不同方法治疗强直性脊柱炎疗效对比观察

Clinical Observation on the Effect of Different Acupuncture Treatment Methods on Ankylosing Spondylitis Patients

目的比较普通针刺、电针、电针配合艾灸温阳通督治疗强直性脊柱炎的疗效差异。方法采用随机的方法,将90例强直性脊柱炎患者分成普通针刺组30例,电针组30例,电针配合艾灸温阳通督组30例,3组均采用后溪、太溪、委中、百会、大椎、筋缩、腰阳关、命门穴,普通针刺组用平补平泻法针刺,电针组于后溪、太溪穴得气后加用6805--Ⅲ电针治疗仪,电针配合温阳通督组在电针组治疗的基础上,于百会、大椎、筋缩、腰阳关、命门5穴采用直接灸,治疗4周共20次。观察治疗前后患者血沉以及C-反应蛋白的水平,分析对比患者治疗前后的晨僵时间、胸廓活动度以及脊柱活动度等变化,并进行疗效评定。结果 3组治疗后血沉、C-反应蛋白及胸廓活动度、晨僵时间均较治疗前明显提高(均P<0.05),电针配合温阳通督较其他2组改善更明显(P<0.05,P<0.05),电针组优于普通针刺组(P<0.05);普通针刺组总有效率为83.33%,电针组为86.67%,电针配合艾灸温阳通督组为96.67%,3组疗效比较差异有统计学意义(P<0.05)。结论普通针刺、电针、电针配合艾灸温阳通督治疗强直性脊柱炎均有效,其中电针配合艾灸温阳通督组疗效最好,临床值得推广和应用。

Objective ： To compare the differences of curative effects of ordinary acupuncture, electro - acupunc- ture, electro - acupuncture with moxibustion warming yang and promoting blood ciuculation on the treatment of ankylosing spondylitis patients. Methods ：90 patients were randomly divided into an ordinary acupuncture group, an EA group and an electro -acupuncture with moxibustion group,30 per group. The three groups were given acupuncture at SI3, KI3, BL40, DU20, DU14, DU8, DU3 and DU4. The ordinary acupuncture group was treated with reinforcing - reducing method, the electro - acupuncture group treated with 6805 - Ⅲ electric needle treatment after the patients get qi at SI3 and KI3, and the electro - acupuncture with moxibustion group was treated with direct moxibustion besides electro - acupuncture treatment at DU20 ,DU14, DU8, DU3 and DU4,20 times in four weeks. The ESR and C -reactive protein levels of the patients were observed before and after the treatment and the changes of their morning stiffness, thoracic activity and spinal motion were analyzed and evaluated. Results ： The ESR and C - reactive protein levels, morning stiffness and thoracic activity of the three groups significantly improved （ all P 〈 0.05 ）. The electro - acupuncture group improved more significantly（P 〈 0.05, P 〈 0. 05 ） than the other two groups, and the electro - better than the ordinary acupuncture group （P 〈 0.05 ）. The total effective rate of the ordinary 83.33% ,the rate of the EA group was 86.67% ,and the rate of the electro- acupuncture with acupuncture group was acupuncture group was moxibustion group was 96.67%. The comparison of the three groups showed statistically significant difference（ P 〈 0.05 ）. Conclusion ： The ordinary acupuncture, electro- acupuncture, electro- acupuncture with moxibustion are effective treatment methods for ankylosing spondylitis patients,among which the electro - acupuncture with moxibustion has the best effect worthy of promotion and application.