【摘要】 目的 观察艾灸治疗活动期类风湿关节炎(RA)的临床疗效,探讨艾灸温通效应与不同灸法、灸程的关系。方法 采用单盲、随机、对照试验的临床研究方法,将纳入的 180例活动期 RA患者(168例完成整个研究过程),随机分为隔姜灸、温和灸及雷公藤多甙三组,每组均治疗 60天,每 30天治疗完成后,采用症状分级量化评分表观察关节疼痛、肿胀和压痛的个数与程度等症状体征指标,并测定治疗前后类风湿因子(RF)、血沉(ESR)、C-反应蛋白(CRP)指标变化。结果 经艾灸治疗后,关节疼痛、肿胀、晨僵、压痛等临床症状体征及实验室指标均得到明显改善 ( P< 0. 05或 P<0. 01);60天明显优于 30天( P <0. 05或 P <0. 01);在症状改善方面,隔姜灸组优于温和灸组 (P<0. 05或 P<0. 01),在实验室指标的改善上,两组无显著性差异(P>0.05)。结论 艾灸可显著改善活动期类风湿关节炎患者临床症状和体征,且与灸程有密切关系。

【关键词】 隔姜灸; 温和灸; 类风湿关节炎; 量效关系

Multicenter randomized controlled clinical study on rheumatoid arthritis with f moxibustion 

【Abstract】  Objective  We observed the clinical effects of moxibustion on patients with activerheumatoid arthritis to investigate the relationship between the effects and different methods or courses. Methods A randomized, controlled and single blind trial was performed. 180 cases were involved in this trial, while 168 finished the whole research. All patients were divided into ginger moxibustion group, mildmoxibustion group and Tripterygium wilfordii group randomly. Each group was treated for 60 days.The in- dicators, such as joint pain, swelling and tenderness were observed, RF, ESR and CRP were detectedbefore the experiment, 30 days after the experiment and 60 days after the experiment to compare thechanges. Results  After moxibustion treatment, joint pain, swelling, tenderness and laboratory indexeshave been significantly improved ( P< 0. 05 or P<0. 01).The effects after 60 days' treatment weresignificantly better than that after 30 days' (P<0. 05 or P<0. 01). The effects of ginger moxibustion groupwere better than mild moxibustion group on symptom improvement (P<0. 05 or P<0. 01). But there was no had no significant difference on laboratory indexes between the two groups (P>0. 05). Conclusion  The moxibustion could significantly improve the clinical symptoms and signs in patients with active rheumatoidarthritis, and the effects are closely related with moxibustion course.

【Key words】  Ginger moxibustion;  Mild moxibustion;  Rheumatoid arthritis; Dose-effect rela- tionship