本文選題：穴位埋線 + 來氟米特�。� 參考：《湖北中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:研究穴位埋線聯合來氟米特對78例類風濕關節(jié)炎患者的臨床療效。方法:利用隨機數字表選取法選取武漢市中醫(yī)院風濕病科2014年10月至2016年10月78例RA患者,并按照隨機分組法將78例RA患者分成研究組40例和對照組38例。其中對照組所有RA患者均常規(guī)使用西藥來氟米特片口服治療,劑量和頻次均嚴格按照說明書規(guī)定使用,使用時間為16周;研究組所有RA患者重復對照組以上所有治療操作且嚴格按照不同RA患者的體質辨證論治配合對應的穴位埋線治療,治療時間為16周,并相互比較治療前后兩組的治療效果(包括:臨床癥狀及體征、DAS28、ESR、CRP),且密切監(jiān)測兩組RA患者的ALT、AST、Cr等肝腎功能安全性指標以確保RA患者的安全性。結果:經過16周治療后,研究組總有效率97.50%(39/40)明顯高于對照組81.58%(31/38)(P0.05);兩組RA患者治療后在休息痛、關節(jié)壓痛、關節(jié)腫脹以及HAQ指數[1]均較治療前減輕(P0.05),且研究組上述指數顯著低于對照組(P0.05),同時DAS28評分顯著低于對照組(P0.05);兩組RA患者在ESR與CRP水平均較治療前降低(P0.05),且治療后研究組RA患者的ESR、CRP水平均顯著低于對照組(P0.05)。兩組RA患者在ALT、AST、PLT、WBC等安全性指標的比較均無提示差異具有明顯統(tǒng)計學意義(P0.05)。結論:單純使用口服來氟米特片治療RA患者臨床療效一般,且臨床上容易出現腹痛、腹脹、輕度腹瀉等不良反應,而口服來氟米特片聯合穴位埋線法則具有明確的臨床療效,臨床上值得進一步推廣和應用。
[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.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R593.22

【參考文獻】

相關期刊論文 前10條

1 章聞;楊聯勝;唐濟湘;張昆;;鉻制羊腸線穴位埋線后排異反應案及分析[J];中國針灸;2015年04期

2 陳華;;穴位埋線不良反應病例報告[J];中國針灸;2013年07期

3 王琦;王佳曼;彭學標;于娜沙;;穴位埋線減肥致多發(fā)性皮膚潰瘍1例[J];皮膚性病診療學雜志;2013年03期

4 李慧穎;;老年類風濕關節(jié)炎71例臨床療效分析[J];中國醫(yī)藥指南;2012年34期

5 徐強;;中醫(yī)藥治療痹證臨床研究進展[J];中醫(yī)藥臨床雜志;2012年10期

6 閆海飛;王莉;;埋線療法引起不良反應10例[J];上海針灸雜志;2012年05期

7 侯華偉;王進;郭華麗;劉曉娟;;穴位埋線療法臨床應用及機理研究[J];光明中醫(yī);2012年01期

8 鄭燕;宋欣偉;;宋欣偉治療類風濕關節(jié)炎經驗擷要[J];山西中醫(yī);2011年09期

9 馬曉晶;何夏秀;馮興華;;馮興華教授治療風濕病學術思想[J];世界中西醫(yī)結合雜志;2011年08期

10 李連波;陳云飛;;針灸治療類風濕關節(jié)炎的臨床研究進展[J];上海針灸雜志;2011年06期

，

本文編號：2065156