穴位埋线联合来氟米特对78例类风湿关节炎患者的临床观察

发布时间：2018-06-25 07:31

本文选题：穴位埋线 + 来氟米特　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的:研究穴位埋线联合来氟米特对78例类风湿关节炎患者的临床疗效。方法:利用随机数字表选取法选取武汉市中医院风湿病科2014年10月至2016年10月78例RA患者,并按照随机分组法将78例RA患者分成研究组40例和对照组38例。其中对照组所有RA患者均常规使用西药来氟米特片口服治疗,剂量和频次均严格按照说明书规定使用,使用时间为16周;研究组所有RA患者重复对照组以上所有治疗操作且严格按照不同RA患者的体质辨证论治配合对应的穴位埋线治疗,治疗时间为16周,并相互比较治疗前后两组的治疗效果(包括:临床症状及体征、DAS28、ESR、CRP),且密切监测两组RA患者的ALT、AST、Cr等肝肾功能安全性指标以确保RA患者的安全性。结果:经过16周治疗后,研究组总有效率97.50%(39/40)明显高于对照组81.58%(31/38)(P0.05);两组RA患者治疗后在休息痛、关节压痛、关节肿胀以及HAQ指数[1]均较治疗前减轻(P0.05),且研究组上述指数显著低于对照组(P0.05),同时DAS28评分显著低于对照组(P0.05);两组RA患者在ESR与CRP水平均较治疗前降低(P0.05),且治疗后研究组RA患者的ESR、CRP水平均显著低于对照组(P0.05)。两组RA患者在ALT、AST、PLT、WBC等安全性指标的比较均无提示差异具有明显统计学意义(P0.05)。结论:单纯使用口服来氟米特片治疗RA患者临床疗效一般,且临床上容易出现腹痛、腹胀、轻度腹泻等不良反应,而口服来氟米特片联合穴位埋线法则具有明确的临床疗效,临床上值得进一步推广和应用。
[Abstract]:Objective: to study the clinical effect of acupoint catgut implantation combined with leflunomide in 78 patients with rheumatoid arthritis. Methods: 78 RA patients were selected from rheumatology department of Wuhan traditional Chinese Medicine Hospital from October 2014 to October 2016 by random number table selection method. According to the method of random grouping, 78 RA patients were divided into study group (n = 40) and control group (n = 38). All RA patients in the control group were treated by oral administration of leflunomide tablets, the dosage and frequency were strictly according to the instructions, and the duration was 16 weeks. All RA patients in the study group repeated all the treatment procedures above in the control group and were treated strictly according to different RA patients' physique differentiation of symptoms and signs combined with corresponding catgut embedding therapy at acupoints. The treatment time was 16 weeks. The therapeutic effects (including clinical symptoms and signs of DAS28ESR-CRP) before and after treatment were compared between the two groups, and the liver and kidney function safety indexes such as alt ASTN Cr were closely monitored in both groups to ensure the safety of RA patients. Results: after 16 weeks of treatment, the total effective rate of the study group was 97.50% (39 / 40) significantly higher than that of the control group 81.58% (31 / 38) (P0.05). The joint swelling and HAQ index [1] were significantly lower in the study group than in the control group (P0.05), and the scores of DAS28 were significantly lower than those in the control group (P0.05), and the levels of ESR and CRP in both groups were lower than those before treatment (P0.05), and after treatment, the levels of ESR and CRP in RA patients in both groups were lower than those before treatment (P0.05). The levels of ESR-CRP in the study group were significantly lower than those in the control group (P 0.05). There was no significant difference between the two groups (P0.05) in the safety indexes of patients with RA, such as alt, AST, PLT, WBC and so on (P0.05). Conclusion: the clinical efficacy of oral leflunomide tablets alone in RA patients is general, and the adverse reactions such as abdominal pain, abdominal distension and mild diarrhea are likely to occur clinically, while oral leflunomide tablets combined with acupoint catgut embedding rule has a clear clinical effect. It is worth popularizing and applying in clinic.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.22

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