来源：风湿病与关节炎,2020,9（1）:17-20.

中医微创针刀镜联合常规西药治疗早期类风湿关节炎膝关节滑膜炎100例临床观察（临床研究）

王笑青¹，李满意²，张依山¹，周子朋³，胡攸水¹

　　【摘　要】目的：观察中医微创针刀镜联合常规西药治疗早期类风湿关节炎膝关节滑膜炎的临床疗效。方法：将200例类风湿关节炎早期患者随机分为治疗组和对照组，每组100例。治疗组行膝关节中医微创针刀镜滑膜切除术后，口服美洛昔康、甲氨蝶呤治疗；对照组仅口服美洛昔康、甲氨蝶呤治疗。2组疗程均为24周。治疗前后对2组患者进行临床评估和影像评估。结果：治疗组显效49例，有效38例，无效13例，总有效率为87.00%；对照组显效24例，有效20例，无效56例，总有效率为44.00%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组MRI检测情况比较，治疗组较对照组明显好转（P < 0.05）。结论：中医微创针刀镜切除早期类风湿关节炎膝关节病变滑膜，后续配合美洛昔康、甲氨蝶呤治疗可有效减轻患者的临床症状，值得临床推广。

　　【关键词】　关节炎，类风湿；早期；膝关节滑膜炎；中医微创；针刀镜

Clinical Observation on 100 Cases of Knee Synovitis in Early Rheumatoid Arthritis Treated by Minimally Invasive Acupotomology Combined with Conventional Western Medicine

WANG Xiao-qing,LI Man-yi,ZHANG Yi-shan,ZHOU Zi-peng,HU You-shui

　　【ABSTRACT】Objective:To observe the clinical effect of minimally invasive acupotomy combined with conventional western medicine in the treatment of knee synovitis in early rheumatoid arthritis.Methods:Two hundred patients with early rheumatoid arthritis were randomly divided into a treatment group and a control group,100 cases in each group.In the treatment group,meloxicam and methotrexate were taken orally after the knee joint synovectomy with minimally invasive needle scalpel;in the control group,only meloxicam and methotrexate were given.Both groups were treated for 24 weeks.Before and after treatment,clinical and imaging evaluations were done for the two groups.Results:In the treatment group,49 cases were markedly effective,38 cases were effective,13 cases were ineffective,and the total effective rate was 87.00%;while in the control group,24 cases were markedly effective,20 cases were effective,56 cases were ineffective,and the total effective rate was 44.00%.The difference between the two groups was statistically significant（P < 0.05）.After treatment,the MRI detection of the two groups showed that the treatment group was better than the control group（P < 0.05）.Conclusion:Treating knee synovitis with acupotomoscope together with methotrexate and meloxicam can effectively reduce the clinical symptoms of patients,worthy of clinical promotion.

　　【Keywords】 arthritis,rheumatoid;early stage;knee synovitis;minimally invasive surgery in TCM;acupotomoscope