王滔 柳玉佳 吴伊莹 皮桂芳

〔摘要〕 目的 采用改良中藥竹罐疗法对寒湿痹阻型类风湿关节炎关节疼痛患者进行干预，观察其临床疗效。方法 选取类风湿关节炎寒湿痹阻型患者72名，按照随机数字表法分为对照组和观察组，各36例。对照组采用常规治疗、护理和中医定向透药的方法，观察组采用常规治疗、护理和改良中药竹罐的方法。每日1次，5 d为1个疗程，两组均治疗两个疗程。两组均采用患者关节疼痛视觉模拟评分法（VAS）评估两组患者关节疼痛程度、采用疾病活动性评分系统（DAS28）评价病情活动度、采用健康评估问卷（HAQ）评估生活质量改善情况，炎症指标红细胞沉降率（ESR）、C反应蛋白（CRP）来评估炎症改善情况。结果 治疗后两组VAS 评分、 DAS28评分、HAQ 指数、ESR、CRP均较本组治疗前降低（P<0.05 ），且治疗后观察组均明显低于对照组（P<0.05）。结论 改良中药竹罐治疗寒湿痹阻型类风湿关节炎关节疼痛，可以明显改善类风湿关节炎患者关节疼痛症状，减轻其炎症反应，改善关节功能，恢复或增强身体功能活动，提高患者生存质量。

〔关键词〕 类风湿关节炎;疼痛;寒湿痹阻;改良中药竹罐

〔中图分类号〕R259       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.10.030

Clinical Observation of Modified Traditional Chinese Medicine Bamboo Pot in the Treatment of Joint Pain of Rheumatoid Arthritis with Cold Dampness Obstruction

WANG Tao， LIU Yujia， WU Yiying， PI Guifang*

（The First Affiliated Hospital of Hunan University of Chinese Medicine， Changsha， Hunan 410007， China）

〔Abstract〕 Objective To use the modified traditional Chinese medicine bamboo pot therapy to intervene the patients with joint pain of rheumatoid arthritis with cold dampness obstruction， and to observe the clinical effect. Methods 72 patients with rheumatoid arthritis with cold dampness obstruction were selected and divided into control group and observation group according to random number table method， with 36 cases in each group. The control group patients were treated with routine treatment， nursing and traditional Chinese medicine directed penetration. The observation group patients were treated with routine treatment， nursing and modified traditional Chinese medicine bamboo pot method once a day for 5 days， The treatment time was two courses. The patients joint pain degree was evaluated by visual analog scale （VAS）， disease activity score in 28 joints （DAS28） was used to evaluate the activity of disease， the quality of life improvement was evaluated by the health assessment questionnaire （HAQ）， and the inflammatory indicators erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） were used to evaluate the improvement of inflammation. Results VAS score， DAS28 score， HAQ index， ESR and CRP were lower in the two groups than before treatment （P<0.05）， and the observation group was significantly lower than that of the control group （P<0.05）. Conclusion By using the modified traditional Chinese medicine bamboo pot to treat the joint pain of rheumatoid arthritis patients with cold dampness obstruction， it can significantly improve the joint pain symptoms of rheumatoid arthritis patients， reduce their inflammatory response， improve joint function， restore or enhance physical functional activities， and improve the quality of life of patients.

〔Keywords〕 rheumatoid arthritis; pain; cold dampness obstruction; modified traditional Chinese medicine bamboo pot

类风湿关节炎（rheumatoid arthritis， RA）是一种慢性、对称性、侵蚀性以关节滑膜炎症为主的自身免疫性疾病[1]。该病病程长且病情反复，可引起关节软骨和骨质破坏，导致关节功能障碍甚至畸形，被称为“不死的癌症”[2]，严重降低患者活动功能和生活质量。本病以女性多发，男女患病比例约1∶3[3]。笔者参加2018年全国中医护理骨干人才游学，在广西中医药大学附属瑞康医院学习到壮医药物竹罐疗法，壮医药物竹罐疗法具有温经散寒，活血祛瘀，通龙路、火路的作用。结合专科特点将竹罐疗法进行改良后，运用于我科寒湿痹阻型类风湿关节炎关节疼痛患者，探索治疗和缓解类风湿关节炎患者关节疼痛的更有效、更实用的治疗方法，现将方法与结果报道如下。……