强直性脊柱炎中医治疗护理研究进展

A review on TCM treatment and nursing of ankylosing spondylitis

强直性脊柱炎(Ankylosing Spondylitis,AS)是一种好发于青壮年人群的慢性炎症性自身免疫病,患病率为0.1%~1.6%。其主要侵犯骶髂关节、脊柱关节,并可累及外周关节、肌腱韧带附着点及其他组织,主要表现为腰背痛和晨僵,中晚期可伴有脊柱强直、畸形及严重活动受限,部分患者可在髋关节、肩关节等部位出现外周关节炎。AS在我国的论述最早见于《素问》:“督脉为病,脊强反折,腰痛不可以转摇。”古人又称其为“竹节风”“骨痹”等。其起病隐匿、迁延不愈、反复发作、致残率高,严重影响患者的生命质量,目前尚无特异性的治疗方法和手段。临床西医治疗AS因药物价格昂贵、具有感染风险以及药物耐受性等问题不断困扰着患者治疗的依从性、持续性和疗效。近年来中医治疗AS以效果佳、不良反应小、治疗方式多、安全性高等特点在治疗上得到了肯定,在改善患者症状及控制病情方面均有明显的疗效,具有一定的临床价值,其旨在减轻西药的不良反应及有效改善预后,减少复发,受到众多国内外学者的密切关注。近年来中医治疗在AS中应用广泛,本文就中医治疗的灸法、推拿、中药熏蒸、传统养生功法和情志护理等方面的研究进展展开综述,为今后医护人员对中医治疗工作进行更深入的研究提供参考。

Ankylosing spondylitis(AS)is a chronic inflammatory autoimmune disease that tends to occur in young adults,with a prevalence of about 0.1%-1.6%.It mainly affects sacroiliac joints and spinal joints,and can involve peripheral joints,tendon and ligament attachment points and other tissues.The main manifestations are low back pain and morning stiffness.The middle and late stage can be accompanied by spinal ankylosis,deformity and severe activity limitation.Some patients can have peripheral arthritis in the hip joint,shoulder joint and other parts.The first discussion of ankylosing spondylitis in our country was found in Huangdi Neijing·Suwen(《素问》)“Du(督)meridian disease manifests in spinal ankylosis,deformity and severe activity limitation”,the ancient people also called it“bamboo joint wind”,“bone Bi(痹)”and so on.Ankylosing spondylitis has hidden onset,it is persistent,recurrent and with high disability rate,which seriously affects the quality of life of patients.There is no specific treatment and means at present.The compliance,persistence and efficacy of clinical Western medicine treatment are constantly troubled due to the high price of medicine,the risk of infection and drug tolerance.In recent years,traditional Chinese medicine(TCM)has been recognized in the treatment of AS with the characteristics of good effect,small adverse reactions,multiple treatment methods and high safety.TCM has obvious curative effect in relieving the symptoms of patients and controlling the disease,and has certain clinical value.It aims to reduce the toxic and adverse reaction of Western drugs,effectively improve the prognosis and reduce recurrence,which has attracted close attention of many scholars at home and abroad.In recent years,TCM therapy has been widely used in treating AS.This paper reviews the research progress of TCM therapy including moxibustion,massage,TCM fumigation,traditional health keeping skills and emotional nursing,so as to provide the medical staff with reference for further research on TCM therapy in the future.