针灸治疗强直性脊柱炎的临床研究

Clinical research on acupuncture in the treatment of ankylosing spondylitis

目的:针灸对强直性脊柱炎具有独特的疗效,综述近年来针灸治疗强直性脊柱炎的临床研究进展。资料来源:应用计算机检索万方数据库1997-06/2006-06期间的相关文章,检索词为“针灸,强直性脊柱炎,临床研究”,并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与针灸治疗强直性脊柱炎研究相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到40篇相关文献,24篇文献符合纳入标准,排除的16篇文献为内容陈旧或重复。符合纳入标准的24篇文献中,8篇涉及针刺疗法,3篇涉及艾灸,4篇涉及蜂针与穴位埋线,3篇涉及火针与梅花针,5篇涉及针刀疗法与挑筋疗法,1篇涉及刺络。资料综合:中医则从痹证角度辨证施治,对缓解临床症状、减缓病程有一定作用。针刺疗法是以相应病变椎体部位的夹脊穴和骶髂关节痛点为治疗点,进针后以中度提插捻转和刮柄法为主;关于艾灸多采用铺灸或长蛇灸,取穴均从大椎到腰俞穴的督脉脊柱段,但施灸药物存在差异;蜂针疗法是将民间蜂蛰疗法与针灸相结合;穴位埋线是在穴位植入可吸收的羊肠线,对穴位形成持续刺激;火针是将特制针具用火烧红后迅速刺入腧穴,借火助阳,达到祛风散寒除湿的效果;梅花针取华佗夹脊穴,用梅花针由上而下叩刺,至皮肤潮红或微出血为度;针刀疗法是用针刀将脊柱各个关节粘连的肌腱、韧带等软组织和挛缩筋脉实施分离、切开和松解;挑筋疗法通过挑、提、摇、摆等手法将穴位相应的皮内或皮下筋膜纤维挑拨出来而达到治疗目的;刺络放血可以缓解强直性脊柱炎腰骶晨僵以及受累部关节肿痛或肌腱附着点疼痛等临床症状。结论:针灸治疗强直性脊柱炎具有手段多样、疗效好、显效快、无副作用等特点,是治疗强直性脊柱炎的一种有效途径,值得临床推广采用。

OBJECTIVE： Acupuncture is particularly effective against ankylosing spondylitis. To summarize further clinical research of acupuncture in the treatment of ankylosing spondylitis in recent years. DATA SOURCES： All articles were searched in Wanfang Database with the words of ＂acupuncture, ankylosing spondylitis, clinical research＂ in Chinese from June 1997 to June 2006. STUDY SELECTION： All the articles were checked firstly and the reference of each article was examined. Inclusive criteria： the content of each article must be relevant to the research of acupuncture in the treatment of ankylosing spondylitis. Exclusive criteria： Meta analysis or duplicate research papers. DATA EXTRACTION： Totally 40 relative articles were found, 24 of which were accorded with the inclusive criteria, while 16 of which belonged to repetitive researches or old contents were excluded. Among these 24 articles, 8 were about acupuncture methods, 3 about moxibustion, 4 about bee acupuncture and catgut implantation at acupoint, 3 about fireneedle and plum-blossom needle, 5 about needle-knife therapy and muscle-pricking therapy and 1 about blood-letting puncture. DATA SYNTHESIS： Chinese specialists applied various acupuncture methods, while in Chinese medicine, treatments were determined based on differentiation of symptoms and signs of arthromyodynia in the treatment of ankylosing spondylitis, so the clinical symptoms were greatly relieved and the course of disease was slowed down to some degree. Acupuncture therapy treated at Jiaji point and pain point of sacroiliac articulation in corresponding injured vertebral body, mainly with the moderate twirling, lifting and thrusting needles and doctor bar. Long snake moxibustion was adopted mainly at Du meridian of spinal column from big vertebra to lumbar Shu point, but the medicine was different. Bee acupuncture therapy was combined with bee-hibernate therapy andacupuncture; catgut implantation at acupoint therapy referred to the implantation of absorbable chorda chirurgicalis in. acupoint and stimulation on acupoints continuously; fire-needle therapy referred to that the specially made needles after burn with fire pricked into acupoints rapidly, asking for a light to help yang, so as to expel wind and remove cold and dehumidity, plum-blossom needle therapy referred to tapping at Huatuo spine points from up to down, until erubescence or slightly bleeding; needle-knife therapy referred to separate, cut open and release the adhesive soft tissues such as tendon and ligament and contractive muscle and vessel; muscle-pricking therapy referred to sow discord the fiber in anadesma intradermally or subcutaneously by picking, lifting, shacking and swinging; blood-letting puncture therapy could relieve clinical symptoms such as lumbosacral early morning stiffness and involved joint swelling or pain at attachment point of tendon, etc. CONCLUSION： Acupuncture is effective in treating ankylosing spondylitis by varied means with good and quick effect and without any side effects, so it is worth promoting in clinic.