针刺研究2016，Vol.41Issue(4)：327-333,7.DOI:10.13702/j.1000-0607.2016.04.008
不同发泡灸量的督脉铺灸治疗类风湿关节炎的临床疗效观察
Medicinal-powder-separated Long-snake Moxibustion over the Governor Vessel with Different Skin Vesiculation Conditions for Treatment of Patients with Rheumatoid Arthritis
摘要
Abstract
Objective To observe the curative effect of herbal-medicine-powder-separated “Long-snake moxibustion”over the Governor Vessel at different vesiculation conditions in the treatment of rheumatoid arthritis (RA).Method A total of 1 20 RA patients received herbal-powder-separated long-snake moxibustion in the present study and randomized into Banmao (Cantharides ,CANT,being able to promote skin vesiculation for enhancing the therapeutic effect)-0 g group,CANT-1 .5 g group and CANT-3.0 g group (n =40 in each group)according to the dosage of CANT used in the herbs-medicinal powder.In addition to Cantharides,the medicinal powder also contained Shexiang (Moschus ,1 g),Dingxiang (Flos Caryophylli ,1 g)and Rougui (Cin-namon bark ,1 g).When treated,the patient was asked to take a prone position,the ginger juice was evenly smeared on the pa-tient’s back from Dazhui (GV 1 4)to Yaoshu (GV 2,about 3 cm wide),then,the above-mentioned medicinal powder was spread on the smeared ginger juice,followed by putting a layer of gauze,ginger powder and ignited moxa-stick,respectively.The treat-ment was conducted once every 30 days,and twice altogether.The visual analog scale (VAS)was used to assess the pain seve-rity of moxibustion-induced skin vesiculation on the patient’s back in 24 h after moxibustion.The severity of vesiculation was as-sessed according to the status of vesicles appeared at the local skin (0 point:no vesicles;3 points:string-of-beads-like vesicles with the vesicle diameter being less than 2 cm;6 points:foliated vesicles with the vesicle diameter being larger than 2 cm).The patient’s symptoms and dysfunction of hand-knee joints were scored,and serum rheumatoid factor (RF),C-reactive protein (CRP),immune globulin IgM and IgG contents were assayed by ELISA,and the erythrocyte sedimentation rate (ESR)was deter-mined by using Westergren method.Results After moxibustion,of the three 40 RA patients in the CANT-0 g,CANT-1 .5 g and CANT-3.0 g groups,0,1 0 and 1 2 cases were under control in their symptoms,7,1 6 and 1 9 experienced marked improvement, 1 7,9 and 6 were improved,1 6,5 and 3 failed in the treatment,with the effective rates being 60.0%(1 6/40),87.5%(35/40) and 92.5% (37/40),respectively.The curative effects of CANT-1 .5 g and CANT-3.0 g were significantly superior to that of CANT-0 g (P <0.0 1 ).Both the scores for skin vesiculation status and pain severity were significantly higher in the CANT-3.0 g group than in the CANT-0 g (no skin vesiculation)and CANT-1 .5 g groups,and markedly higher in the CANT-1 .5 g group than in the CANT-0 g group (P <0.0 1 ).Following the treatment,the symptom score and joint dysfunction score,ESR level,and serum RF,CRP,IgM and IgG contents were considerably decreased in the three groups in comparison with pre-treatment in the same one group (P <0.0 1 );and those of the CANT-1 .5 g and CANT-3.0 g groups were markedly lower than those of CANT-0 g group (P <0.0 1 ).In addition,CANT-3.0 g was notably superior to CANT-1 .5 g in lowering symptom and joint dysfunction scores, ESR,serum RF and CRP contents (P <0.05).No significant differences were found between the CANT-1 .5 g and CANT-3.0 g groups in serum IgM and IgG levels and in the therapeutic effect (P >0.05).Conclusion Long-snake moxibustion combined with CANT-induced vesiculation has a good curative effect in the treatment of RA,which may be associated with its effects in lo-wering ESR level,and serum RF,CRP,IgM and IgG contents.The curative effect of vesiculation moxibustion is far better than non-vesiculation moxibustion,but mild vesiculation moxibustion is recommended due to severe pain of CANT-3.0 g.关键词
类风湿关节炎/铺灸/发泡灸/督脉/灸量Key words
Rheumatoid arthritis/Long-snake moxibustion/Vesiculation moxibustion/Governor Vessel/Moxibus-tion quantities分类
医药卫生引用本文复制引用
张伟,陈明人,胡锦玉..不同发泡灸量的督脉铺灸治疗类风湿关节炎的临床疗效观察[J].针刺研究,2016,41(4):327-333,7.基金项目
项目来源:江西省科技支撑计划项目(No.20142 BBG 70085) （No.20142 BBG 70085）
