中医适宜技术参与活动期类风湿关节炎治疗的ACR20评价

吴方真 吴方正 马慧澜 吴宽裕 黄丽红 张卓依 郭燕芬 齐张旸 陈煜宇 赵钟文

【摘 要】目的：观察中医适宜技术“经络刮疗 + 关节操”对活动期类风湿关节炎ACR20的疗效。方法：将66例活动期类风湿关节炎患者随机分为治疗组和对照组，每组33例。对照组给予常规药物治疗，治疗组在对照组治疗基础上联合中医适宜技术“经络刮疗 + 关节操”。2组均以3个月为1个疗程。观察2组的疗效指标ACR20，包括关节肿胀数、关节压痛数、休息痛（VAS1）、患者对疾病活动程度的评价（VAS2）、医生对疾病活动程度的评价（VAS3）。结果：第4周ACR20达标率，第4，8，12周的关节压痛数、VAS1、VAS2、VAS3的改善情况，治疗组均优于对照组（P < 0.05）。结论：对于活动期类风湿关节炎患者，中医适宜技术可促进关节功能的恢复、生活质量的优化，使ACR20早期达标，值得推广应用。

【关键词】 类风湿关节炎;活动期;中医适宜技术;经络刮疗;关节操;ACR20

【ABSTRACT】Objective：To observe the curative effect of meridian curettage and joint exercise on active rheumatoid arthritis ACR20.Methods：Sixty-six patients with active rheumatoid arthritis were randomly divided into a treatment group and a control group，33 cases in each group.The control group was given routine medical treatment，and the treatment group was treated with meridian curettage and joint exercises based on the routine medical treatment.The course of treatment for both groups was 3 months.The curative effect indexes ACR20 of the two groups were observed，including the number of joint swelling，joint tenderness，rest pain（VAS1），patients' evaluation of disease activity（VAS2）and doctors' evaluation of disease activity（VAS3）.Results：The compliance rate of ACR20 at the 4th week，the number of joint tenderness and the improvement of VAS1，VAS2 and VAS3 at the 4th，8th and 12th weeks in the treatment group were better than those in the control group（P < 0.05）.Conclusion：For patients with active rheumatoid arthritis，the appropriate technology of traditional Chinese medicine can promote the recovery of joint function，optimize the quality of life，and promote the early standard of ACR20，worthy of popularization and application.

【Keywords】 rheumatoid arthritis;activity period;appropriate technology of traditional Chinese medicine;meridian curettage;joint exercises;ACR20

類风湿关节炎（rheumatoid arthritis，RA）是临床中较多见且较难治的关节病之一，病情反复，致残率高。药物治疗在活动期RA中占据较主要的地位，但部分患者心理和经济负担大，常难坚持治疗[1]。面对多元化的RA患者，发掘更多有效改善RA的非药物外治疗法，特别是简便效廉的中医外治适宜技术，已被临床所需要。在提高疗效的同时，减少药物使用剂量及种类，提高依从性，是今后发展趋势之一[2]。笔者科室采用的RA非药物中医外治法中，中医适宜技术“经络刮疗+关节操”应用多年，现对该适宜技术参与活动期RA治疗的ACR 20进行疗效评价。

1 临床资料

1.1 一般资料 选取2019年1月至2020年12月在福建中医药大学附属第二人民医院风湿内分泌科就诊的活动期RA患者66例，按随机数字表法分为治疗组和对照组，每组33例。……