益赛普穴位注射治疗强直性脊柱炎临床观察

The Clinical Observation of Acupoint Injection of Etanercept in the Treatment of Ankylosing Spondylitis

目的探讨益赛普穴位注射与皮下注射治疗强直性脊柱炎疗效的差异及最佳疗程。方法将60例强直性脊柱炎患者分为试验组和对照组,每组各30例。在口服双氯芬酸钠肠溶片基础上,试验组患者予双侧骶髂关节阿是穴处穴位注射益赛普,对照组患者予双侧上臂外侧三角肌皮下注射益赛普,12周为1疗程。治疗2周、4周、8周、12周分别进行疗效评估。结果干预1个疗程后,各组患者的CRP、ESR、VAS评分、BASDAI、BASFI、晨僵时间均下降,与治疗前比较差异均有统计学意义(P<0.05);治疗2周试验组在BASFI评分上改善幅度优于对照组(P<0.05);治疗4周试验组在VAS评分、晨僵时间、BASFI上改善幅度优于对照组(P<0.05);治疗8周试验组在VAS评分、晨僵时间、BASDAI、BASFI、CRP上改善幅度优于对照组(P<0.05);治疗12周试验组在VAS评分、晨僵时间、BASDAI、BASFI、CRP上改善幅度优于对照组(P<0.05)。结论穴位注射治疗强直性脊柱炎疗效肯定,在改善患者VAS评分、晨僵时间、BASDAI、BASFI、CRP方面比皮下注射疗效好,注射12周可较好控制病情,建议以12周为1疗程。

Objective To investigate the difference between acupoint injection and subcutaneous injection of etanercept in the treatment of ankylosing spondylitis(AS).Methods Sixty patients with AS were divided into experimental group and control group by random number table method,30 cases in each one.On the basis of oral diclofenac sodium enteric-coated tablets,patients in the experimental group were injected with etanercept at ashi point of bilateral sacroiliac joint,while patients in the control group were injected with etanercept at bilateral lateral deltoid muscle of the upper arm subcutaneously for a course of 12 weeks.Efficacy was evaluated at 2 weeks,4 weeks,8 weeks and 12 weeks.Results After one course of intervention,CRP,ESR,VAS score,bath ankylosing spondylitis disease activity index(BASDAI),bath ankylosing spondylitis functional index(BASFI),and morning stiffness time of patients in each group all decreased,and the differences were statistically significant(P<0.05);2 weeks treatment group on the BASFI score improvement is better than that of control group(P<0.05);4 weeks treatment of the experimental group on the VAS score,morning stiffness time,BASFI improved better than that of control group(P<0.05);The improvement of VAS score,morning stiffness time,BASDAI,BASFI and CRP in the 8-week treatment group was better than that in the control group(P<0.05).The improvement of VAS score,morning stiffness time,BASDAI,BASFI and CRP in the 12-week treatment group was better than that in the control group(P<0.05).Conclusion Etanercept is effective in the treatment of AS,and injection of etanercept at point a is better than subcutaneous injection in improving patients'VAS score,morning stiffness time,BASDAI,BASFI and CRP.