温督通痹方督灸联合针刺治疗强直性脊柱炎临床观察

Clinical Observations on Warming-unblocking Prescription Du Moxibustion plus Acupuncture for Ankylosing Spondylitis

目的观察温督通痹方督灸联合针刺治疗肾虚督寒型强直性脊柱炎的临床疗效。方法选择120例肾虚督寒型强直性脊柱炎为研究对象,依据就诊顺序分为对照组、观察组,每组60例。对照组给予西药口服,观察组选择针刺(取穴以华佗夹脊穴为主)配合特制灸粉(自拟温督通痹方)行督脉艾灸治疗。治疗3个疗程后,比较两组患者的临床疗效(ASAS20改善达标率),治疗前后患者中医症状积分、指地距、枕墙距、胸廓活动度、脊柱活动度、BathAS疾病活动指数(BASDAI)、BathAS功能指数(BASFI)及C反应蛋白(CRP)、血沉(ESR)水平。结果观察组总有效率为78.6%,明显优于对照组的55.2%(P<0.05)。两组各项观察指标均较治疗前明显改善(P<0.05),且治疗后观察组中医症状积分、指地距、枕墙距、BASDAI、BASFI及CRP、ESR水平均低于对照组,胸廓活动度、脊柱活动度明显高于对照组,差异均有统计学意义(P<0.05)。治疗期间未见严重不良反应发生。结论温督通痹方督灸联合针刺治疗肾虚督寒型强直性脊柱炎的效果明显优于单用口服西药,且安全性好。

Objective To investigate the clinical efficacy of warming-unblocking prescription Du moxibustion plus acupuncture in treating ankylosing spondylitis of kidney-deficiency and Du-cold type. Method One hundred and twenty patients with ankylosing spondylitis of kidney-deficiency and Du-cold type were enrolled as subjects and allocated, in order of visits, to control and observation groups, 60 cases each. The control group received oral administration of Western medicines and the observation group, acupuncture (mainly Huatuo jiaji points) plus special powder (self-made warming-unblocking prescription) moxibustion on the Du meridian. After three courses of treatment, the therapeutic effects (ASAS20-based improvement compliance rate) were compared between the two groups of patients. Before and after treatment, the TCM symptom score was recorded, finger-to-ground distance, occiput-to-wall distance, thoracic mobility and spinal mobility were measured, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score and the Bath Ankylosing Spondylitis Functional Index (BASFI) score were kept and C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) were determined in the two groups, and comparisons were made between them. Result The total efficacy rate was 78.6% in the observation group, which was significantly higher than 55.2% in the control group (P<0.05). Every observation indicator improved significantly in the two groups compared with before treatment (P<0.05). After treatment, the TCM symptom score, finger-to-ground distance, occiput-to-wall distance, the BASDAI score, the BASFI score, CRP levels and ESR were lower and thoracic mobility and spinal mobility were significantly higher in the observation group than in the control group with statistically significant differences (P<0.05). No serious adverse reactions occurred during treatment. Conclusion Warming-unblocking prescription Du moxibustion plus acupuncture is much more effective than oral administration of Western medicines alone in treating ankylosing spondylitis of kidney-deficiency and Du-cold type.