银质针配合舒筋通络中药序贯疗法对顽固性关节疼痛及生存质量的评价(1)
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【摘要】 目的 观察热银质针物理因子序贯疗法对类风湿关节炎(rheumatoid arthritis,RA)、强直性脊柱炎(ankylosing spondylitis,AS)患者顽固性关节疼痛及生存质量的影响。方法 将RA、AS伴有顽固性关节疼痛的患者随机分为对照组和热银质针组,每组169例。对照组采用中成药口服配合功能训练治疗;热银质针组采用热银质针、中成药口服配合功能训练、心理康复治疗。2组治疗前后均采用视觉模拟评分法(visual analogue scale,VAS)评定疼痛程度,并采用SF-36量表评定生存质量。结果 热银质针组疼痛程度评分及生存质量评分明显改善,长期随访疗效稳定,与对照组比较差异有统计学意义(P<0.05,P<0.01)。结论 热银质针物理因子序贯疗法可明显改善RA和AS患者顽固性关节疼痛程度及生存质量,且远期疗效稳定。
【关键词】 银质针;类风湿关节炎;强直性脊柱炎;疼痛;生存质量
【Abstract】 Objective To observe the effect of thermal silver needle and sequential physical factors therapy on obstinate joint pain and qualify of life in patients with rheumatoid arthritis(RA)and ankylosing spondylitis(AS).Methods 338 patients with RA or AS complicated with obstinate joint pain were randomly divided into control group and thermal silver needle group,with 169 cases in each group.The control group was treated with oral Chinese patent medicine and function training.The thermal silver needle group was treated with thermal silver needle,oral Chinese patent medicine,function training and psychological rehabilitation.Pain was measured by visual analog scale(VAS)and quality of life was assessed by SF-36 scale before and after treatment.Results The scores of pain and life quality were significantly improved in the thermal silver needle group with stable efficacy on long-term follow up,which were obviously higher than that in the control group(P<0.05,P<0.01).Conclusion Thermal silver needle and sequential physical factors therapy has better effects on obstinate joint pain and qualify of life in patients with rheumatoid arthritis(RA)and ankylosing spondylitis(AS)and long term effect is stable.
【Key words】 Silver needle;Rheumatoid arthritis;Ankylosing spondylitis;Pain;Quality of life
风湿类疾病是以关节病变为主要表现的慢性自身免疫性疾病,反复发作,多数患者终生残疾,尤其类风湿关节炎(rheumatoid arthritis,RA)、强直性脊柱炎(ankylosing spondylitis,AS),其病理改变为滑膜炎,关节滑膜异常增生形成绒毛突入关节腔,对关节软骨、软骨下骨、韧带、肌腱等组织进行性侵蚀,从而引起关节软骨、骨和关节囊破坏,最终导致关节畸形、功能丧失、顽固性关节肿痛,严重影响生活质量。本文旨在探讨热银质针配合舒筋通络中药序贯疗法对顽固性关节疼痛和生存质量的影响,现报告如下。
1资料与方法
1.1一般资料选取1997-08—2008-06在门诊就诊和住院治疗的RA、AS伴有顽固性关节疼痛患者338例,均经X线摄片、血沉、类风湿因子、C反应蛋白、抗链“O”、血常规、心电图检查,如:①安静时心电图有ST段下移或T波倒置。②缺血型ST段下移出现典型心绞痛频繁发作。③缺血型ST段下移见于多个导联(5个)。④PTFV1≥-0.04 mmos。⑤严重心律失常。具备其中一项以上条件者应先内科治疗改善后,再进行施治。剔除骨折、结核、肿瘤等所致疼痛。将338例患者随机分组,对照组169例,男性61例,女性108例;年龄16～73岁;病程6个月～38年。热银质针组169例,男性67例,女性102例;年龄19～75岁;病程6个月～36年。2组患者性别、年龄、病种、病程等方面差异无统计学意义(P>0 ......
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