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目的:研究针刺疗法联合塞来昔布对老年类风湿性关节炎患者的临床疗效及其对患者血清基质金属蛋白酶-3(MMP-3)、白细胞介素-6(IL-6)及自身抗体水平的影响。方法:选取2014年10月至2015年9月本院收治的86例类风湿性关节炎患者,随机分为观察组(43例)和对照组(43例)。对照组使用塞来昔布胶囊治疗,观察组在对照组基础上联合针刺疗法。分析和比较两组患者临床疗效、治疗前后20 m步行时间、晨僵时间、关节压痛数、治疗前后MMP-3、IL-6及自身抗体水平的变化。结果:观察组总有效率显著高于对照组[90.70%(39/43)比65.12%(28/43)](P<0.05)。治疗后,两组患者20m步行时间、晨僵时间、关节压痛数均较治疗前显著降低或缩短,其中观察组明显低于或短于对照组(P<0.05)。治疗后,两组患者血清MMP-3、IL-6水平较治疗前显著降低,其中观察组显著低于对照组(P<0.05)。治疗后,两组患者AFA、抗-CCP抗体、抗Sa抗体、AKA、ANA自身抗体阳性率较治疗前显著降低,其中观察组显著低于对照组(P<0.05)。结论:针刺疗法联合塞来昔布治疗老年类风湿性关节炎的临床疗效良好,能有效降低患者血清MMP-3、IL-6水平及自身抗体阳性率。
Objective: To study the clinical effects of acupuncture plus celecoxib on senile patients with rheumatoid arthritis and its effect on serum levels of matrix metalloproteinase-3 (MMP-3), interleukin-6 (IL-6) The effect of antibody levels. Methods: A total of 86 rheumatoid arthritis patients admitted to our hospital from October 2014 to September 2015 were randomly divided into observation group (43 cases) and control group (43 cases). The control group was treated with celecoxib capsules. The observation group was combined with acupuncture on the basis of the control group. The clinical curative effect, the walking time of 20 m before and after treatment, morning stiffness, joint tenderness, the levels of MMP-3, IL-6 and autoantibodies before and after treatment were analyzed and compared. Results: The total effective rate in the observation group was significantly higher than that in the control group [90.70% (39/43) vs 65.12% (28/43)] (P <0.05). After treatment, the walking time, morning stiffness time and joint tenderness in both groups were significantly decreased or shortened compared with that before treatment, and the observation group was significantly lower or shorter than the control group (P <0.05). After treatment, the levels of serum MMP-3 and IL-6 in the two groups were significantly lower than those before treatment, and the observation group was significantly lower than the control group (P <0.05). After treatment, the positive rates of AFA, anti-CCP antibody, anti-Sa antibody, AKA and ANA autoantibodies in both groups were significantly lower than those before treatment, and the observation group was significantly lower than the control group (P <0.05). Conclusion: Acupuncture combined with celecoxib has good clinical curative effect on senile rheumatoid arthritis, which can effectively reduce the level of serum MMP-3, IL-6 and the positive rate of autoantibodies.