| Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease, mainly characterized by inflammation of the lining or synovium of the joints. In the early stage, it manifests symmetrical multiple arthritis, involving the cartilage, ligaments and tendons of the joints. It develops progressively, and may attack and relieve automatically. In the late stage, it may affect multiple tissues and organs of the whole body, and causes the joint to lose its shape, accompanied with different degrees of dysfunction or loss of movement. RA is known first in 1858 and is named in due form in 1922 by British Health Bureau. RA affects about 0.1%~2.0% of Chinese population, and is mainly seen in young and middle-aged people with age between 20 and 50 years. The proportion between male and female patients is about 1: 2~4. Concerning its pathogenesis, it remains unknown in modern medicine up to now, but may be associated with some pathogenic factors as immune, infection, heredity, environment and psychology. There have been no any specifically effective drugs for curing it nowadays. Therefore, the research on RA, a complicated disease, attracts great attention from the medical scientific workers and patients. The present paper reviews newest development about acupuncture treatment of RA and its clinical and experimental researches on the underlying mechanisms. In addition, the author terrifies the nomenclature of "Bizheng" , "Wangbi" , etc., in traditional Chinese medicine (TCM) and expounds their pathogenesis and the general state about acupuncture treatment of arthralgia-syndrome in Chinese ancient times. Moreover, this paper also reviews clinical application of needle-sticking therapy in detail. In regard to clinical research on RA, the present paper uses "the criteria for diagnosis of RA" modified by American College of Rheumatology (ACR) and "the standards for diagnosis of wind-cold-dampness type "Wangbi" from "The Criteria for Diagnosis of Syndromes of TCM and Evaluation of the Therapeutic Effect" promulgated by Chinese State Administration of TCM, and sums up the related results of clinical treatment of RA by using needle-sticking therapy. Concerning the selection of acupoints, we not only choose the acupoints according to syndrome-differentiation but also employ three-portion-acupoint selection method of the Governor Vessel, i.e., Dazhui (GV 14) to Zhiyang (GV 9) to Mingmen (GV 4) portions,and their corresponding Jiaji (EX-B 2) Points. The treatment is conducted 3 times every week, with 6 times being a therapeutic course. Following two courses of treatment, comparison between treatment group and conventional filiform needle group shows that: 1)Both needle-sticking and filiform needle have an apparent therapeutic effect in improving wind-cold-damp type RA, but the therapeutic effects of needle-sticking group are significantly superior to those of filiform needle group in ameliorating rheumatoid factor and the total score of symptoms, and reducing the number of pressure-pain joints (P<0.01), showing that needle-sticking can potentiate the stimulating quantity of acupuncture to cause the patient obtain stronger needling sensation in the topical region, and thus, may greatly facilitate the repair of the injured joint to achieve a better therapeutic effect. 2) Joint application of two types of criteria for diagnosis of RA and evaluation of its therapeutic effect of Western medicine and traditional Chinese medicine not only causes our RA patients recruited in the present paper to have a strict and definite diagnosis from the aspect of Western medicine but also corresponds to the characteristics of TCM about treatment and typing according to syndrome-differentiation. 3) In the treatment of wind-cold-damp type RA, we should pay more attention to the needling methods for dredging the Governor Vessel and invigorating yang, and adopt three-portion-acupoint-selection method of Governor Vessel in supplement with conventional acupoint-selection method. This is one of the key factors for achieving an ideal clinical... |
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