世界中医药
文章摘要
引用本文:蒲卉明1,赵凌艳1,程建明2,郭俐宏2.温针灸配合穴位注射鹿瓜多肽注射液治疗类风湿性关节炎的临床研究[J].世界中医药,2016,(04):.  
温针灸配合穴位注射鹿瓜多肽注射液治疗类风湿性关节炎的临床研究
Clinical Study of Warm Acupuncture and Moxibustion Combined with Acupoint Injection of Cervus and Cucumis Polypeptide in Treatment of Rheumatoid Arthritis
投稿时间:2015-08-14  
DOI:10.3969/j.issn.1673-7202.2016.04.038
中文关键词:  鹿瓜多肽注射液  类风湿因子  穴位注射  温针灸
English Keywords:CCP injection  Rheumatoid factor  Acupoint injection  Warming needle moxibustion
基金项目:湖北省教育厅重点项目(编号:B20122406)
作者单位
蒲卉明1,赵凌艳1,程建明2,郭俐宏2 1 十堰市太和医院(湖北医药学院附属医院)内分泌风湿科十堰442000 2 十堰市太和医院(湖北医药学院附属医院)康复中心十堰442000 
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中文摘要:
      目的:研究温针灸联合穴位注射鹿瓜多肽注射液对类风湿性关节炎血清类风湿因子(Rheumatoid Factor,RF)及关节滑膜骨形态发生蛋白(Bone Morphogenetic Protein,BMPs)的影响,探讨其治疗机制。方法:按入院先后顺序将内分泌科2014年1月至2015年3月收治的214例类风湿性关节炎住院患者,采用随机原则分为对照组及治疗组,每组107例,对照组口服来氟米特,并采用温针灸痛点循经取穴为主穴,辅以关元、足三里、脾俞、气海、阳陵泉、肾俞、肝俞等温针灸20 min,治疗组在对照组治疗方法的基础上穴位注射鹿瓜多肽注射液,2组患者均治疗3个疗程。采用免疫组化及原位杂交检测BMPs在患者膝关节滑膜组织中的表达、夹心ELISA法测定膝关节滑液中基质金属蛋白酶-1(MMP-1)含量、外周血血沉(ESR)、血清MMP-1、类风湿因子IgA-RF、IgM-RF,记录患者治疗前后关节疼痛、压痛、肿胀、功能障碍指数、握力,晨僵时间,并计算总有效率。结果:温针灸联合穴位注射鹿瓜多肽注射液可提高BMPs,降低MMP-1、ESR、IgA-RF、IgM-RF,明显缩短晨僵时间,改善临床症状,与对照组比较(P<0.05),差异有统计学意义。结论:温针灸联合穴位注射鹿瓜多肽注射液治疗类风湿性关节炎疗效显著,其作用机制可能与温针灸激发经气,运行气血,通经活络,促进局部血液循环及局部病变组织新陈代谢,鹿瓜多肽注射液促进BMPs合成,抑制RF造成的变态变态反应有关。
English Summary:
      To study the effect of warming needle moxibustion combined with acupoint injection with Cervus and Cucumis Polypeptide (CCP) on rheumatoid arthritis serum rheumatoid factor (rheumatoid, factor, RF) and synovial membrane of bone morphogenetic protein (BMPs) effect, and to explore its therapeutic mechanism. Methods: According to the hospital admission date, total 214 cases of rheumatoid arthritis patients from January 2014 to March 2015 in Department of Endocrinology were randomly divided into control group and treatment group, with 107 cases in each group. The control group was treated with oral leflunomide as well as warming needle moxibustion on some sore acupoints and CV 4, ST 36, BL 2O, CV 6, GB 34, BL 23, BL18 etc. for 20 minutes every time. The control group was also treated with CCP acupoint injection on the basis of control group’s treatment; two groups were treated for three courses. Pathological examination of patients’ MMP-1 and BMPs, erythrocyte sedimentation rate (ESR), serum rheumatoid factor IgA-RF, IgM-RF-, as well as joint pain, swelling, tenderness, dysfunction index, duration of morning stiffness, grip strength and total effective rate were recorded and analyzed before and after the treatment. Results: Warming needle moxibustion combined with CCP acupoint injection improved BMPs, reduced MMP-1, ESR, IgA-RF, IgM-RF, shortened the duration of morning stiffness, relieved the clinical symptoms, treatment group compared with control (P<0.05), the difference was statistically significant. Conclusion: The therapeutic effect of warming needle moxibustion combined with CCP acupoint injection in treatment of rheumatoid arthritis is significant, and it may function through acupuncture and moxibustion to stimulate qi and blood movement, dredge channels and activate col laterals, promote the local blood circulation and local tissue. CCP injection can also lead to the generation of BMPs synthesis, and inhibition of allergic allergic reaction caused by RF.
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