【作者】 李野囡；

【导师】 侯丽萍；

【作者基本信息】 湖北中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的观察募疗法结合雷公藤多苷对类风湿关节炎(rheumatoid arthritis,RA)湿热痹阻型患者的疗效,对晨僵时间、疼痛指数、关节压痛指数和关节肿胀指数、关节功能障碍指数,口渴、汗出等主要症状体征的改善作用及其对血沉、C反应蛋白等多项实验室指标的调节作用,初步探讨其治疗的机制。方法1募疗法简介募疗法是侯丽萍教授创立的一种以腹部穴为主穴的按摩方法,通过穴位按摩,起到通调三焦,调理脏腑功能的作用,达到清热利湿,舒筋活络,通络止痛,三焦气机通畅,脏腑功能调和的目的。2方法62例类风湿关节炎湿热痹阻型患者随机分成两组：雷公藤多甙片口服并行募疗法为治疗组(32例),简称治疗组,每周2次,8次为1疗程,共治疗2个疗程(8周)。雷公藤多苷(国药准字Z42021212)口服为对照组(30例),简称对照组,10mg/次,每日3次,饭后口服,疗程8周。观察治疗前后两组患者的晨僵时间(h)、关节疼痛指数、关节肿胀指数、关节压痛指数、关节功能障碍指数,口渴、汗出等主要症状体征的改善情况,实验室指标血沉(ESR)、类风湿因子(RF)、C反应蛋白(CRP)、免疫球蛋白(IgG、IgA、IgM)的变化情况和不良反应。结果治疗组显效8例,进步9例,有效13例,总有效率为93.75%,对照组显效5例,进步6例,有效14例,总有效率为83.33%。两组总疗效对比有显著差异(P＜0.05)。治疗组治疗后的晨僵时间(h)、关节疼痛指数、关节压痛指数、关节肿胀指数和关节功能障碍指数,发热、关节发热、口渴、汗出、类风湿因子(RF)、C反应蛋白(CRP)、血沉(ESR)、IgA、IgM、IgG的改善均有显著差异(P＜0.05)。对照组治疗后的晨僵时间(h)、关节疼痛指数、关节压痛指数、关节肿胀指数和关节功能障碍指数,发热、关节发热,类风湿因子(RF)、C反应蛋白(CRP)、血沉(ESR)、IgA、IgM、IgG的改善均有显著差异(P＜0.05)。治疗组与对照组比较,晨僵时间、关节肿胀指数、关节压痛指数、关节疼痛指数、关节功能障碍指数、C反应蛋白、血沉、口渴、汗出、关节发热的改善差异显著(P＜0.05),发热、类风湿因子、IgA、IgM、IgG无显著差异(P＞0.05)。治疗组出现1例不良反应,对照组出现5例不良反应,两组比较无显著性差异(P＞0.05)。结论募疗法结合雷公藤多苷治疗类风湿关节炎疗效优于单用雷公藤多苷。能明显缓解或消除关节疼痛、关节肿胀、关节压痛、关节功能障碍,缩短或消除晨僵时间,对发热、口渴、汗出等症状及实验室指标ESR、CRP有明显改善作用。更多还原

【Abstract】 Objective Front Mu Point Massage combined with observation of Tripterygium treatment of rheumatoid arthritis (rheumatoid arth ritis, RA) efficacy. Observed erythrocyte sedimentation rate, C reactive protein regulation of a number of indicators, Explore the therapeutic mechanism.Methods 1. Front Mu Point Massage introduction:Mu Point Massa ge is a method invented by Professor Hou Liping. Through massag e,adjustment triple burner and internal organs. The purpose of clearing heat and dampness, shujin,tongluozhitong, triple burne r smooth, normal function of organs.2.62 RA patients were randomlly divided into two grou ps:treatment group (32 cases) and control group(30 cases). The c ontrol group was treated with Tripterygium for 8 weeks,10mg,Tid, p. o. Tripterygium and Mu point massage are the treatment group. 2 times per week, eight times as a course of treatment,a total of 2 courses of treatment (8 weeks). Observed the time omorning stiffness (h), joint pain index, joint swelling index,joint ten derness index, joint dysfunction index and ESR, RF, CRP,IgG, Ig A, IgM.Results Treatment group that were 8 cases of obvious effect,9 cases of progressive, effective in 13 cases, total effective ra te was 93.75% in the control group that were 5 cases of obvious effect,6 cases of progressive, effective in 14 cases, total ef fective rate was 83.33%. Comparison of the two groups were sign ificantly different effect (P＜0.05). After treatment, the time o f morning stiffness(h),joint pain index, joint tenderness index, joint swelling index and joint dysfunction index, rheumatoid fa ctor (RF), C-reactive protein (CRP), erythrocyte sedimentation r ate (ESR), IgA, IgM, IgG, clinical symptoms improved was signif icantly different (P＜0.05).The control group after treatmenttim e of morning stiffness(h),joint pain index,joint tendernessinde x,joint swelling index and the dysfunction index,rheumatoid fac tor (RF),C-reactive protein(CRP),erythrocyte sedimentationrate (ESR), IgA,IgM,IgG,clinical symptoms improved was signifycantly different(P＜0.05). After treatment,the treated group than the co ntrol group,time of morning stiffness,pain index,jointtendernes s index,joint swelling index and joint dysfunction index, Creac tive protein,erythrocyte sedimentation rate,thirst, sweating,fe ver and other symptoms and signs improved significantly differe nt (P＜0.05),but the treatment group than in the control group of rheumatoid factors, IgA, IgM, IgG, tongue no difference (P<0.0 5). Patients of group 1 cases of adverse reactions,thecontrol gr oup had five cases of adverse reactions showed no significant d ifference(P＞0.05).Conclusion Front-Mu-Point combined with Tripterygium effective than treatment of rheumatoid arthritis tripterygium alone.更多还原