逐经督脉灸疗法对肾虚督寒型的强直性脊柱炎患者肠道微生物和肠黏膜免疫反应的影响

Clinical effect of diuretic moxibustion therapy in treatment of kidney deficiency type ankylosing spondylitis

目的探讨逐经督脉灸疗法对肾虚督寒型强直性脊柱炎患者肠道微生物和肠黏膜免疫反应的影响。方法回顾性选择59例肾虚督寒型强直性脊柱炎患者,根据治疗方法分为两组,逐经督脉灸组(29例)采用自制逐经灸自动艾灸机及特制空心艾条进行督脉治疗,传统督脉灸组(30例)采用传统艾灸盒及传统艾灸进行督脉治疗。观察两组的主次中医证候评分、实验室指标、炎症因子水平、粪便微生物数量及T细胞亚群水平。结果治疗后两组主次中医证候评分均明显低于治疗前,且治疗后逐经督脉灸组各评分明显低于传统督脉灸组(P <0. 05)。治疗后,两组红细胞沉降率(ESR)及C反应蛋白(CRP)水平明显降低,且治疗后逐经督脉灸组的ESP及CRP水平明显低于传统督脉灸组(P <0. 05)。治疗后,两组肿瘤坏死因子(TNF-α)及白细胞介素-6(IL-6)水平明显降低,且治疗后逐经督脉灸组明显低于传统督脉灸组(P <0. 05)。治疗后,两组的粪便微生物硫酸盐还原菌、自体杆菌和类杆菌数量显著降低,且逐经督脉灸组显著低于传统督脉灸组(P <0. 05)。治疗后,两组CD4^+T细胞水平、CD4^+T细胞/CD8+T细胞比值均降低,且逐经督脉灸组显著低于传统督脉灸组(P <0. 05),两组CD8+T细胞水平均增加,且逐经督脉灸组显著高于传统督脉灸组(P <0. 05)。结论采用自制的逐经灸自动艾灸机和特制空心艾条逐经灸督脉法治疗肾虚督寒型强直性脊柱炎,可有效改善患者的主次中医证候、实验室指标及炎症因子水平,同时也能够调节肠道微生物的数量,增强患者的免疫功能,安全有效,值得临床推广应用。

Objective To investigate clinical effect of diuretic moxibustion therapy in treatment of kidney deficiency type ankylosing spondylitis.Methods 59 cases with kidney deficiency type ankylosing spondylitis were selected retrospectively and randomized into two groups.Dumai moxibustion group(n=29)underwent moxibustion by self-made automatic moxibustion machine and special hollow moxa.Traditional vessel moxibustion group(n=30)underwent traditional moxibustion by traditional moxibustion box.Primary and secondary TCM syndromes,laboratory indexes,inflammatory factor levels,fecal microbial quantity and T cell subsets were observed.Results After treatment,the levels of ESP and CRP in the two groups were significantly reduced,and the levels of ESP and CRP in the meridian tutor-pulse-moxibustion group after treatment were significantly lower than those in the traditional tutor-pulse-moxibustion group(P<0.05).After the treatment,the levels of TNF-α and IL-6 in the two groups were significantly decreased,and the levels in the meridian tube-meridian moxibustion group were significantly lower than those in the traditional tube-vein moxibustion group(P<0.05).After treatment,the sulfate reducing bacteria,autologous bacilli and bacteroid-like bacteria in feces of the two groups were significantly reduced,and the meridian tutor-pulse-moxibustion group was significantly lower than the traditional tutor-pulse-moxibustion group(P<0.05).After treatment,the levels of CD4^+T cells and the ratio of CD4^+T cells to CD8^+T cells in both groups decreased,and the levels of CD8^+T cells in the meridian tube-and-moxibustion group were significantly lower than those in the traditional meridian tube-and-moxibustion group(P<0.05).The levels of CD8 +T cells in the two groups increased,and the levels in the meridian tube-and-moxibustion group were significantly higher than those in the traditional meridian tube-and-moxibustion group(P<0.05).Conclusion Dumai method with our homemade moxibustion machine and special hollow moxa roll has excellent efficacy in treating kidney deficiency type ankylosing spondylitis regarding primary and secondary TCM syndromes,inflammatory factors,gut microbes and immunization aspects,which is safe,effective,and worthy of clinical application.