来源：风湿病与关节炎,2023,12（2）:7-10,30.

针刺治疗类风湿关节炎患者的临床疗效及对血小板相关参数的影响（临床研究）

柏林康¹，梁　慧¹，王文娟¹，朱　艳²

　　【摘　要】目的：观察针刺治疗类风湿关节炎患者的临床疗效及对血清中血小板相关参数［血小板计数（PLT）、血小板分布宽度（MPV）、平均血小板体积（PDW）、血小板压积（PCT）］的影响，探讨针刺治疗类风湿关节炎的可能作用机制。方法：将40例类风湿关节炎患者随机分为治疗组和对照组，每组20例。对照组予以口服来氟米特和塞来昔布治疗，治疗组在对照组的基础上加用针刺治疗。观察2组临床疗效，治疗前后类风湿因子（RF）、超敏C反应蛋白（hs-CRP）、红细胞沉降率（ESR）、DAS28评分及血清中PLT、MPV、PDW、PCT含量的变化。结果：治疗组临床治愈5例，显效7例，有效5例，无效3例，总有效率为85.00%；对照组临床治愈2例，显效2例，有效9例，无效7例，总有效率为65.00%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组RF、ESR、hs-CRP、DAS28评分、PLT、MPV、PDW、PCT较治疗前均明显降低（P < 0.01）；且治疗组RF、ESR、hs-CRP、DAS28评分、PLT、MPV、PCT较对照组改善更为明显（P < 0.05）。结论：针刺能够明显提高类风湿关节炎患者临床疗效，可能与其抑制血小板活化有关。

　　【关键词】　类风湿关节炎；针刺；血小板活化；随机对照试验

Effect of Acupuncture on the Clinical Efficacy of Rheumatoid Arthritis and the Platelet-related Parameters in Serum

BAI Lin-kang,LIANG Hui,WANG Wen-juan,ZHU Yan

　　【ABSTRACT】Objective:To observe the effect of acupuncture on the clinical efficacy of rheumatoid arthritis and the platelet related parameters in serum（PLT,MPV,PDW and PCT）,and to explore the possible mechanism of acupuncture in the treatment of rheumatoid arthritis.Methods:Forty patients with rheumatoid arthritis were randomly divided into a treatment group and a control group,with 20 cases in each group.The control group was treated with Leflunomide and Celecoxib,and the treatment group was treated with acupuncture based on the treatment as that in the control group,observing the clinical efficacy of both groups,and the changes of RF,ESR,hs-CRP,DAS28 score and the contents of PLT,MPV,PDW,PCT in serum before and after treatment.Results:In the treatment group,5 cases were clinically cured,7 cases were markedly effective,5 cases were effective,and 3 cases were ineffective,the total effective rate was 85.00%.In the control group,2 cases were clinically cured,2 cases were markedly effective,9 cases were effective,and 7 cases were ineffective,the total effective rate was 65.00%.The difference between the two groups was statistically significant（P < 0.05）.After treatment,RF,ESR,hs-CRP,DAS28 score,PLT,MPV,PDW and PCT of both groups were significantly lower than those before treatment（P < 0.01）.RF,ESR,hs-CRP,DAS28 score,PLT,MPV and PCT in the treatment group were significantly improved than those in the control group（P < 0.05）.Conclusion:Acupuncture can significantly improve the clinical efficacy of rheumatoid arthritis,which may be related to its inhibition of platelet activation.

　　【Keywords】 rheumatoid arthritis;acupuncture;platelet activation;randomized controlled study