针药并用治疗强直性脊柱炎临床观察

Clinical Observations on Combined Use of Acupuncture and Medicine for the Treatment of Ankylosing Spondylitis

目的观察针药并用治疗强直性脊柱炎的临床疗效。方法将90例强直性脊柱炎患者随机分为两组,针药组45例予以夹脊穴为主的温针灸及柳氮磺胺吡啶口服治疗,西药组45例予柳氮磺胺吡啶口服治疗。治疗1个月后,观察治疗前后主要症状、体征和炎症指标情况。结果治疗后,两组患者各症状积分均显著改善(P<0.01,P<0.05);除关节肿胀、晨僵外,其余各项症状积分改善程度优于西药组(P<0.05)。两组除枕墙距外,其余各项体征均有改善,针药组在VAS评分、Schober试验、指地距改善方面较西药组更明显(P<0.05)。治疗后,两组ESR、CRP均有明显下降(P<0.01,P<0.05)。针药组CRP下降程度优于西药组(P<0.05)。结论温针灸配合抗风湿西药治疗能有效减轻强直性脊柱炎患者的关节疼痛,改善关节活动度,提高生活质量。

Objective To investigate the clinical efficacy of combined acupuncture and medicine in treating ankylosing spondylitis.Method Ninety patients with ankylosing spondylitis were randomly allocated to two groups.The acupuncture-medicine group of 45 cases was treated by warm needling moxibustion at Huatuo jiaji （Ex-B2） points as main ones and oral administration of sulfasalazine.The Western drug group of 45 cases was treated by oral administration of sulfasalazine.The main symptoms and signs and inflammatory indices were assessed before and after one month of treatment.Result The scores of symptoms decreased significantly in both groups after treatment （P＜0.01,P＜0.05）.The scores of symptoms except joint swelling and morning stiffness decreased more than in the Western drug group （P＜0.05）.The scores of signs except the occiput-wall distance improved in both groups.The VAS score,Schober＇s test results and the finger-earth distance improved more in the acupuncture-medicine group than in the Western drug group （P＜0.05）.ESR and CRP decreased significantly in both groups after treatment （P＜0.01,P＜0.05）.CRP decreased more in the acupuncture-medicine group than in the Western drug group （P＜0.05）.Conclusion Treatment with warm needling moxibustion plus antirheumatics can effectively relieve arthralgia,ameliorate joint mobility and improve the quality of life in ankylosing spondylitis patients.