刘怀省++韩文朝++栾淇景++刘殿选

【摘 要】目的：观察酉时隔花椒饼督灸对中老年类风湿关节炎患者疼痛的影响。方法：将80例中老年类风湿关节炎患者按照随机数字表法分为治疗组和对照组，每组40例。对照组给予塞来昔布胶囊口服治疗，治疗组在对照组的基础上给予酉时隔花椒饼督灸治疗。2组均治疗3周。观察2组治疗前后关节压痛数、疼痛持续时间及疼痛视觉模拟评分法（VAS）评分。结果：治疗后，2组患者关节压痛數、疼痛持续时间及疼痛VAS评分较治疗前均降低（P < 0.05）；且治疗组优于对照组（P < 0.05）。结论：酉时隔花椒饼督灸可有效缓解中老年类风湿关节炎患者的疼痛，值得临床应用。

【关键词】 关节炎，类风湿；隔花椒饼督灸；疼痛；子午流注

Effect of Pepper-cake Separated Du-moxibustion from 5：00 p.m.to 7：00 p.m on Pain in Elderly Patients with Rheumatoid Arthritis

LIU Huai-sheng，HAN Wen-chao，LUAN Qi-jing，LIU Dian-xuan

【ABSTRACT】Objective：To observe the effect of pepper-cake separated Du-moxibustion from 5：00 p.m.to 7：00 p.m on pain in elderly patients with rheumatoid arthritis.Methods：Eighty middle-aged and elderly patients with rheumatoid arthritis were randomly divided into a treatment group and a control group，40 cases in each group.The control group was orally given Celecoxib Capsules，while the treatment group was given pepper-cake separated Du-moxibustion based on the treatment for the control group.Both groups were treated for three weeks.The tender joint count，the time of joint pain and the visual analogue scale（VAS）score of two groups were observed and evaluated.Results：After treatment，the tender joint count，pain duration and VAS score were lower

than those before treatment（P < 0.05），and the treatment group was better than the control group（P < 0.05）.Conclusion：Pepper-cake separated Du-moxibustion from 5：00 p.m.to 7：00 p.m can effectively relieve the pain in the middle-aged and elderly patients with rheumatoid arthritis，worthy of clinical application.

【Keywords】 arthritis，rheumatoid；pepper-cake separated Du-moxibustion；pain；midnight-noon and ebb-flow doctrine

类风湿关节炎（rheumatoid arthritis，RA）是一种全身性慢性炎症性疾病，病因尚未完全明确，临床上主要表现为慢性、对称性的多关节滑膜炎和关节外病变[1]，最常累及近端指间关节和掌指关节，腕关节、足关节及膝关节也较常见，并且具有容易反复、病程长和致残率高的特点，女性发病率高于男性。目前尚无特效治疗药物及方法，西医主要是运用改善病情抗风湿药、非甾体抗炎药及糖皮质激素治疗，具有一定的效果，但是长时间运用会产生较严重的毒副作用[2]。中医药治疗RA毒副作用较小，主要是辨证运用清热通络、补益肝肾、化痰祛瘀、祛风除湿等药物治疗，但是中药汤剂需服用较长时间，患者难以坚持。由于本病病程较长且容易反复，很多患者常常会选择在社区进行治疗[3]，所以，探索一种操作简便、经济有效的治疗方法具有重大的意义。笔者运用酉时隔花椒饼督灸对中老年RA患者进行为期3周的治疗观察，对患者的疼痛症状有较好的缓解作用，现总结报告如下。……