艾灸对类风湿关节炎患者临床疗效及对外周血NLR、PLR和RDW的影响
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摘要
目的:探究艾灸对类风湿关节炎(rheumatoid arthritis,RA)患者的临床疗效及对NLR、PLR和RDW的影响。方法:选取46例RA患者,按随机数字表随机分为常规治疗组(对照组)及针刺治疗组(治疗组),每组23例,对照组予以:①双氯芬酸钠缓释片0.3 g/d,2次/d;②甲氨蝶呤片(Methotrexate Tablets,MTX)10 mg/次,1次/周;③叶酸片5 mg/次,1次/周,以10天为1个疗程,连续治疗3个疗程;治疗组在药物组治疗的基础上加用艾灸治疗,选取有肿、痛关节,每天灸1次,一次15～20 min。疗程:每日治疗1次,治疗6次休息1 d,以30 d为一疗程,治疗1个疗程。观察两组治疗前后临床疗效、类风湿因子(Rheumatoid factor,RF)、超敏C反应蛋白(High sensitivity C-reactive protein,hs-CRP)、血沉(Erythrocyte Sedimentation Rata,ESR)、疾病活动性评分(Disease activity score, DAS)-28、中性粒细胞/淋巴细胞比率(neutrophil/lymphocyte ratio,NLR)、血小板/淋巴细胞比率(platelet to lymphocyte ratio,PLR)、红细胞分布宽度(red blood cell distribution width,RDW)水平的变化。结果:(1)治疗组RF、hs-CRP、ESR、DAS-28、NLR水平显著低于对照组(P<0.05);(2)治疗组患者临床疗效86.96%,对照组为69.57%,治疗组明显优于对照组(P<0.05)。结论:艾灸能够明显提高RA患者临床疗效可能与其调节外周血NLR、PLR和RDW水平有关。
Objective:To explore the clinical curative effect of moxibustion therapy in patients with rheumatoid arthritis(RA) and influences on peripheral blood NLR,PLR and RDW.Methods:Forty-six RA patients were randomly divided into therapy group and control group.Control group:(1)Ibuprofen Capsules,0.3 g/time,once every 12 hours;(2)Methotrexate Tablets,10 mg/time,once a week;(3)Folic acid,15 mg/time,once a week.Ten days was a period of treatment,continuously 3 courses.Therapy group:(1)Moxibustion therapy in addition to the therapy in the control group;(2)Moxibustion was used at the most painful points of the red turgid and painful joint,once a day,one day interval for every six days,with 10 days for a period of treatment,totally for 3 courses.The changes of rheumatoid factor(RF),hypersensitive C-reactive protein(hs-CRP),blood sedimentation(ESR),DAS-28 points,NLR,PLR and RDW before and after treatment were observed.Results:(1) The levels of RF,hs-CRP,ESR,DAS-28 and NLR in the therapy group were lower than those in the control group(P<0.05).(2)The total effective rate in the therapy group was 86.96%,which was obviously better than 69.57% in the control group(P<0.05).Conclusion:Moxibustion can improve the clinical curative effect of the patients with RA,which may be related to regulating the levels of peripheral blood NLR,PLR and RDW.
Objective:To explore the clinical curative effect of moxibustion therapy in patients with rheumatoid arthritis(RA) and influences on peripheral blood NLR,PLR and RDW.Methods:Forty-six RA patients were randomly divided into therapy group and control group.Control group:(1)Ibuprofen Capsules,0.3 g/time,once every 12 hours;(2)Methotrexate Tablets,10 mg/time,once a week;(3)Folic acid,15 mg/time,once a week.Ten days was a period of treatment,continuously 3 courses.Therapy group:(1)Moxibustion therapy in addition to the therapy in the control group;(2)Moxibustion was used at the most painful points of the red turgid and painful joint,once a day,one day interval for every six days,with 10 days for a period of treatment,totally for 3 courses.The changes of rheumatoid factor(RF),hypersensitive C-reactive protein(hs-CRP),blood sedimentation(ESR),DAS-28 points,NLR,PLR and RDW before and after treatment were observed.Results:(1) The levels of RF,hs-CRP,ESR,DAS-28 and NLR in the therapy group were lower than those in the control group(P<0.05).(2)The total effective rate in the therapy group was 86.96%,which was obviously better than 69.57% in the control group(P<0.05).Conclusion:Moxibustion can improve the clinical curative effect of the patients with RA,which may be related to regulating the levels of peripheral blood NLR,PLR and RDW.
引文
[1] 邹晓军.外周血NLR、PLR、RDW 对类风湿关节炎患者病情的评估价值[J].中国现代医药杂志,2017,7,19(7):25-28.
[2] 冯子彦.类风湿关节炎的诊断治疗进展[J].中国误诊学杂志,2012,12(2):262-263.
[3] Krishnamurthy D,Starkl P,Szalai K.et al.Monitoring neutro phils and platelets during case in-induced anaphylaxis in an experimental BALB/c mouse model[J].Clinical &experimental allergy:Journal of the British Society for Allergy and Clinical Immunology,2012,42(7):1119-1128.
[4] 邹晓军.外周血NLR、PLR、RDW 对类风湿关节炎患者病情的评估价值[J].中国现代医药杂志,2017,7,19(7):25-28.
[5] 俞红五,朱艳,潘喻珍,等.艾灸辅助治疗类风湿关节炎患者临床疗效观察及机制探讨[J].中国针灸,2016,36(1):17-20.
[6] Villenenve E,Nam J,Emery P.2010-ACR-EULAR classification criteria for rheumatoid arthritis[J].RevBras Reumatol,2010,50(5):481-483.
[7] Prevoo MLL, van t H of MA, Kuper HH, et at.Modified disease acitivity scores that include twenty- eight-joint counts Developent and validation in aprospective longitudinal study of patients with rheumatoid arthritis[J].Arthritis Rheum, 1995,38(1):315-324.
[8] Prevoo M L, Vant H of M A, Kuper H H,et al.Modified disease activity scoresthat include twenty-eight-joint counts Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis[J].Arthritis Rheum, 1995, 38(1):315-324.
[9] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:115-119.
[10] 王薇,周晓鸿,邓丹琪.类风湿性关节炎临床活动度评估[J].医学综述,2009,15(2):239-242.
[11] Yang M,Li L,Su N,et al.Dynamic monitoring of the neutrophil/ lymphocyte ratio could predict the prognosis of patients with bloodstream infection[J].Zhonghua Wei Zhong Bing Ji Jiu Yi Xue,2015,27(6): 471-476.
[12] Meng X,Wei G,Qian C,et al.The platelet-to-lymphocyte ratio,superior to the neutrophil-to-lymphocyte ratio,correlates with hepatitis C virus infection[J].Intern J Infect Dis,2016,45: 72-77.
[13] 张袁露,庄思慧,张诗颜,等.血细胞相关参数在炎症性肠病患者中的变化及临床意义[J].检验医学与临床,2016,13(6):837-839.
[14] 李书梅,徐小莉,梁迪,等.外周血中性粒细胞与淋巴细胞比值以及血小板与淋巴细胞比值评估胃癌患者预后的价值[J].中华肿瘤杂志,2014,36(12):910-915.
[15] 厉彦山,陈慧勇,潘文志,等.红细胞体积分布宽度(RDW)与类风湿关节炎(RA)病情活动的相关性分析[J].复旦学报(医学版),2012,39(2):152-156
[16] 朱艳,俞红五,潘喻珍,等.刺血加艾灸治疗急性痛风性关节炎临床疗效观察[J].中国针灸,2015,35(9):885-888.
[2] 冯子彦.类风湿关节炎的诊断治疗进展[J].中国误诊学杂志,2012,12(2):262-263.
[3] Krishnamurthy D,Starkl P,Szalai K.et al.Monitoring neutro phils and platelets during case in-induced anaphylaxis in an experimental BALB/c mouse model[J].Clinical &experimental allergy:Journal of the British Society for Allergy and Clinical Immunology,2012,42(7):1119-1128.
[4] 邹晓军.外周血NLR、PLR、RDW 对类风湿关节炎患者病情的评估价值[J].中国现代医药杂志,2017,7,19(7):25-28.
[5] 俞红五,朱艳,潘喻珍,等.艾灸辅助治疗类风湿关节炎患者临床疗效观察及机制探讨[J].中国针灸,2016,36(1):17-20.
[6] Villenenve E,Nam J,Emery P.2010-ACR-EULAR classification criteria for rheumatoid arthritis[J].RevBras Reumatol,2010,50(5):481-483.
[7] Prevoo MLL, van t H of MA, Kuper HH, et at.Modified disease acitivity scores that include twenty- eight-joint counts Developent and validation in aprospective longitudinal study of patients with rheumatoid arthritis[J].Arthritis Rheum, 1995,38(1):315-324.
[8] Prevoo M L, Vant H of M A, Kuper H H,et al.Modified disease activity scoresthat include twenty-eight-joint counts Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis[J].Arthritis Rheum, 1995, 38(1):315-324.
[9] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:115-119.
[10] 王薇,周晓鸿,邓丹琪.类风湿性关节炎临床活动度评估[J].医学综述,2009,15(2):239-242.
[11] Yang M,Li L,Su N,et al.Dynamic monitoring of the neutrophil/ lymphocyte ratio could predict the prognosis of patients with bloodstream infection[J].Zhonghua Wei Zhong Bing Ji Jiu Yi Xue,2015,27(6): 471-476.
[12] Meng X,Wei G,Qian C,et al.The platelet-to-lymphocyte ratio,superior to the neutrophil-to-lymphocyte ratio,correlates with hepatitis C virus infection[J].Intern J Infect Dis,2016,45: 72-77.
[13] 张袁露,庄思慧,张诗颜,等.血细胞相关参数在炎症性肠病患者中的变化及临床意义[J].检验医学与临床,2016,13(6):837-839.
[14] 李书梅,徐小莉,梁迪,等.外周血中性粒细胞与淋巴细胞比值以及血小板与淋巴细胞比值评估胃癌患者预后的价值[J].中华肿瘤杂志,2014,36(12):910-915.
[15] 厉彦山,陈慧勇,潘文志,等.红细胞体积分布宽度(RDW)与类风湿关节炎(RA)病情活动的相关性分析[J].复旦学报(医学版),2012,39(2):152-156
[16] 朱艳,俞红五,潘喻珍,等.刺血加艾灸治疗急性痛风性关节炎临床疗效观察[J].中国针灸,2015,35(9):885-888.
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