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2021 ACR:针灸联合药物治疗类风湿性关节炎更有效!

2021-11-17 MedSci原创 MedSci原创

大会速递!

类风湿性关节炎RA)是一种以侵蚀性关节炎为主要表现的系统性自身免疫病,且女性多发。RA以持续的滑膜炎和血管 翳形成为主要特征,进而破坏关节软骨和软骨下 骨,最终可导致关节畸形和功能丧失。

RA 因其难治性,成为风湿病学中的热门话题之 一,目前,对于类风湿性关节炎的治疗,除了抗炎镇痛、免疫抑制等方法,针灸疗法备受追捧。世界卫生组织统计数据显示,目前有103个会员国认可使用针灸,其中29个设立了传统医学的法律法规,18个将针灸纳入医疗保险体系。

近日,在ACR大会上公布了一项研究,针灸与药物联合对RA治疗效果的影响。在这项随机、前瞻性和对照研究中,共收纳101名患者,并随机分配至实验组(n=50)和对照组(n=51),所有患者都保持药物治疗。实验组患者每周接受一次针灸治疗,连续8周,在第一次针灸治疗前立即进行类风湿关节炎病情活动度评估(DAS28-CRP),在最后一次针灸治疗后一周再进行一次评估。

DAS28可以随时评估患者疾病活动度,不管是用于临床试验还是临床实践治疗中都非常适合,因此截止目前,DAS28仍是临床上最广泛使用的标准。疾病活动度评分越低,说明症状有所缓解。

结果显示,第一次评估DAS28-CRP评分两组结果非常相似,没有显著性差异,平均值(4129 VS 4245)和中位数(4220 VS 4200)。实验组患者进行针灸治疗后,DAS28-CRP评分平均值为2993,中位数为4541。对照组则呈现出不同的结果,平均值为4541,中位数为4705。根据DAS28-CRP的定义,在针灸治疗后,实验组患者疾病活动指数降低,而对照组则保持与第一次评估非常接近的值,具有中等疾病活动指数。

1 DAS28-CRP 评分(实验组和对照组)

最后1DAS28-CRP 评分(对照组和实验组)

综上,针刺治疗与已有药物治疗相结合的患者疗效明显。DAS28-CRP 评分的降低是清晰可见的,并且有可能表明针灸与已经进行的治疗相结合,可以降低 RA 活动。因此,针灸可能是一种在诊断 RA 时早期开始的非药物干预。

原始出处

Seixas D, Farinha F, Pacheco da Fonte M, Laranjeira M, Rua M. Acupuncture in Rheumatoid Arthritis Activity [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 10). https://acrabstracts.org/abstract/acupuncture-in-rheumatoid-arthritis-activity/. Accessed November 16, 2021.

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    2022-03-25 ms3000000235780593

    针刺治疗与已有药物治疗相结合的患者疗效明显。用结构调节来治病

    0

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    2021-11-19 lmm397
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    2021-11-19 10518094zz
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    2021-11-18 医者仁者

    梅斯客观公正报道中医针灸,值得点赞!!

    0

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