小针刀结合龙火灸治疗强直性脊柱炎的疗效及对ESR、CRP的影响

Clinical Efficacy of Acupotomy Combined with Long-Fire Moxibustion in Treatment of AS and Its Influence to ESR and CRP

目的:观察针刀结合龙火灸治疗强直性脊柱炎急性发作期的临床疗效及对血清水平的影响。方法:将符合本研究纳入标准的72例患者随机分为两组,治疗期间未坚持自动放弃者1例,最后完成71例。药物组(对照组)35例给予柳氮磺胺吡啶、甲氨蝶呤常规口服药物治疗,综合组(治疗组)36例在对照组基础上加小针刀结合龙火灸治疗。针刀与龙火灸治疗每周各1次,且两个治疗间隔3 d。治疗4个周期后分别对治疗前后Schober试验(脊柱活动度)、枕墙距、VAS视觉模拟评分及血清ESR、CRP检测结果进行评价。结果:两组治疗后临床疗效比较,治疗组总有效率为91.7%(33/36)优于对照组的74.3%(26/35)(P<0.05)。两组治疗后VAS、枕墙距治疗组比对照组改善显著(P<0.05或P<0.01),Schober试验治疗组与对照组疗效相当。治疗后1~4周血清ESR和1~2周CRP比较治疗组更优(P<0.05),提示ESR、CRP指标治疗组比对照组恢复快,其中CRP指标3、4周两组疗效相当。结论:小针刀结合龙火灸治疗强直性脊柱炎能提高疗效并改善功能,降低炎症反应,加速恢复。

Objective:To observe the clinical efficacy of acupotomy combined with long-fire moxibustion in treatment of ankylosing spondylitis(AS)and its influence to the serum levels of ESR and CRP.Methods:72 patients met the inclusion criteria were randomly divided into the control group(n=35)and the treatment group(n=36),one patients failed in finishing the treatment.The control group was treated with Sulfasalazine and Methotrexate;on which basis,the treatment group was also treated with acupotomy combined with long-fire moxibustion.Both acupotomy and long-fire moxibustion were once per week,with 3 days interval between each treatment.After 4 weeks of treatment,the scores of Schober test and VAS,the occipital bone-wall distance,as well as the serum levels of ESR and CRP were assessed before and after the treatment in the two group.The clinical efficacy was also compared between the two groups.Results:The clinical efficacy of the treatment group was 91.7%(33/36),which was significantly higher than 74.3%(26/35)of the control group(P<0.05).The score of VAS and the occipital bone-wall distance were significantly improved in the treatment group compared with those in the control group(P<0.05,P<0.01).There were no statistical difference in the score of Schober between the two groups after the treatment.In terms of the serum level of ESR,the treatment group was lower than the control group after 1 week,2 weeks,3 weeks and 4 weeks of treatment(P<0.05);in terms of the serum level of CRP,the treatment group was lower than the control group after 1 week and 2 weeks of treatment(P<0.05);which suggested that the treatment group recovered earlier than the control group in terms of the serum levels of ESR and CRP;the two groups have similar effect on CRP after 3 weeks and 4 weeks of treatment.Conclusion:Acupotomy combined with long-fire moxibustion can effectively improve clinical efficacy,reduce inflammation response and accelerate recovery in treatment of AS.