| Objective: To investigate the clinical efficacy and safety of moxibustion combined with five elements music therapy in the treatment of rheumatoid arthritis with liver and kidney deficiency,and to provide some reference value for clinical treatment.Methods: Ninety patients with rheumatoid arthritis of liver and kidney deficiency who met the inclusion criteria from January 2022 to January 2023 were selected as subjects,which were randomly divided into control group,moxibustion group and moxibustion combined with five elements music therapy group(combined group),with 30 cases in each group.The control group was given conventional western medicine(methotrexate tablets orally,10 mg daily,once a week;folic acid tablets,10 mg each time,once a week,taken orally the day after methotrexate;leflunomide tablets orally,10 mg each time,once a day)and nursing care.The moxibustion group was given moxibustion on the basis of the control group: moxibustion was applied to the Kidney,Liver,Foot Sanli,Sanyinjiao and A-Yi acupoints for 10-15 minutes each;in the combined group,moxibustion was combined with five elements music therapy on the basis of the control group.The moxibustion therapy was the same as that of the moxibustion group,and the five elements music of Chinese medicine was selected from the “Tian Yun Wu Xing Music”,which was played at the same time as the moxibustion therapy,and the patients could play and listen to it by themselves at other times.All three groups were treated and observed once a day,7times a week for 2 weeks.The rheumatoid arthritis pain assessment scale(RAPS),tenderness joint number(TJC),swelling joint number(SJC),self-assessment anxiety scale(SAS),self-assessment depression scale(SDS)and TCM syndrome scale were filled in before,1 week and 2 weeks after the intervention to evaluate the effect of the intervention.The t-test,chi-square test and repeated measure ANOVA were used for statistical analysis.Result:1.Baseline comparison: The differences in general information,RAPS dimensions and total scores,number of joint tenderness,number of joint swelling,SAS,SDS and TCM syndrome score before the intervention among the three groups were not statistically significant(P>0.05).2.Comparison of clinical symptoms between the three groups of patients(1)Comparison of RAPS scores: All three groups showed improvement in pain symptoms after the intervention,with significant differences in RAPS scores before and after the intervention in all three groups(P<0.05);the combined group had significantly lower scores on the total RAPS,emotional cognitive and physical dimension after 1 week of intervention compared to the control group(P<0.05),the difference with the moxibustion group was not statistically significant(P>0.05),the difference between the sensory dimension scores of patients in the three groups was not statistically significant(P>0.05).After 2 weeks of intervention,patients in the combined group had significantly lower scores on the total RAPS and emotional cognitive dimension than the control and moxibustion groups(P<0.05);The results of repeated measurement ANOVA showed that the total RAPS and each dimension scores were affected by time,intervention and interaction effect in all three groups,the differences were statistically significant(P<0.05).(2)Comparison of the number of joint pressure pains: The number of joint tenderness decreased in all three groups after the intervention,with statistically significant differences between the three groups before and after the intervention(P<0.05);the number of joint tenderness was significantly improved in the combined group after 1 week and 2 weeks of intervention compared with the control and moxibustion groups(P<0.05);the results of repeated measurement ANOVA showed that there was a statistically significant difference in the number of joint tenderness among three groups,which were affected by time,intervention and interaction effects(P<0.05).(3)Comparison of the number of swollen joints: The number of swollen joints decreased in all three groups after the intervention,with statistically significant differences between the three groups before and after the intervention(P<0.05);the number of joint swelling in the combined group was significantly reduced after 1 week and 2 weeks of intervention was significantly reduced compared with the control group(P<0.05),and there was no significant change compared to moxibustion group(P>0.05);the results of the repeated measures ANOVA showed that the time effect of the number of joint swelling among three groups was statistically significant(P<0.05),and no significant difference in the intervention and interaction effects(P>0.05).3.Comparison of negative emotions among the three groups of patients(1)Comparison of anxiety: After the intervention,anxiety was reduced in all three groups,with a significant difference in SAS scores before and after the intervention in each group(P<0.05);the SAS scores in the combined group decreased more significantly after 1 week and 2 weeks of intervention compared with the control and moxibustion groups(P<0.05);Repeated measurement ANOVA results showed that the SAS scores in all three groups were affected by time,intervention and interaction effects(P<0.05).(2)Comparison of depression: After the intervention,depression was reduced in all three groups,with a significant difference in SDS scores before and after the intervention in each group(P<0.05);the SDS scores in the combined group were significantly lower than those in the control and moxibustion groups after 1 week and 2 weeks of intervention(P<0.05);Repeated measurement ANOVA results showed that the SDS scores in all three groups were affected by time,intervention and interaction effects(P<0.05).4.Comparison of the TCM symptom scores in the three groups: After 2 weeks of intervention,the total TCM symptom score in the combined group was significantly lower than that of the control group(P<0.05),and there was no statistical difference compared with the moxibustion group(P>0.05),however,the decreasing trend of TCM evidence points was more obvious in the combined group than in the control and moxibustion groups.5.Comparison of the efficacy of TCM symptoms: The effective rate of the control group was69.0%,moxibustion group was 86.2%,combined group was 89.7%.There was a statistically significant difference in the efficacy of TCM symptoms among three groups(P>0.05).Conclusion:(1)Moxibustion combined with five elements music therapy can effectively improve the clinical symptoms of rheumatoid arthritis patients with liver and kidney deficiency,relieve their anxiety and depression,and alleviate the symptoms of Chinese Medicine,especially in improving joint pain,joint pressure,joint swelling,and unfavourable joint flexion and extension.(2)Moxibustion combined with five elements music therapy is more effective and safe in the treatment of rheumatoid arthritis with liver and kidney deficiency,which is worthy of clinical promotion and practice. |
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