火龙灸联合右归丸及麦肯基疗法治疗强直性脊柱炎肾阳亏虚证临床研究

Clinical study of fire dragon moxibustion combined with Yougui Pill and Mckenzie method for ankylosing spondylitis of kidney-yang deficiency syndrome

目的观察火龙灸联合右归丸及麦肯基疗法治疗强直性脊柱炎(AS)肾阳亏虚证的临床疗效。方法将60例AS肾阳亏虚证患者按照随机数字表法分为2组,治疗组30例予火龙灸联合右归丸及麦肯基疗法治疗,对照组30例予柳氮磺吡啶肠溶片及塞来昔布胶囊口服治疗。2组均治疗1个月。比较2组治疗前后关节活动性指标、脊柱疼痛视觉模拟评分(VAS)、Bath强直性脊柱炎疾病功能指数(BASFI)、Bath强直性脊柱炎疾病活动指数(BASDAI)、C反应蛋白(CRP)、红细胞沉降率(ESR)、中医证候评分,并统计2组临床疗效及不良反应发生情况,随访1年,比较2组复发率。结果治疗组总有效率90%(27/30),对照组总有效率66.67%(20/30),治疗组疗效优于对照组(P<0.05)。2组治疗后枕-墙距、指-地距均较本组治疗前降低(P<0.05),腰椎活动度、胸廓活动度均升高(P<0.05),且治疗组治疗后枕-墙距、指-地距均低于对照组(P<0.05),腰椎活动度、胸廓活动度均高于对照组(P<0.05)。2组治疗后疼痛VAS、BASFI、BASDAI评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后CRP、ESR水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗组治疗后1年复发率低于对照组(P<0.05)。治疗组不良反应发生率低于对照组(P<0.05)。结论运用火龙灸联合右归丸及麦肯基疗法治疗AS肾阳亏虚证疗效较优,能有效缓解患者疼痛症状、提高关节活动功能,降低CRP及ESR水平,改善中医证候。

Objective To observe the clinical effect of fire dragon moxibustion combined with Yougui Pill and Mckenzie method for ankylosing spondylitis(AS)of kidney-yang deficiency syndrome.Methods Totally 60 AS patients(kidney-yang deficiency syndrome)were randomly assigned into the treatment group(n=30)and the control group(n=30),the treatment group received fire dragon moxibustion combined with Yougui Pill and Mckenzie method,and the control group received oral sulfasalazine enteric-coated tablets and celecoxib capsules.The treatment period was 1 month,joint mobility index,visual analogue scale(VAS)of spinal pain,Bath Ankylosing Spondylitis Functional Index(BASFI),Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),traditional Chinese medicine(TCM)syndrome score,recurrence rate were included as comparators;the curative effect and adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(90%[27/30]vs 66.67%[20/30],[P<0.05],respectively).After treatment,occiput-wall distance(OWD)and finger-to-floor distance(FFD)in groups were decreased(P<0.05),which were more lower in the treatment group(P<0.05);lumbar range of motion(ROM)and thoracic ROM in groups were increased(P<0.05),which in the treatment group were higher than the control group(P<0.05);VAS,BASFI,BASDAI in groups were decreased(P<0.05),which in the treatment group were more common(P<0.05);CRP and ESR in groups were decreased(P<0.05),which in the treatment group were more prevalent(P<0.05);TCM syndrome scores in groups were decreased(P<0.05),improvement of which in the treatment group were significantly better(P<0.05);compared with the control group,1-year recurrence rate in the treatment group was decreased(P<0.05),incidence of adverse reactions in the treatment group was lower(P<0.05).Conclusion The clinical effect of fire dragon moxibustion combined with Yougui Pill and Mckenzie method for AS patients(kidney-yang deficiency syndrome)is outstanding,it can effectively relieve the pain,improve joint function,reduce CRP and ESR levels,and improve TCM syndromes,with worthy of further exploration.