针刺治疗强直性脊柱炎随机平行对照研究

A Randomized Parallel Controlled Study on Acupuncture for Treatment of Ankylosing Spondylitis

[目的]观察针刺治疗强直性脊柱炎疗效。[方法]使用随机平行对照方法,将86例住院/门诊患者按病志号抽签/就诊顺序号方法简单随机分两组。对照组43例柳氮磺吡啶,0.25～0.50g/次,4次/d,维持量0.25g/次,2次/d;沙利度胺,25～50mg/次,4次/d。治疗组43例针刺（患侧肩髃、曲池、手三里、外关、合谷、委中及三阴交）,使用直径0.35mm,长度40mm一次性针灸针,患者仰卧,处于良肢位,上肢屈肌侧的穴位用弱刺激手法,伸肌侧的穴位用强刺激手法;下肢内侧的穴位用弱刺激手法,外侧穴位用强刺激手法,留针30min,10min行针一次,1次/d,治疗3次休息1d。连续治疗5周为1疗程。观测临床症状、活动性指数（BASDAI）、功能性指数（BASFI）、血沉（ESR）、C反应蛋白（CRP）、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效26例,有效14例,无效3例,总有效率93.02%。对照组显效15例,有效20例,无效8例,总有效率81.40%。治疗组疗效优于对照组（P〈0.05）。BASDAI、BASFI、ESR及CRP治疗组改善优于对照组（P〈0.05）。[结论]针刺治疗强直性脊柱炎,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the therapeutic effect of acupuncture and moxibustion for treating ankylosing spondylitis. [Methods] 86 patients were randomly divided into two groups according to the number of patients with the disease. Control group（n=43）, sulfasalazine, 0.25～0.50g/ times, 4 times / d, sustain 0.25g/ times, 2 times daily; thalidomide, 25～50mg, 4 times daily. Treatment group of 43 cases of acupuncture（affected side Jianyu, Quchi, third hand, Waiguan, Hegu, Venezuela and Sanyinjiao）, use a diameter 0.35 mm, length of 40 mm disposable acupuncture needle, supine patients in good limb position and points of upper limb flexor side with weak stimulation techniques and points of extensor strong stimulation techniques; the medial extremity acupoints with weak stimulation technique and lateral points with strong stimulation techniques, each time the needle for 30 minutes, every 10 minutes a time line, 1 times / d treatment 3 times 1D rest. Continuous treatment for 5 weeks for 1 courses. Observation of clinical symptoms, activity index（BASDAI）, functional index（BASFI）, erythrocyte sedimentation rate（ESR）, and C-reactive protein（CRP）, adverse reactions. Treatment of 1 courses, determine the efficacy.[Results] 26 cases were markedly effective in the treatment group, 14 cases were effective, 3 cases were ineffective, the total effective rate was 93.02%. In the control group, 15 cases were markedly effective, effective in18 cases, invalid in 10 cases, the total effective rate was 76.74%. The curative effect of the treatment group was better than that of the control group（P〈0.05）. The improvement of BASDAI, BASFI, ESR and CRP in reatment group was better than that in control group（P〈0.05）. [Conclusion] Acupuncture treatment of ankylosing spondylitis, curative effect is satisfactory, no serious adverse reactions, it is worth promoting.