挑刺法治疗急性痛风性关节炎的临床疗效研究
发布时间：2018-11-03 20:31
【摘要】：目的：通过对比挑刺法与常规西药治疗急性痛风性关节炎的疗效差异,探讨挑刺法治疗急性痛风性关节炎的临床疗效及作用优势,为临床急性痛风性关节炎的治疗提供思路,同时为挑刺法的治疗机制提供临床依据。方法：1.分组：将70例符合纳入标准并自愿参加本研究的急性痛风性关节炎患者,采用随机数字表分为挑刺组和药物对照组,每组各35例。2.治疗方法：挑刺组：以受累关节红肿疼痛最明显部位为中心,每次散在的选取3-5个点做为挑刺点,常规消毒,采用三棱针快速挑刺,挑出白色筋丝或纤维后,予利多卡因外用局麻,休息5分钟后行第二遍操作,血流自凝为度,再行消毒包扎。每天一次,每次两遍,连续3天。药物对照组：口服秋水仙碱,0.5mg/次,首剂加倍,3次/d,连续3天。3.观测指标：分别采集治疗前后血尿酸(UA)值、炎性因子IL-8、红外热图平均温度值,评价两组临床疗效；分别记录治疗前、治疗后第一天、治疗后第二天及治疗结束后四个时间点上的VAS疼痛评分,评价两组缓解疼痛差异；在1个月后随访,记录急性复发例数及不良反应情况,比较两组近期复发或不良反应情况。在观察结束后,运用SPSS19.0进行统计数据分析。结果：1.综合疗效分析治疗结束后,挑刺组总有效率为85.7%,药物对照组为82.4%,两组比较无统计学差异(P0.05)。2.组间分析(1)治疗后第一天,挑刺组和药物对照组之间VAS疼痛评分存在显著性统计学差异(P0.01)；治疗后第二天,两组间VAS疼痛评分存在统计学差异(P0.05)；治疗结束后两组之间VAS评分比较无统计学差异(P0.05)。(2)治疗结束后,挑刺组和药物对照组之间的UA值、炎性因子IL-8值及红外热图平均温度值三项指标差异比较均无统计学意义(P0.05)。3.组内前后分析治疗结束后,挑刺组和药物对照组的VAS疼痛评分、UA值、炎性因子IL-8值及红外热图平均温度值四个指标与治疗前比较均有统计学差异(P0.05)。4.安全性及不良反应分析两组安全性比较无统计学意义(P0.05),随访不良反应的差异比较有统计学差异(P0.05)。结论：1.挑刺法与药物治疗急性痛风性关节炎均有良好的临床疗效。2.从临床症状改善情况看,挑刺法能较快的缓解疼痛症状。3.从不良反应发生情况看,挑刺组明显少于药物对照组。
[Abstract]:Objective: to explore the clinical efficacy and advantages of acupuncture in the treatment of acute gouty arthritis by comparing the curative effect of acupuncture and conventional western medicine in the treatment of acute gouty arthritis, and to provide ideas for the treatment of acute gouty arthritis. At the same time, it provides the clinical basis for the treatment mechanism of prick method. Method 1: 1. Group: 70 patients with acute gouty arthritis who met the inclusion criteria and volunteered to participate in the study were randomly divided into two groups: the prickly group and the drug control group, with 35 cases in each group. Treatment method: in the prick group, the center was the most obvious part of the redness and swelling of the affected joint, 3-5 points were selected as the prickly spots each time, the routine disinfection was done, and the triangulate needle was used to quickly pick out the white tendons or fibers. Lidocaine was given external anesthesia. After 5 minutes rest, the second operation was performed. The blood flow was self-coagulated and then disinfected and bandaged. Once a day, twice a time, for 3 days in a row. Drug control group: oral colchicine, 0.5mg/ times, the first dose doubled, 3 times per day, 3 days in a row. Measurements: the serum uric acid (UA) and the average temperature of inflammatory factor IL-8, (IR) were collected before and after treatment to evaluate the clinical efficacy of the two groups. The VAS pain scores were recorded before, on the first day after treatment, on the second day after treatment and at four time points after treatment to evaluate the difference of pain relief between the two groups. After 1 month follow-up, the number of acute recurrence and adverse reactions were recorded, and the recent recurrence or adverse reactions were compared between the two groups. After observation, the statistical data were analyzed by SPSS19.0. Results: 1. After the treatment, the total effective rate of the prick group was 85.7 and that of the drug control group was 82.4. There was no statistical difference between the two groups (P0.05). Analysis among groups (1) on the first day after treatment, there was a significant statistical difference in VAS pain score between the prick group and the drug control group (P0.01), and there was a statistical difference in the VAS pain score between the two groups on the second day after treatment (P0.05). There was no significant difference in VAS scores between the two groups after treatment (P0.05). (2). After the treatment, the UA values of the prick group and the drug control group were not significantly different. The IL-8 value of inflammatory factor and the average temperature value of infrared calorimeter were not significantly different (P0.05). There were significant differences in VAS pain score, UA value, inflammatory factor IL-8 value and infrared calorimetric mean temperature between the prick group and the drug control group after treatment (P0.05). There was no significant difference in safety and adverse reaction between the two groups (P0.05), but there was significant difference in the adverse reaction in follow-up (P0.05). Conclusion 1. The pricking method and the medicine both have good clinical curative effect on acute gouty arthritis. 2. According to the improvement of clinical symptoms, pricking can relieve pain symptoms more quickly. 3. The incidence of adverse reactions was significantly less in the prick group than in the drug control group.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1
[Abstract]:Objective: to explore the clinical efficacy and advantages of acupuncture in the treatment of acute gouty arthritis by comparing the curative effect of acupuncture and conventional western medicine in the treatment of acute gouty arthritis, and to provide ideas for the treatment of acute gouty arthritis. At the same time, it provides the clinical basis for the treatment mechanism of prick method. Method 1: 1. Group: 70 patients with acute gouty arthritis who met the inclusion criteria and volunteered to participate in the study were randomly divided into two groups: the prickly group and the drug control group, with 35 cases in each group. Treatment method: in the prick group, the center was the most obvious part of the redness and swelling of the affected joint, 3-5 points were selected as the prickly spots each time, the routine disinfection was done, and the triangulate needle was used to quickly pick out the white tendons or fibers. Lidocaine was given external anesthesia. After 5 minutes rest, the second operation was performed. The blood flow was self-coagulated and then disinfected and bandaged. Once a day, twice a time, for 3 days in a row. Drug control group: oral colchicine, 0.5mg/ times, the first dose doubled, 3 times per day, 3 days in a row. Measurements: the serum uric acid (UA) and the average temperature of inflammatory factor IL-8, (IR) were collected before and after treatment to evaluate the clinical efficacy of the two groups. The VAS pain scores were recorded before, on the first day after treatment, on the second day after treatment and at four time points after treatment to evaluate the difference of pain relief between the two groups. After 1 month follow-up, the number of acute recurrence and adverse reactions were recorded, and the recent recurrence or adverse reactions were compared between the two groups. After observation, the statistical data were analyzed by SPSS19.0. Results: 1. After the treatment, the total effective rate of the prick group was 85.7 and that of the drug control group was 82.4. There was no statistical difference between the two groups (P0.05). Analysis among groups (1) on the first day after treatment, there was a significant statistical difference in VAS pain score between the prick group and the drug control group (P0.01), and there was a statistical difference in the VAS pain score between the two groups on the second day after treatment (P0.05). There was no significant difference in VAS scores between the two groups after treatment (P0.05). (2). After the treatment, the UA values of the prick group and the drug control group were not significantly different. The IL-8 value of inflammatory factor and the average temperature value of infrared calorimeter were not significantly different (P0.05). There were significant differences in VAS pain score, UA value, inflammatory factor IL-8 value and infrared calorimetric mean temperature between the prick group and the drug control group after treatment (P0.05). There was no significant difference in safety and adverse reaction between the two groups (P0.05), but there was significant difference in the adverse reaction in follow-up (P0.05). Conclusion 1. The pricking method and the medicine both have good clinical curative effect on acute gouty arthritis. 2. According to the improvement of clinical symptoms, pricking can relieve pain symptoms more quickly. 3. The incidence of adverse reactions was significantly less in the prick group than in the drug control group.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1
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1 洪潇挺;yけ，
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