摘要
目的观察补肾壮骨温经汤配合针刺循经取穴治疗类风湿性膝关节炎(RG)的疗效。方法选取2020年6月至2022年6月宝鸡市中医医院收治的102例RG患者作为研究对象,按随机数表法分为联合组、对照1组与对照2组各34例。对照1组患者给予常规西药治疗,对照2组患者给予常规西药联合针刺循经取穴治疗,联合组患者则在对照2组基础上予以补肾壮骨温经汤联合治疗。治疗3个月后,比较三组患者的临床疗效及治疗前后的临床证候评分、骨关节炎指数(WOMAC)评分以及血清学指标[类风湿因子(RF)、红细胞沉降率(ESR)、抗环状瓜氨酸抗体(CCP)]水平;同时比较三组患者治疗期间的不良反应的发生情况。结果联合组患者的临床治疗总有效率为91.18%,明显高于对照1组的64.71%和对照2组的70.59%,差异均具有统计学意义(P<0.05),但对照1组与对照2组患者的治疗总有效率比较差异均无统计学意义(P>0.05);治疗3个月后,联合组患者的关节冷痛、屈伸不利、肿胀、头晕耳鸣以及肢体沉重各临床证候评分明显低于对照1组与对照2组,差异均具有统计学意义(P<0.05),但对照1组与对照2组患者的临床证候评分比较差异均无统计学意义(P>0.05);联合组患者的WOMAC评分为(38.45±11.48)分,明显低于对照1组的(45.58±12.71)分和对照2组的(44.34±12.06)分,且联合组患者的RF、ESR及CCP水平分别为(86.37±14.74)IU/mL、(32.27±3.38)mm/h、(187.34±19.08)IU/mL,明显低于对照1组的(103.22±16.75)IU/mL、(43.16±5.25)mm/h、(219.58±21.77)IU/mL和对照2组的(98.41±15.28)IU/mL、(41.83±5.19)mm/h、(210.66±19.48)IU/mL,差异均有统计学意义(P<0.05),但对照1组与对照2组患者的WOMAC评分、RF、ESR及CCP水平比较差异均无统计学意义(P>0.05);治疗期间三组患者的不良反应总发生率比较差异无统计学意义(P>0.05)。结论补肾壮骨温经汤配合针刺循经取穴治疗RG可有效缓解患者的相关临床症状,改善膝关节功能及血清学指标水平,临床疗效确切,具有临床应用价值。
Objective To observe the effect of Bushen Zhuanggu Wenjing Decoction combined with acupunc-ture with acupoint selection along meridian in the treatment of rheumatoid gonarthritis(RG).Methods One hundred and two patients with RG who were admitted to Baoji Traditional Chinese Medicine Hospital from June 2020 to June 2022 were selected as the research subjects.According to random number table method,the patients were divided into combination group,control group 1,and control group 2,with 34 cases in each group.The patients in control group 1 were given conventional western medicine treatment.The patients in control group 2 were given conventional western medicine treatment and acupuncture with acupoint selection along meridian.The patients in combination group were treated with Bushen Zhuanggu Wenjing Decoction on the basis of treatment of the control group 2.After 3 months of treatment,the clinical effects,clinical syndrome scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,the levels of serological indexes[rheumatoid factor(RF),erythrocyte settlement rate(ESR),and cy-clic citrullinated peptide(CCP)]before and after treatment,and the incidence of adverse reactions during treatment were compared among the three groups.Results The total clinical response rate in the combination group(91.18%)was sig-nificantly higher than that in the control group 1(64.71%)and that in the control group 2(70.59%),with statistically sig-nificant differences(P<0.05).After 3 months of treatment,the scores for clinical syndromes(joint crymodynia,unfavor-able flexion and extension,swelling,dizziness and tinnitus,limb heaviness)in the combination group were significantly lower than those in the control group 1 and the control group 2,with statistically significant differences(P<0.05).There was no statistically significant difference in the total effective rate or clinical syndrome scores between the control group 1 and the control group 2(P>0.05).WOMAC score in the combination group was(38.45±11.48)points,significantly lower than(45.58±12.71)points in the control group 1 and(44.34±12.06)points in the control group 2;the levels of RF,ESR,and CCP in the combination group were(86.37±14.74)IU/mL,(32.27±3.38)mm/h,and(187.34±19.08)IU/mL,significantly lower than(103.22±16.75)IU/mL,(43.16±5.25)mm/h,and(219.58±21.77)IU/mL in the control group 1 and(98.41±15.28)IU/mL,(41.83±5.19)mm/h and(210.66±19.48)IU/mL in the control group 2;the differences were statistically significant(P<0.05).There was no statistically significant difference in WOMAC score or the levels of RF,ESR,and CCP between the control group 1 and the control group 2(P>0.05).There was no statistically significant differ-ence in the total incidence of adverse reactions during treatment among the three groups(P>0.05).Conclusion Bushen Zhuanggu Wenjing Decoction combined with acupuncture with acupoint selection along meridian can effectively relieve relevant clinical symptoms and improve knee function and serological indexes in patients with RG.
作者
郑喜
阎小萍
李仁心秀
王丽娜
ZHENG Xi;YAN Xiao-ping;LIREN Xin-xiu;WANG Li-na(Department of Acupuncture,Baoji Traditional Chinese Medicine Hospital,Baoji 721000,Shaanxi,CHINA;Department of Internal Medicine of Traditional Chinese Medicine,Sino-Japanese Friendship Hospital,Beijing 100029,CHINA;Department of Rheumatology,Baoji Traditional Chinese Medicine Hospital,Baoji 721000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2024年第8期1081-1086,共6页
Hainan Medical Journal
基金
陕西省中医药管理局项目(编号:SZY-NLTL-2022-023)。
关键词
补肾壮骨温经汤
针刺循经取穴
类风湿膝关节炎
疗效
膝关节功能
Bushen Zhuanggu Wenjing Decoction
Acupuncture with acupoint selection along meridian
Rheu-matoid gonarthritis
Curative effect
Knee function
