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

【摘要】：目的:研究穴位埋線聯(lián)合來(lái)氟米特對(duì)78例類風(fēng)濕關(guān)節(jié)炎患者的臨床療效。方法:利用隨機(jī)數(shù)字表選取法選取武漢市中醫(yī)院風(fēng)濕病科2014年10月至2016年10月78例RA患者,并按照隨機(jī)分組法將78例RA患者分成研究組40例和對(duì)照組38例。其中對(duì)照組所有RA患者均常規(guī)使用西藥來(lái)氟米特片口服治療,劑量和頻次均嚴(yán)格按照說(shuō)明書(shū)規(guī)定使用,使用時(shí)間為16周;研究組所有RA患者重復(fù)對(duì)照組以上所有治療操作且嚴(yán)格按照不同RA患者的體質(zhì)辨證論治配合對(duì)應(yīng)的穴位埋線治療,治療時(shí)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(cè)兩組RA患者的ALT、AST、Cr等肝腎功能安全性指標(biāo)以確保RA患者的安全性。結(jié)果:經(jīng)過(guò)16周治療后,研究組總有效率97.50%(39/40)明顯高于對(duì)照組81.58%(31/38)(P0.05);兩組RA患者治療后在休息痛、關(guān)節(jié)壓痛、關(guān)節(jié)腫脹以及HAQ指數(shù)[1]均較治療前減輕(P0.05),且研究組上述指數(shù)顯著低于對(duì)照組(P0.05),同時(shí)DAS28評(píng)分顯著低于對(duì)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(duì)照組(P0.05)。兩組RA患者在ALT、AST、PLT、WBC等安全性指標(biāo)的比較均無(wú)提示差異具有明顯統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:單純使用口服來(lái)氟米特片治療RA患者臨床療效一般,且臨床上容易出現(xiàn)腹痛、腹脹、輕度腹瀉等不良反應(yīng),而口服來(lái)氟米特片聯(lián)合穴位埋線法則具有明確的臨床療效,臨床上值得進(jìn)一步推廣和應(yīng)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(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R593.22

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