研究独活寄生汤联合针灸治疗对类风湿性关节炎患者红细胞沉降率、C-反应蛋白及关节功能的影响。

本研究为前瞻性研究，选择2018年3月至2021年3月在海安市中医院进行诊治的类风湿关节炎患者188例，采用随机数字表法分为观察组和对照组，各94例。对照组采用口服基础药物加针灸进行治疗，观察组在对照组的基础上联合应用独活寄生汤。比较2组治疗前后的中医症状评分（冷痛、肿胀与屈伸不利、压痛）、压痛与肿胀关节数量、疼痛视觉模拟评分（VAS）、外周血红细胞沉降率及C-反应蛋水平。

2组治疗前的中医评分（冷痛、肿胀与屈伸不利、压痛）、压痛与肿胀关节数量、VAS、外周血红细胞沉降率、C-反应蛋白水平差异无统计学意义（P＞0.05）。与对照组治疗后相比，观察组治疗后的膝关节冷痛［（0.35±0.08）分vs（0.97±0.26）分，P＜0.001］、肿胀与屈伸不利［（0.41±0.12）分vs（1.03±0.28）分，P＜0.001）］、压痛评分［（0.38±0.10）分vs（0.92±0.24）分，P＜0.001）］显著降低；压痛关节数量［（5.78±1.09）个vs（9.83±1.42）个，P=0.005）］、肿胀关节数量［（4.08±1.35）个vs（6.13±1.74）个，P=0.010）］明显减少；VAS评分［（2.39±0.46）分vs（3.78±0.71）分，P=0.031）］、外周血红细胞沉降率［（24.27±3.14）mm/h vs（35.42±4.76）mm/h，P=0.016）］，C-反应蛋白水平［（9.83±1.23）mg/L vs（17.49±3.20）mg/L，P＜0.001）］显著降低。观察组治疗总有效率为93.62%，显著高于对照组的74.47%，差异有统计学意义（P=0.013）。

采用独活寄生汤联合针灸治疗类风湿性关节炎可显著改善患者膝关节的疼痛、肿胀和压痛，降低外周血红细胞沉降率和C-反应蛋白水平，有助于缓解类风湿病情，促进关节功能恢复，疗效优于单纯针灸治疗。

To investigate the effects of Duhuo Jisheng decoction combined with acupuncture on erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and joint function in patients with rheumatoid knee arthritis.

This study was a prospective study. One hundred and eighty-eight patients with rheumatoid arthritis treated at Hai'an Traditional Chinese Medicine Hospital from March 2018 to March 2021 were randomly divided into an observation group and a control group, with 94 cases in each group. Both groups were treated with oral basic drugs and acupuncture, and the observation group was additionally treated with Duhuo Jisheng decoction. Traditional Chinese medicine (TCM) symptom scores (pain, swelling, and tenderness), the number of joints with tenderness and swelling, visual analog scale (VAS) score, and peripheral blood ESR and CRP levels were compared between the two groups before and after treatment.

Before treatment, there were no differences in the TCM scores (knee pain, swelling, and tenderness), the number of joints with tenderness and swelling, VAS score, peripheral blood ESR, or CRP levels between the two groups (P＞0.05). Compared with the control group after treatment, the TCM scores of knee joint pain (0.35±0.08 vs 0.97±0.26, P＜0.001), swelling (0.41±0.12 vs 1.03±0.28, P＜0.001), and tenderness (0.38±0.10 vs 0.92±0.24, P＜0.001); the number of joints with tenderness joints (5.78±1.09 vs 9.83±1.42, P=0.005) and swelling (4.08±1.35 vs 6.13±1.74, P=0.010); VAS score (2.39±0.46 vs 3.78±0.71, P=0.031); and peripheral blood ESR [(24.27±3.14) mm/h vs (35.42±4.76) mm/h, P=0.016] and CRP levels [(9.83±1.23) mg/L vs (17.49±3.20) mg/L, P＜0.001] of the observation group decreased significantly. The total effective rate of the observation group was 93.62%, which was significantly higher than 74.47% of the control group (P=0.013).

Duhuo Jisheng decoction combined with acupuncture in the treatment of rheumatoid arthritis can significantly relieve the pain, swelling, and tenderness of knee joints, and reduce ESR and CRP levels in peripheral blood, which helps to alleviate the condition of rheumatoid arthritis and promote the recovery of joint function. The therapeutic effect of this combination therapy is better than that of simple acupuncture.