【目的】 观察“东垣针法”指导下针刺配合西药治疗类风湿关节炎（RA）伴轻度贫血的临床疗效。【方法】 选取 2024年 2 月至2024年9月广州中医药大学第一附属医院重庆医院风湿病科病房及门诊收治的80例明确诊断为气血两虚证RA轻度贫 血的患者为研究对象。按随机数字表将患者随机分为观察组和对照组，每组各40例。对照组给予西药常规治疗，观察组在 对照组治疗的基础上，给予“东垣针法”指导下的针刺治疗。连续治疗 4周。治疗 1个月后，评价 2组临床疗效，观察 2组 患者治疗前后中医证候积分和疼痛视觉模拟量表（VAS）评分的变化情况，以及疾病活动度评分（DAS-28）的情况，比较 2组 患者治疗前后类风湿因子（RF）、C反应蛋白（CRP）、血沉（ESR）、红细胞计数（RBC）、血红蛋白（Hb）水平的变化情况，并评 价2组的安全性及不良反应的发生情况。【结果】（1）治疗后，观察组患者的中医证候积分明显改善（P < 0.05），且观察组在改 善患者的中医证候积分方面明显优于对照组，差异有统计学意义（P < 0.05）。（2）治疗后，2组患者的VAS评分和DAS-28评分 均明显改善（P < 0.05），且观察组在改善 VAS评分和 DAS-28评分方面均明显优于对照组，差异均有统计学意义（P < 0.05）。 （3）治疗后，2组患者的RF、CRP、ESR水平均有明显改善（P < 0.05），且观察组在改善RF、CRP、ESR水平方面均明显优于 对照组，差异均有统计学意义（P < 0.05）；治疗后，观察组RBC水平有明显改善（P < 0.05），但与对照组比较，差异无统计学 意义（P > 0.05）；治疗后，2组患者的Hb水平有明显改善（P < 0.05），且观察组在改善Hb水平方面明显优于对照组，差异有 统计学意义（P < 0.05）。（4）观察组总有效率为95.00%（38/40），对照组为87.50%（35/40）；组间比较（秩和检验），观察组的疗 效明显优于对照组，差异有统计学意义（P < 0.05）。（5）观察组不良反应发生率为 7.50%（3/40），对照组为 27.50（11/40），组间 比较，观察组的不良反应发生率明显低于对照组，差异有统计学意义（P < 0.05）。【结论】 在“东垣针法”的指导下，采用 针刺与西药相结合治疗类风湿关节炎（RA）伴轻度贫血，不仅能实现针药互补，提高临床疗效，降低炎症因子水平，显著缓 解患者的关节症状，还能提高血细胞水平，改善患者的贫血状态，且不良反应较少，从而提高患者生活质量，疗效显著。

Objective To observe the clinical efficacy of acupuncture combined with western medicine in the treatment of rheumatoid arthritis（RA）complicated with mild anemia under the guidance of“Dongyuan acupuncture”. Methods A total of 80 cases of patients definitively diagnosed as RA complicated with mild anemia of deficiency of qi and blood were selected and randomly divided into the observation group and the control group according to the random number table method，those who were admitted to the wards and outpatient clinics of the Department. of Rheumatology，Chongqing Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine from February 2024 to September 2024，with 40 cases in each group. The control group was given conventional treatment with western medicines，while the observation group was additionally treated with acupuncture under the guidance of “Dongguan acupuncture”. The course of treatment covered four consecutive weeks. After one month of treatment， the clinical efficacy of the two groups was evaluated， and the changes in traditional Chinese medicine（TCM）syndrome scores and Visual Analogue Scale（VAS）of pain scores，as well as Disease Activity Scores（DAS-28）before and after treatment were observed in the two groups. The changes of rheumatoid factor （RF），C-reactive protein（CRP），erythrocyte sedimentation rate（ESR），red blood cell count（RBC），and hemoglobin（Hb）levels before and after treatment were compared between the two groups. The safety and incidence of adverse reactions in the two groups were also evaluated. Results（1）After treatment，the TCM syndrome scores of the patients in the observation group were improved significantly（P < 0.05）， and the improvement in the observation group was significantly superior to that in the control group， the difference being statistically significant（P < 0.05）.（2）After treatment，the VAS scores and DAS-28 scores of the patients in the two groups were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（3）After treatment，the RF， CRP，and ESR levels of patients in the two groups were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）；after treatment，there was a significant improvement in the RBC level of the observation group（P < 0.05），but the difference was not statistically significant when compared with the control group（P > 0.05）；after treatment，the Hb level of patients in the two groups were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（4）The total effective rate was 95.00%（38/40）in the observation group and 87.50%（35/40）in the control group，and the efficacy of the observation group was superior to that of the control group，the difference being statistically significant（P < 0.05）.（5）The incidence of adverse reactions was 7.50% （3/40）in the observation group and 27.50%（11/40）in the control group，the incidence of adverse reactions in the observation group was significantly lower than that in the control group， the difference being statistically significant （P < 0.05）. Conclusion Under the guidance of “Dongyuan acupuncture”， the application of acupuncture combined with western medicine in the treatment of RA complicated with mild anemia can not only realize the complementarity of acupuncture and medicine， improve the clinical efficacy， reduce the level of inflammatory factors，and significantly alleviate the joint symptoms of the patients，but also increase the level of blood cells，improve the anemia condition of the patients and have fewer adverse reactions，thus enhancing their quality of life.

R246.9

重庆市北碚区2024年川渝科技合作项目（编号：2024cykjhz-22）