督脉灸结合夹脊穴治疗小儿强直性脊柱炎51例临床观察

Effect of governor vessel moxibustion with Jiaji point therapy on juvenile ankylosing spondylitis:a clinical observation of 51 cases

目的探讨督脉灸结合夹脊穴治疗在小儿强直性脊柱炎(AS)治疗中的应用价值。方法选取2016年12月—2018年12月收治的AS患儿51例,根据患儿的治疗方式分成对照组25例、治疗组26例。对照组采用基础药物治疗,治疗组经督脉灸结合夹脊穴治疗。两组均治疗6个月,比较两组中医证候疗效以及中医证候评分。分别在治疗前、治疗6个月后评估两组患者的病情活动指数、功能活动指数、疼痛评分。采用影像学检查分析两组胸腰椎、颈椎活动度丧失率,并比较两组不良事件发生率。结果治疗组总有效率为92.31%,显著高于对照组的68.00%,差异有统计学意义(P<0.05)。两组治疗后中医证候积分均低于治疗前,且治疗组显著低于对照组,差异有统计学意义(P<0.05)。两组治疗后病情活动指数、功能活动指数、疼痛评分均低于治疗前,且治疗组显著低于对照组,差异有统计学意义(P<0.05)。两组治疗后胸腰椎、颈椎活动度丧失率均低于治疗前,且治疗组显著低于对照组,差异有统计学意义(P<0.05)。两组神经系统病变、虹膜炎、肺部病变发生率比较,差异无统计学意义(P>0.05)。结论与基础治疗相比,AS患儿采用督脉灸结合夹脊穴治疗,能进一步缓解中医证候症状,改善病情活动指数、功能活动指数以及疼痛评分,降低胸腰椎、颈椎活动度丧失率,总体疗效良好。

Objective To evaluate the effect of governor vessel moxibustion with Jiaji point therapy on juvenile ankylosing spondylitis(JAS).Methods A total of 51 children with JAS admitted to our hospital from December,2016 to December,2018 were divided into a control group(25)and an observation group(26)according to the treatment approach.The control group was given conventional treatment,while the observation group was given governor vessel moxibustion with Jiaji point therapy.Both groups were treated for 6 months,and the efficacy and TCM syndrome scores of the two groups were compared.The disease activity index,functional activity index,and pain score of the patients in both groups were evaluated before and after treatment.The imaging test was taken to analyze the loss of mobility in the thoracolumbar spine and the cervical spine in both groups.The incidence of adverse events was compared between the two groups.ResultsThe total effective rate of the observation group(92.31%)was significantly higher than that of the control group(68.00%),with statistical significance(P<0.05).After treatment,the TCM syndrome scores in both groups decreased,and the scores in the observation group were significantly lower than those in the control group,with statistical significance(P<0.05).After treatment,the disease activity index,functional activity index and pain score in both groups decreased,and the indices in the observation group were significantly lower than in the control group,with statistical significance(P<0.05).After treatment,the rate of mobility loss in the thoracolumbar spine and cervical spine in both groups decreased,and the rate in the observation group was significantly lower than in the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of neuropathy,iritis and pulmonary disease between the two groups(P>0.05).Conclusion Compared with the conventional treatment,governor vessel moxibustion with Jiaji point therapy can alleviate the symptoms of TCM syndrome,improve the disease activity index,functional activity index and pain score,reduce the rate ofmobility loss in the thoracolumbar spine and cervical spine,with a satisfactory clinical effect.