| Objective: To observe the effect of moxibustion combined with pricking blood therapy on the clinical curative effect and blood coagulation function of Rheumatoid arthritis(RA)at active stage,and to explore the mechanism of moxibustion combined with pricking blood therapy in the treatment of RA.Methods: According to the randomized controlled study method,60 cases of RA patients with blood stasis obstruction type who met the inclusion and exclusion criteria were divided into observation group and treatment group,with 30 cases in each group.The observation group was given leflunomide tablets orally,20 mg/time,once a day;the treatment group was given moxibustion combined with blood pricking therapy on the basis of the treatment of the observation group.Specific methods of moxibustion:Gentle moxibustion on "Zusanli","Shenshu",and "Xuehai" points,moxibustion once every other day,3 times a week,continuous treatment for 8 weeks;Specific methods for bloodletting: Perform blood pricking treatment on "Quze","Weizhong" points and local petechiae and collaterals on swollen and painful joints.Blood pricking is performed once a week for 8 weeks.Observe the main clinical symptoms(number of joint tenderness,number of joint swelling,morning stiffness score and patient’s visual analog score for joint pain),laboratory indicators(physical and chemical examination: ESR,CRP,RF;inflammatory factor: IL-1β,TNF-α;coagulation function indicators: FIB,DD),changes in TCM symptoms and signs score before and after treatment,compare the efficacy of the two groups,and compare the general routine inspections as safety observation indicators and the incidence of adverse drug reactions and complications.Results: A total of 57 cases were completed in this trial,including 3 cases of shedding and elimination,28 cases in the final observation group and 29 cases in the treatment group.1 Comparison of main clinical manifestationsIntra-group comparison: After treatment,the number of joint tenderness,swelling,morning stiffness score,and VAS score of the two groups were significantly lower than before treatment(P<0.05);comparison between groups: the above indicators in the treatment group improved better than the observation group(P<0.05).2 Comparison of laboratory indicators2.1 Comparison of physical and chemical inspections Intra-group comparison: After treatment,the levels of ESR,CRP,and RF in the treatment group were significantly lower than before treatment(P<0.05),and the other indicators in the observation group except RF were also lower than before treatment(P<0.05).Comparison between groups: The improvement of the above indicators in the treatment group was better than that in the observation group(P<0.05).2.2 Comparison of inflammatory factors Intra-group comparison: After treatment,the levels of IL-1β and TNF-α in the two groups were significantly lower than before treatment(P<0.01).Comparison between groups: The improvement of the above indicators in the treatment group was better than that in the observation group(P<0.05).2.3 Comparison of coagulation indicators Intra-group comparison: After treatment,the levels of FIB and DD in the treatment group were significantly lower than before treatment(P<0.01),while the above indicators in the observation group were not significantly reduced(P>0.05).Comparison between groups: The improvement of the above indicators in the treatment group was better than that in the observation group(P<0.05).3 Comparison of TCM Symptoms and Signs ScoreComparison within the group: After treatment,the scores of TCM symptoms and signs of the two groups of patients were significantly lower than before treatment(P<0.01).Comparison between groups: The treatment group’s score improved better than the observation group(P<0.01).4 Efficacy comparisonAfter treatment,in the treatment group,3 cases were markedly effective,11 cases were improved,13 cases were effective,and 2 cases were ineffective,with a total effective rate of 93.1%(27/29);in the observation group,0 case was markedly effective,6 cases were improved,13 cases were effective,and 9 cases were ineffective,with a total effective rate of 67.8%(19/28).The total effective rate of the two groups was compared by correction χ~2 test P=0.038(P<0.05).Conclusion:1 Moxibustion combined with pricking blood therapy can significantly improve the clinical symptoms of RA patients with blood stasis and blockage during the active period,reduce the level of inflammatory factors and the integration of TCM syndromes,improve blood coagulation function,and improve the clinical efficacy of western medicine in the treatment of RA.2 The mechanism of moxibustion combined with pricking blood in the treatment of RA may be related to reducing inflammation,inhibiting the level of inflammatory factors,improving blood hypercoagulability and hyperfibrinolysis. |
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