CAJ | 학술논문

目的：观察温针结合补肾活血中药治疗肩关节周围炎的疗效及对患者免疫球蛋白 IgA、IgG、IgM的影响,探讨其作用机制。方法将90例肩关节周围炎患者随机分为针药组、针灸组和药物组,每组30例。针药组采用温针结合补肾活血中药治疗,针灸组采用温针治疗,药物组采用补肾活血中药治疗。补肾活血中药连续服用30 d；针灸隔日治疗1次,5次为1个疗程,治疗3个疗程。治疗前后分别评定3组患者肩部疼痛指数,检测IgA、IgG、IgM含量,比较3组临床疗效。结果针药组总有效率为93.33%(28/30),针灸组为73.33%(22/30),药物组为66.67%(20/30),针药组与针灸组和药物组比较差异有统计学意义(P＜0.05),针灸组和药物组比较差异无统计学意义(P＞0.05)。3组患者治疗后肩部疼痛指数与本组治疗前比较差异均有统计学意义(P＜0.05),针药组治疗前后肩痛指数差值与针灸组、药物组差值比较差异有统计学意义(P＜0.05)。3组患者治疗前IgA、IgG、IgM与正常参考值比较均显著升高(P＜0.05)；与治疗前比较,3组治疗后IgA、IgG、IgM含量均显著降低(P＜0.05),针药组IgA、IgG、IgM含量显著低于针灸组和药物组(P＜0.05)。结论温针结合补肾活血中药治疗肩关节周围炎疗效优于单纯温针治疗或药物治疗,可显著改善患者肩痛症状,降低IgA、IgG、IgM含量,调节机体免疫功能,这可能是其治疗肩关节周围炎的作用机制之一。
목적：관찰온침결합보신활혈중약치료견관절주위염적료효급대환자면역구단백 IgA、IgG、IgM적영향,탐토기작용궤제。방법장90례견관절주위염환자수궤분위침약조、침구조화약물조,매조30례。침약조채용온침결합보신활혈중약치료,침구조채용온침치료,약물조채용보신활혈중약치료。보신활혈중약련속복용30 d；침구격일치료1차,5차위1개료정,치료3개료정。치료전후분별평정3조환자견부동통지수,검측IgA、IgG、IgM함량,비교3조림상료효。결과침약조총유효솔위93.33%(28/30),침구조위73.33%(22/30),약물조위66.67%(20/30),침약조여침구조화약물조비교차이유통계학의의(P＜0.05),침구조화약물조비교차이무통계학의의(P＞0.05)。3조환자치료후견부동통지수여본조치료전비교차이균유통계학의의(P＜0.05),침약조치료전후견통지수차치여침구조、약물조차치비교차이유통계학의의(P＜0.05)。3조환자치료전IgA、IgG、IgM여정상삼고치비교균현저승고(P＜0.05)；여치료전비교,3조치료후IgA、IgG、IgM함량균현저강저(P＜0.05),침약조IgA、IgG、IgM함량현저저우침구조화약물조(P＜0.05)。결론온침결합보신활혈중약치료견관절주위염료효우우단순온침치료혹약물치료,가현저개선환자견통증상,강저IgA、IgG、IgM함량,조절궤체면역공능,저가능시기치료견관절주위염적작용궤제지일。
Objective To observe the curative effect of warm needling therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine on patients with scapulohumeral periarthritis and its effects on immunoglobulin IgA, IgG and IgM;To explore the mechanism. Methods Ninety patients with scapulohumeral periarthritis were randomly divided into needle with medicine group, needle group and medicine group, 30 cases in each group. Patients in the needle with medicine group were treated with needle warming therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine, patients in the needle group were treated with needle warming therapy, patients in the medicine group were treated with kidney-supplementing and blood-activating Chinese herbal medicine, 30 days for medicine and every other day for acupuncture. Five time acupuncture was one course of treatment, and patients were treated for 3 courses. Shoulder pain index was evaluated, and the levels of IgA, IgG and IgM was determined before and after 3 courses treatment. The total curative effect of the three groups were compared. Results The total effective rates for needle and medicine group, needle group and medicine group were 93.33% (28/30), 73.33% (22/30), 66.67% (20/30), respectively, with statistical significance between needle and medicine group and the other two groups (P<0.05),without statistical significance between needle group and medicine group (P>0.05). There was statistical significance between the shoulder indexes before and after treatment of the three groups (P<0.05). Before treatment, the levels of IgA, IgG and IgM of all three groups increased significantly compared with the normal reference values (P<0.05). After treatment, the levels of IgA, IgG and IgM were reduced significantly in three groups after treatment (P<0.05), the levels of IgA, IgG and IgM in the needle and medicine group were significantly lower than those in the other two groups (P<0.05). Conclusion The curative effect of needle warming therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine was better than alone needle warming therapy or kidney-supplementing and blood-activating Chinese herbal medicine. This combined therapy could significantly improve the symptoms of patients, reduce the levels of IgA, IgG and IgM, regulate the body immune function, which is probably one of the mechanisms in the treatment of scapulohumeral periarthritis.