摘要
目的：比较穴位与痛点贴敷回药通络定痛散及口服来氟米特治疗类风湿关节炎的临床疗效差异。方法：将96例患者随机分为穴位贴敷组、痛点贴敷组、来氟米特组,每组32例。穴位贴敷组采用自制回药通络定痛散贴敷,穴取大椎、命门、足三里、患病关节局部阳经所过之穴等,痛点贴敷组采用自制回药通络定痛散行痛点贴敷,每次贴敷4~6h,7d后行下一次贴敷;来氟米特组口服来氟米特,前3d每次50mg,每天1次,3d后改为每次20mg,每天1次。3组均1个月为一疗程,连续治疗3个疗程。观察3组患者治疗前后临床症状,实验室指标血沉（ESR）、C反应蛋白（CRP）、类风湿因子（RF）以及症候总积分的变化,并评定3组疗效。结果：穴位贴敷组总有效率为87.5%（28/32）,来氟米特组总有效率为90.6%（29/32）,均优于痛点贴敷组的68.8%（22/32,均P〈0.05）;3组患者治疗后临床症状、各项实验室指标以及症候总积分均较治疗前改善（均P〈0.05）,其中穴位贴敷组与来氟米特组对疼痛、肿胀、压痛、症候总积分以及实验室指标ESR、RF的改善均优于痛点贴敷组（P〈0.05,P〈0.01）;穴位贴敷组与痛点贴敷组各有2例局部皮肤出现水泡、瘙痒症状;来氟米特组2例出现恶心、食欲下降,1例出现头晕、乏力,1例出现皮疹。结论：回药通络定痛散穴位贴敷对类风湿关节炎症状及实验室指标的改善优于痛点贴敷,与西药来氟米特疗效相当,且无恶心、食欲下降、头晕、乏力等不良反应。
Objective To observe the clinical efficacy differences on rheumatoid arthritis treated with acupoint application of huiyao tongluo dingtong san（preparation of Hui medicine）,tender point herbal application and leflunomide.Methods Ninety-six patients were randomized into an acupoint herbal application group,a tender point herbal application group and a leflunomide group,32 cases in each one.In the acupoint herbal application group,huiyao tongluo dingtong san paste was used at Dazhui（GV 14）,Mingmen（GV 4）,Zusanli（ST 36）and the local points on the yang meridians around the knee joint.In the tender point herbal application group,the selfprepared Hui medicine was used at tender points,4to 6heach time,at the interval of 7days.In the leflunomide group,leflunomide was applied for oral administration,50 mg on each of the first 3days,once a day;20mg each time 3days later,once a day.The treatment for 1month made one session in the three groups,and continuous three sessions of treatment were required.The clinical symptoms,laboratory indices such as erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,rheumatoid factor（RF）and the total score of symptoms were observed before and after treatment in the patients of three groups.The efficacy was evaluated in the 3groups.Results The total effective rate was 87.5%（28/32）in the acupoint herbal application group and was 90.6%（29/32）in the leflunomide group,better than 68.8%（22/32）in the tender point herbal application group（both P〈0.05）.After treatment,the clinical symptoms,laboratory indices and the total score of symptoms were all improved as compared with those before treatment in the three groups（all P〈0.05）.Among the three groups,the results of pain,swelling,tenderness and the total score of symptoms as well as ESR and RF in the acupoint herbal application group and the leflunomide group were all better than those in the tender point herbal application group（P〈0.05,P〈0.01）.Blister and pruritus occurred in 2cases in each of the acupoint herbal application group and the tender point herbal application group.Nausea and poor appetites in 2cases,dizziness and lassitude in 1case and skin rashes in 1case occurred in the leflunomide group.Conclusion The improvements in the symptoms of rheumatoid arthritis and laboratory indices in the acupoint herbal application of huiyao tongluo dingtong san are better than those in the treatment with tender point herbal application.The efficacy of it is similar to that of leflunomide,without adverse reactions such as nausea,poor appetite,dizziness and lassitude.
出处
《中国针灸》
CAS
CSCD
北大核心
2016年第7期699-703,共5页
Chinese Acupuncture & Moxibustion
基金
宁夏回族自治区自然科学基金项目:NZ13233
关键词
类风湿关节炎
穴位贴敷
痛点贴敷
回药
来氟米特
rheumatoid arthritis
acupoint herbal application
tender point herbal application
Hui medicine
leflunomide
