摘要
目的:基于多准则决策模型评价穴位离子导入及中药敷贴联合关节训练的中医综合外治法治疗风湿性关节炎(rheumatoid arthritis,RA)的效益-风险。方法:将160例RA患者按照随机数字表法分为观察组和对照组各80例。对照组口服倍他米松,观察组在对照组基础上予穴位离子导入及中药敷贴联合关节训练的中医综合外治法。比较两组患者治疗前后中医症候积分、临床体征指标、血清免疫功能指标、外周血象指标变化情况以及临床疗效、不良反应发生情况;建立中医综合外治法治疗RA的多准则决策模型,比较两组患者效益指标和风险指标效应值。结果:治疗后观察组畏寒、关节肿胀、晨僵、关节疼痛积分均低于对照组(P<0.05);观察组双手握力高于对照组(P<0.05),关节压痛指数、晨僵时间、关节肿胀个数均低于对照组(P<0.05);观察组患者免疫功能及外周血象相关指标水平均低于对照组(P<0.05);观察组总有效率[86.25%(69/80)]高于对照组[62.50%(50/80)](P<0.05),不良反应发生率[3.75%(3/80)]低于对照组[13.75%(11/80)](P<0.05)。与对照组相比,观察组治疗效益高、风险低,观察组及对照组的效益-风险总值分别为78、66,且观察组优于对照组,多准则决策评价模型稳定性较好。结论:与传统西医相比,穴位离子导入及中药敷贴联合关节训练组成的中医综合外治法治疗RA的获益高于风险,可用于临床治疗RA。临床上中医综合外治法治疗RA的效益-风险可能优于传统西医治疗。
Objective:To assess the risk-benefit of rheumatoid arthritis(RA)treated with TCM comprehensive external treatment including acupoint iontophoresis,herbal application and joint training based on multi-criteria decision making.Methods:A total of 160 RA patients were allocated to the observation group and the control group according to random number table method with 80 cases in each group.The control group took betamethasone orally,and the observation group accepted TCM comprehensive external treatment including acupoint iontophoresis,herbal application and joint training.To compare TCM syndrome integrals,the indexes of clinical body signs,serum immune function indexes,the changes in peripheral blood parameters,clinical effects and the incidences of adverse reaction before and after the treatment between the two groups;a multi-criteria decision making model of integrated external treatment for RA was established,and the effect values of benefit indicators and risk indicators were compared between the two groups.Results:After the treatment,the observation group was lower than the control group in aversion to cold,joint swelling,morning stiffness and joint pain scores(P<0.05);the observation group was higher than the control group in hand grip strength(P<0.05),lower than the control group in joint tenderness indexes,morning stiffness and the number of swollen joints(P<0.05);serum immune function indexes and the changes in peripheral blood parameters of the observation group were lower than these of the control group(P<0.05);total effective rate of the observation group was[86.25%(69/80)],higher than[62.50%(50/80)]of the control group(P<0.05),and the incidence of adverse reaction of the observation group was[3.75%(3/80)],lower than[13.75%(11/80)]of the control group.Compared with the control group,the observation group presents high therapeutic efficiency and low risk,total risk-benefit values of the observation group and the control group were 78 and 66 respectively,and the observation group was better than the control group,and the multi-criteria decision making model showed better stability.Conclusion:Compared with traditional Western medicine,the benefits of TCM comprehensive external treatment including acupoint iontophoresis,herbal application and joint training are higher than the risks in the treatment of RA,hence,it could be applied in clinical treatment of RA.Risk-benefit of TCM comprehensive external treatment in clinic might be better than that of traditional Western medicine.
作者
索秋实
狄舒男
宋成杰
彭宇飞
SUO Qiushi;DI Shunan;SONG Chengjie;PENG Yufei(First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China;Daqing Hospital of TCM,Daqing 163000,China)
出处
《西部中医药》
2025年第6期154-160,共7页
Western Journal of Traditional Chinese Medicine
关键词
风湿性关节炎
穴位离子导入
中药敷贴
关节训练
中医综合外治法
rheumatoid arthritis
acupoint iontophoresis
herbal application
joint training
TCM comprehensive external treatment
