督灸治疗肾阳亏虚型强直性脊柱炎临床对照研究

Clinical Controlled Trial of Du Meridian Moxibustion for Ankylosing Spondylitis of Kidney Yang Deficiency Type

目的评价督灸治疗肾阳亏虚型强直性脊柱炎(AS)的疗效。方法将60例活动性肾阳亏虚型AS患者随机分为治疗组和对照组,每组30例,治疗组予督灸联合口服柳氮磺吡啶片,对照组假灸联合口服柳氮磺吡啶片。隔日治疗1次,4星期为1个疗程,共治疗2个疗程。观察患者病情活动指数(BASDAI量表)、疼痛改善(VAS评分)、躯体功能指数(BASFI量表)、骨骼和肌肉系统活动度评估(BASMI)及实验室安全性指标的变化。结果治疗4星期和8星期AS患者中医证候量化积分结果显示治疗组与对照组均有明显改善(P<0.05),治疗组疗效明显优于对照组(P<0.05),疗程间疗效无差别(P>0.05)。两组AS患者治疗4星期后病情活动指数、VAS评分、BASFI量表、BASMI等临床指标均有所改善(P<0.05);治疗8星期后,治疗组疗效更为显著,与对照组比较差异有统计学意义(P<0.05)。两组实验室安全性指标均未发现明显异常。结论口服柳氮磺吡啶片配合督灸能有效缓解AS患者的临床症状,无明显不良反应,是治疗AS的一种安全有效的方法。

Objective To evaluate the therapeutic effect of Du meridian moxibustion on ankylosing spondylitis（AS） of kidney yang deficiency type.Method Sixty patients with active AS of kidney yang deficiency type were randomly allocated to treatment and control groups,30 cases each.The treatment group received Du meridian moxibustion plus oral administration of sulfasalazine tablets and the control group,sham moxibustion plus oral administration of sulfasalazine tablets.Treatment was given once every other day,four weeks as a course,for a total of two courses.The Bath Ankylosing Spondylitis Disease Activity Index（BASDAI） score,the Pain Visual Analogue Scale（VAS） score,the Bath Ankylosing Spondylitis Functional Index（BASFI） score and the Bath Ankylosing Spondilitis Metrology Index（BASMI） score were recorded and laboratory safety indicators were observed in the patients.Result The TCM syndrome score decreased in both treatment and control groups of AS patients at four and eight weeks of treatment（P〈0.05）.The therapeutic effect was significantly better in the treatment group than in the control group（P〈0.05）.There was no statistically significant difference in therapeutic effect between different courses（P〉0.05）.The BASDAI,VAS,BASFI and BASMI scores decreased in the two groups of AS patients at four weeks of treatment（P〈0.05）.They decreased more in the treatment group at eight weeks of treatment;there were statistically significant differences compared with the control group（P〈0.05）.The laboratory safety indicators were not markedly abnormal.Conclusion Du meridian moxibustion can effectively relieve the clinical symptoms and does not cause obvious adverse reactions in AS patients.It is a safe and effective way to treat AS.