摘要
目的:分析近10年来外治疗法治疗类风湿关节炎的研究进展。资料来源:通过计算机检索中国期刊全文数据库1996-01/2006-01与类风湿关节炎的外治疗法的相关文章,限定文章语言种类为中文,检索词“类风湿关节炎,外治疗法”,同时手工查找近年出版的中文相关著作。资料选择:对资料进行初审,选择有关类风湿关节炎外治的文献中包括针灸、中药薰蒸、药浴、穴位注射等73篇。纳入标准:①类风湿关节炎的中医外治疗法(包括针灸、中药薰蒸、穴位注射等)。②类风湿关节炎的物理疗法(包括矿泉浴、激光照射等),排除标准:综述文献,重复研究,重复临床报道的文献。资料提炼:在73篇文献中33篇内容有不同程度的重复,给予删除,对40篇文献进行分类整理,纳入其中23篇参考文献。选取包括针灸、中药薰蒸、药浴、敷贴疗法、矿泉浴、穴位注射、中药离子导入、经穴埋线、激光穴位照射、刮痧等10种外治法治疗类风湿关节炎的文献研究。资料综合:总结多种外治法在类风湿关节炎治疗中的应用。针灸疗法:温针灸配合抗风湿药治疗类风湿关节炎有效,电针可以恢复类风湿关节炎发病后的免疫失稳,火针治疗可改善类风湿患者的甲皱微循环,艾灸具有温散寒邪、温通经络、活血逐痹等作用;中药薰蒸能改善局部血液循环,清除关节炎症介质,改善关节功能;药浴集水浴疗法和药物疗法于一体,用温热的中药煎液洗浴以治疗疾病;中药敷贴是将中药熬膏或研末调和敷贴于一定部位,使药物有效成份渗入皮肤肉理而治疗疾病;矿泉浴通过矿泉水对人体的特异性和非特异性作用,起到按摩、收敛、消肿和止痛的作用;穴位注射是通过将药物注入有关穴位治疗疾病;中药离子导入是将中药离子通过脉冲电疗仪的脉冲电流导入病变部位;经穴埋线利用埋入穴位内的羊肠线在吸收过程中对穴位的持续刺激作用以治疗疾病;激光穴位照射利用激光的热、光化学、电磁效应直接刺激经络穴位来治疗疾病;刮痧能通过刺激络脉,达到调节机体功能、恢复生理状态、治疗类风湿关节炎的目的。结论:外治疗法治疗类风湿关节炎,方法较多,为提高疗效,降低致残率,可在全身用药的基础上,根据个体情况,采用一种或多种外治疗法综合治疗;对局部关节疼痛较明显、痛点较局限固定的患者,则可采用以外治法为主,配合全身用药。
OBJECTIVE： To analyze the research developments of the extrinsic therapies treating patients with rheumatoid arthritis （RA） in recent 10 Years.
DATA SOURCES： Relative articles about the extrinsic therapies of RA published from January 1996 to January 2006 were searched in Chinese Journals Full-text Database in Chinese, with the key words of ＂Rheumatoid Arthritis, extrinsic therapies＂. And the related Chinese literatures published recently were manually found out.
STUDY SELECTION： After rough selection, 73 articles about the extrinsic therapies of RA were chosen, including acupuncture, traditional Chinese medicine （TCM） suffocation, medicated bath and acupoint injection, etc. Inclusion standard： ①TCM external therapies of RA （including acupuncture, TCM suffocation, acupoint injection, etc.）; ②physical therapies of RA （including mineral bath, laser irradiation, etc.）. Exclusion standard： reviews, repetitive researches or repeatedly reported literature.
DATA EXTRACTION： Among 73 selected articles, 33 repeated articles were deleted. And the left 40 ones were classified and summarized to cite 23 references. The articles about more than ten methods of external therapies for RA were included, such as acupuncture, TCM suffocation, medicated bath, external application therapy, mineral bath, acupoint injection, TCM iron intervention, acupoint catgut embedding, laser irradiation, scraping, etc.
DATA SYNTHESIS： The applications of various extrinsic therapies for RA were summarized. Acupuncture： Warming acupuncture and antirheumatic medication have a combined effect in the treatment of RA, and the electro-acupuncture can recover the unstable immunity of RA patients after episode while heat needles improve the nailfold microcirculation. In addition, moxibustion is effective on warming meridian to dredge collaterals and promoting blood circulation to remove palsy; TCM suffocation can improve the local blood circulation, clear the inflammatory medium of joints and meliorate the joint function; Medicated bath convenes water bath with drug therapy, and the warm decoction is suitable; TCM external application therapy means to compress TCM paste and power on certain position in order to penetrate the effective components into skin; Mineral bath make impacts on massage, restrain, repercussion and acesodyne by the specificity and non-specificity of mineral water on human body; Acupoint injection is to treat diseases with the injections on some acupoints; TCM iron intervention can introduce the TCM iron into the lesion locus by the current of impulse electro-therapeutic apparatus; Acupoint catgut embedding is referring to apply the embedded caprine oatgut to perform continuous stimulation on acupoints during the absorption; Laser irradiation makes Used of the heat, photochemical and electromagnetic effects of laser irradiation to stimulate directly the meridian acupoints; Scraping aims to regulate the functions, recover the physical status and treat RA through stimulating collateral branch of the large channel.
CONCLUSION： The extrinsic therapies of RA are various. In order to in-crease the curative effect and decrease the deformity rate, single or systemic medications are preferred on basis of wholly medication; And the extrinsic therapies can be an assistant treatment of the patients accompanied with obvious and fixed pain in local joint.
出处
《中国临床康复》
CSCD
北大核心
2006年第27期116-118,共3页
Chinese Journal of Clinical Rehabilitation
