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目的:观察温针灸配合药物治疗类风湿性关节炎的临床疗效及对细胞因子的影响。方法:将60例RA患者随机分为对照组和观察组各30例。对照组患者口服双氯芬酸钠缓释片、甲氨蝶呤片;观察组患者在对照组患者治疗基础上加用温针灸治疗。记录治疗前及治疗30天后两组患者症状评分,检测ESR、RF、CPR、IL-1β、TNF-α等指标。结果:治疗后两组患者症状积分均低于本组治疗前,组内治疗前后比较差异有统计学意义(P<0.05);治疗后观察组症状积分优于对照组,组间比较差异有统计学意义(P<0.05)。治疗30天后,两组患者ESR、RF、CRP、IL-1β、TNF-α细胞因子水平均低于治疗前(P<0.05);观察组患者各细胞因子水平均优于对照组,差异均有统计学意义(P<0.05)。治疗30天后,观察组患者总有效率为86.67%,优于对照组的80.00%,差异有统计学意义(P<0.05)。观察组有2例出现上腹胀痛、嗳气,1例出现白细胞下降,对照组有2例出现白细胞下降,停药或对症处理后两组患者的不良反应均消失,未影响治疗。结论:温针灸配合药物治疗RA安全有效,能改善RA患者关节症状,降低炎性反应指标,值得临床推广应用。
Objective: To observe the clinical curative effect of warming needle moxibustion and drugs on rheumatoid arthritis and its effect on cytokines. Methods: Sixty RA patients were randomly divided into control group and observation group, 30 cases each. Control group patients oral diclofenac sodium sustained release tablets, methotrexate tablets; observation group patients in the control group based on the treatment plus warm acupuncture treatment. The scores of symptoms before and 30 days after treatment were recorded and the indexes of ESR, RF, CPR, IL-1β and TNF-α were detected. Results: After treatment, symptom scores of two groups were lower than before treatment, the difference was statistically significant before and after treatment (P <0.05); symptom score of observation group was better than that of control group after treatment Significance (P <0.05). After 30 days of treatment, the levels of ESR, RF, CRP, IL-1β and TNF-α in the two groups were lower than those before treatment (P <0.05). The levels of cytokines in the observation group were better than those in the control group Statistical significance (P <0.05). After 30 days of treatment, the total effective rate in the observation group was 86.67%, which was better than that in the control group (80.00%), the difference was statistically significant (P <0.05). In the observation group, 2 cases had abdominal pain, belching, 1 case of leukopenia, 2 cases of leukopenia in the control group, and no adverse reactions disappeared in the two groups after stopping or symptomatic treatment. Conclusion: Warm acupuncture and moxibustion combined with drug treatment of RA is safe and effective, can improve the joint symptoms of RA patients, reduce the inflammatory response index, worthy of clinical promotion and application.