神经阻滞联合中药热奄包治疗早中期强直性脊柱炎的疗效观察

Efficacy observation of nerve block combined with TCM hot election bag in the treatment of early and middle ankylosing spondylitis

目的观察神经阻滞联合中药热奄包治疗早中期强直性脊柱炎肾虚督寒证的疗效观察。方法将90例早中期强直性脊柱炎患者按照随机数字表法分为对照组和观察组,每组45例。对照组给予神经阻滞,观察组给予神经阻滞联合中药热奄包,疗程均为4周。比较两组临床症状[巴氏强直性脊柱炎病情活动指数(BASDAI)、活动度衡量指数(BASMI)、中医症状]、血清炎性因子[肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-17(IL-17)]、疼痛介质[环氧化酶-2(COX-2)、前列腺素E2(PGE2)、内皮素-1(ET-1)]、临床疗效及不良反应。结果观察组临床疗效优于对照组(P <0.05);观察组治疗后BASDAI、BASMI、中医症状、TNF-α、IL-1β、IL-17、COX-2、PGE2、ET-1明显低于对照组(P <0.05);两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论神经阻滞联合中药热奄包可有效改善早中期强直性脊柱炎肾虚督寒证患者的临床症状,降低患者的炎症反应和疼痛程度。

Objective To observe the therapeutic effect of nerve block combined with TCM hot election bag on early and middle stage ankylosing spondylitis duo to kidney deficiency and du pulse cold syndrome.Methods 90 patients with early and middle ankylosing spondylitis were randomly divided into the control group and the observation group,45 cases in each group.The control group was given nerve block,and the observation group was given nerve block combined with TCM hot election bag.The course of treatment was 4 weeks.The clinical symptoms[basdai ankylosing spondylitis disease activity index(BASDAI),basdai ankylosing spondylitis measure index(BASMI),traditional Chinese medicine(TCM)symptoms],serum inflammatory factors[tumor necrosis factor alpha(TNF-α),interleukin-1β(IL-1β),interleukin-17(IL-17)],pain medium[cyclooxygenase-2(cox-2),human prostaglandin E2(PGE2),endothelin 1(ET-1)],clinical efficacy and safety of the two groups were compared before and after treatment.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the BASDAI,BASMI,TCM symptoms,TNF-α,IL-1β,IL-17,COX-2,PGE2 and ET-1 in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Nerve block combined with TCM hot election bag can effectively improve the clinical symptoms of patients with early and middle ankylosing spondylitis with kidney deficiency and du pulse cold syndrome,and reduce the patient’s inflammatory response and pain.