挑刺法治療急性痛風(fēng)性關(guān)節(jié)炎的臨床療效研究
發(fā)布時間：2018-11-03 20:31
【摘要】：目的：通過對比挑刺法與常規(guī)西藥治療急性痛風(fēng)性關(guān)節(jié)炎的療效差異,探討挑刺法治療急性痛風(fēng)性關(guān)節(jié)炎的臨床療效及作用優(yōu)勢,為臨床急性痛風(fēng)性關(guān)節(jié)炎的治療提供思路,同時為挑刺法的治療機制提供臨床依據(jù)。方法：1.分組：將70例符合納入標準并自愿參加本研究的急性痛風(fēng)性關(guān)節(jié)炎患者,采用隨機數(shù)字表分為挑刺組和藥物對照組,每組各35例。2.治療方法：挑刺組：以受累關(guān)節(jié)紅腫疼痛最明顯部位為中心,每次散在的選取3-5個點做為挑刺點,常規(guī)消毒,采用三棱針快速挑刺,挑出白色筋絲或纖維后,予利多卡因外用局麻,休息5分鐘后行第二遍操作,血流自凝為度,再行消毒包扎。每天一次,每次兩遍,連續(xù)3天。藥物對照組：口服秋水仙堿,0.5mg/次,首劑加倍,3次/d,連續(xù)3天。3.觀測指標：分別采集治療前后血尿酸(UA)值、炎性因子IL-8、紅外熱圖平均溫度值,評價兩組臨床療效；分別記錄治療前、治療后第一天、治療后第二天及治療結(jié)束后四個時間點上的VAS疼痛評分,評價兩組緩解疼痛差異；在1個月后隨訪,記錄急性復(fù)發(fā)例數(shù)及不良反應(yīng)情況,比較兩組近期復(fù)發(fā)或不良反應(yīng)情況。在觀察結(jié)束后,運用SPSS19.0進行統(tǒng)計數(shù)據(jù)分析。結(jié)果：1.綜合療效分析治療結(jié)束后,挑刺組總有效率為85.7%,藥物對照組為82.4%,兩組比較無統(tǒng)計學(xué)差異(P0.05)。2.組間分析(1)治療后第一天,挑刺組和藥物對照組之間VAS疼痛評分存在顯著性統(tǒng)計學(xué)差異(P0.01)；治療后第二天,兩組間VAS疼痛評分存在統(tǒng)計學(xué)差異(P0.05)；治療結(jié)束后兩組之間VAS評分比較無統(tǒng)計學(xué)差異(P0.05)。(2)治療結(jié)束后,挑刺組和藥物對照組之間的UA值、炎性因子IL-8值及紅外熱圖平均溫度值三項指標差異比較均無統(tǒng)計學(xué)意義(P0.05)。3.組內(nèi)前后分析治療結(jié)束后,挑刺組和藥物對照組的VAS疼痛評分、UA值、炎性因子IL-8值及紅外熱圖平均溫度值四個指標與治療前比較均有統(tǒng)計學(xué)差異(P0.05)。4.安全性及不良反應(yīng)分析兩組安全性比較無統(tǒng)計學(xué)意義(P0.05),隨訪不良反應(yīng)的差異比較有統(tǒng)計學(xué)差異(P0.05)。結(jié)論：1.挑刺法與藥物治療急性痛風(fēng)性關(guān)節(jié)炎均有良好的臨床療效。2.從臨床癥狀改善情況看,挑刺法能較快的緩解疼痛癥狀。3.從不良反應(yīng)發(fā)生情況看,挑刺組明顯少于藥物對照組。
[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.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：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.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.1
【引證文獻】
相關(guān)期刊論文 前1條
1 洪瀟挺;yけ，
本文編號：2308949
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