内热针治疗中晚期强直性脊柱炎的疗效观察

Therapeutic effects of internal warm acupuncture on middle-and late-stage ankylosing spondylitis

目的观察内热针治疗中晚期强直性脊柱炎的临床疗效和安全性,探讨其应用前景。方法62例中晚期强直性脊柱炎患者按就诊顺序分为采用内热针治疗的治疗组(31例)和采用常规针刺治疗的对照组(31例),连续治疗8周后观察2组患者治疗前后的主要症状及体征(胸廓活动度、枕墙距、指地距、Schober试验),实验室指标(血沉、C反应蛋白),脊椎疼痛VAS评分、Bath强直性脊柱炎功能指数(BASFI)和Bath强直性脊柱炎疾病活动指数(BASDAI)。结果2组患者治疗后的主要体征、脊柱疼痛VAS评分与治疗前比较均有明显改善(P<0.05);2组之间在枕墙距、指地距、Schober试验、脊柱疼痛VAS评分方面差异有统计学意义(P<0.05),而在胸廓活动方面无明显差异(P>0.05)。治疗前后2组的血沉、C反应蛋白相比有明显降低(P<0.05);治疗后2组在血沉、C反应蛋白无明显变化(P>0.05)。治疗前后2组组内的BASFI、BASDAI相比差异有统计学意义(P<0.05),且组间比较治疗组疗效更佳(P<0.05)。结论内热针疗法和常规针刺疗法对中晚期强直性脊柱炎均有较好的临床疗效及安全性,但内热针疗法在改善脊柱关节活动度、缓解疼痛症状、降低致残率、延缓病情等方面的疗效更为显著,安全可行,值得探索和推广应用。

Objective To observe the clinical efficacy and safety of internal warm acupuncture in the treatment of middle-stage and advanced ankylosing spondylitis,and to explore its application prospects.Methods 62 patients with middle-stage and advanced ankylosing spondylitis were divided according to the sequence of their consultations into treatment group treated with internal warm acupuncture and control group given conventional acupuncture treatment with 31 cases in each group.After 8 consecutive weeks of treatment,the main signs and symptoms(thoracic mobility,occiput to wall,finger to ground and Schober’s test),laboratory test results(ESR and CRP),spinal pain VAS scores,Bath Ankylosing Spondylitis Functional Index(BASFI)and Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)of patients in the two groups before and after treatment were observed.Results The main signs and the VAS scores of spinal pain of both groups after treatment were significantly improved compared with those before treatment(P<0.05).There were statistically significant differences between the two groups in terms of occiput to wall,finger to ground,Schober’s test and VAS score(P<0.05),but there was no significant difference in thoracic mobility(P>0.05).After treatment,ESR and CRP of both groups were significantly lower than those before treatment(P<0.05).There was,however,no significant difference in ESR and CRP between the two groups after treatment(P>0.05).There were statistically significant differences in BASFI and BASDAI of both groups before and after treatment(P<0.05),and the treatment group demonstrated better outcome than the control group(P<0.05).Conclusion Both internal warm acupuncture therapy and conventional acupuncture therapy have good clinical efficacy and safety in treating middle-stage and advanced ankylosing spondylitis,but the former produced better curative effect in improving spinal mobility,relieving pain,preventing disability,and slowing progression with satisfying safety and feasibility,thus warranting further investigation and popularization.