the degree of pain,shortens the span,and improves inflammatory reaction in the patients with AGA in the ankle joint.
作者
王鑫
刘金山
WANG Xin;LIU Jin shan(Department of Orthopaedics NO 2,Shenyang Orthopaedics Hospital,Shenyang 110030,China)
出处
《中国急救复苏与灾害医学杂志》
2018年第12期1208-1212,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
内蒙古高等学校科学研究项目(NJZY173).
关键词
中药贴敷
穴位
火针
疼痛
急性痛风性关节炎
氧化
临床疗效
Application of Chinese herbal medicine
Acupoint
Fire-needle
Pain
Acute gouty arthritis
