Abstract:

Objective　The efficacy of floating needle therapy in treating patients with rheumatoid arthritis (RA) and its impact on the balance of Th17/Tregs in peripheral blood. Methods　A prospective study was conducted. The research subjects were 104 RA patients who received treatment at Xi'an Fifth Hospital from July 2022 to September 2023. They were divided into two groups using the random number table method, with 52 patients in each group. Control group: 13 males and 39 females, aged 40 to 70 (58.64 ± 3.90) years; received conventional anti-rheumatic drug treatment. Experimental group: 14 males and 38 females, aged 40 to 70 (58.76 ± 3.49) years. They were treated with floating needle therapy on the basis of the control group. Both groups were treated for one month. Compare the changes in TCM syndrome scores (joint swelling and pain, limb coldness and numbness, limited joint movement), 28-joint disease activity score (DAS-28), as well as the levels of peripheral blood Th17/Tregs and laboratory indicators [rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)]. Statistical methods employed t-test and χ² test. Results　After treatment, the total effective rate of the experimental group was higher than that of the control group [92.31% (48/52) vs. 76.92% (40/52)], and the difference was statistically significant (χ²=4.727, P=0.030). The scores of TCM syndromes related to joint swelling and pain, limb coldness and numbness, and limited joint movement in the experimental group, as well as the levels of serum CRP and ESR, were all lower than those in the control group, and the differences were statistically significant (all P<0.05). After the treatment, the DAS-28 score of the experimental group was lower than that of the control group [(3.05±0.78) points vs. (4.10±0.96) points], and the difference was statistically significant (t=6.121, P<0.05). There was no statistically significant difference in the ratio of Th17/Tregs between the two groups of peripheral blood (t=1.357, P>0.05). Conclusion　Floating needle therapy can enhance the clinical treatment effect of RA patients, reduce the TCM syndrome score, lower the levels of serum ESR, CRP and DAS-28 score, but it cannot regulate the balance of Th17/Tregs. When applying floating needle therapy for rheumatoid arthritis in clinical practice, it is necessary to combine with systemic anti-rheumatic treatment.

Key words: Rheumatoid arthritis, Helper T-lymphocytes, Regulatory T-lympho-cytes, Floating acupuncture therapy, Th17/Tregs

摘要： 目的　探讨浮针疗法在治疗类风湿关节炎（RA）患者中的效果，以及对外周血Th17/Tregs平衡的影响。方法　采用前瞻性研究。研究对象为2022年7月至2023年9月西安市第五医院接受治疗的104例RA患者，应用随机数字表法将其分为两组，每组52例。对照组：男13例、女39例，年龄40～70（58.64±3.90）岁；接受常规抗风湿药治疗。试验组：男14例，女38例，年龄40～70（58.76±3.49）岁，在对照组基础上予以浮针疗法治疗。两组均治疗1个月。对比治疗前后中医证候积分（关节胀痛、肢冷麻木、屈伸不利）、28处关节疾病活动度评分（DAS-28）变化，外周血Th17/Tregs及实验室指标［类风湿因子（RF）、血沉（ESR）、C反应蛋白（CRP）］水平改变。统计学方法采用t检验、χ²检验。结果　治疗后，试验组总有效率高于对照组［92.31%（48/52）比76.92%（40/52）］，差异有统计学意义（χ²=4.727，P=0.030）；试验组关节胀痛、肢冷麻木、屈伸不利中医证候积分，以及血清CRP、ESR水平均低于对照组，差异均有统计学意义（均P<0.05）。治疗后，试验组DAS-28评分低于对照组［（3.05±0.78）分比（4.10±0.96）分］，差异有统计学意义（t=6.121，P<0.05）；两组外周血Th17/Tregs比值差异无统计学意义（t=1.357，P>0.05）。结论　浮针疗法能够提高RA患者临床治疗效果，降低中医证候积分与DAS-28评分，下调血清ESR、CRP水平，但不能调节Th17/Tregs平衡，临床应用浮针治疗类风湿关节炎时需要配合系统抗风湿治疗。

关键词: 类风湿关节炎, 辅助性T淋巴细胞, 调节性T淋巴细胞, 浮针疗法