针刺联合耳穴贴压治疗早中期强直性脊柱炎的疗效观察

Efficacy Observation of Acupuncture Combined with Auricular Point Sticking for Early-to-moderate-stage Ankylosing Spondylitis

目的观察针刺联合耳穴贴压治疗早中期强直性脊柱炎的临床疗效。方法将110例肾虚督寒型早中期强直性脊柱炎患者随机分为对照组(55例)和观察组(55例)。对照组予美洛昔康治疗,观察组采用针刺联合耳穴贴压治疗。观察两组治疗前后疾病活动指标(晨僵时间、脊柱疼痛、关节肿胀和疲惫感觉)以及脊柱功能(腰椎前屈度、腰椎侧弯度、腰椎后仰度和颈椎旋转度)的变化。观察两组患者血清炎性因子、疼痛介质以及肠道菌群水平的变化。比较两组临床疗效。结果观察组总有效率为98.1%,高于对照组的81.1%(P<0.05)。两组治疗后疾病活动指标和脊柱功能的各项指标均较同组治疗前改善(P<0.05),且观察组治疗后上述各项指标均优于对照组(P<0.05)。观察组治疗后血清炎性因子和疼痛介质各项指标以及肠道肠杆菌和拟杆菌均低于对照组(P<0.05),肠道乳酸杆菌和双歧杆菌高于对照组(P<0.05)。结论针刺联合耳穴贴压可改善肾虚督寒型早中期强直性脊柱炎患者的症状和脊柱功能,降低血清炎性因子和疼痛介质,优化肠道菌群水平,疗效优于口服美洛昔康片治疗。

Objective To observe the clinical efficacy of acupuncture plus auricular point sticking in treating early-to-moderate-stage ankylosing spondylitis(AS).Method A total of 110 patients with early-to-moderate-stage AS due to kidney deficiency and cold in the Governor Vessel were randomized into a control group(55 cases)and an observation group(55 cases).The control group was treated with Meloxicam,and the observation group was treated with acupuncture plus auricular point sticking therapy.Before and after treatment,the disease activity index(morning stiffness duration,spinal pain,joint swelling,and fatigue)and spinal function(forward flexion,lateral flexion,and backward extending of the lumbar spine and the rotation of the cervical spine)were observed in the two groups.The changes in the serum inflammatory factors and pain mediators and intestinal flora levels were also observed.The clinical efficacy was compared between the two groups.Result The total effective rate was 98.1%in the observation group,higher than 81.1%in the control group(P<0.05).After treatment,the disease activity index and spinal function parameters were improved in both groups(P<0.05)and were better in the observation group than in the control group(P<0.05).The levels of serum inflammatory factors and pain mediators and intestinal Enterobacteriaceae and Bacteroides were lower in the observation group than in the control group after treatment(P<0.05),and the levels of intestinal Lactobacillus and Bifidobacterium were higher in the observation group than in the control group(P<0.05).Conclusion Acupuncture plus auricular point sticking can improve the symptoms and spinal function in patients with early-to-moderate-stage AS due to kidney deficiency and cold in the Governor Vessel;it can down-regulate serum inflammatory factors and pain mediators,improve the levels of intestinal flora,and produce more significant efficacy than oral Meloxicam.