长蛇灸对强直性脊柱炎的炎症因子水平及关节活动度的影响

Effect of Long-Snake Moxibustion on Levels of Inflammatory Factors and Range of Motion in Treatment of AS

目的:探讨长蛇灸对强直性脊柱炎(AS)患者的炎症因子水平及关节活动度的影响。方法:60例强直性脊柱炎(AS)患者随机分成观察组和对照组,各30例,观察组在口服柳氮磺胺吡啶的基础上给予长蛇灸治疗(选取两组经穴:一组以脊柱督脉经穴大椎穴至腰俞穴为主,另一组以两侧华佗夹脊穴颈1至骶髂关节部为主),两组交替使用,每次灸3壮,1次/3 d,2次间隔1 d,连续治疗8次(1个月);对照组在口服柳氮磺胺吡啶的基础上给予塞来昔布胶囊(西乐葆)治疗,2次/d,每次100 mg,连续口服治疗1个月。采用ELISA法检测外周血白细胞介素-17(IL-17)、肿瘤坏死因子α(TNF-α)水平,流式细胞术检测C反应蛋白(CRP)、血沉(ESR)的变化,并比较两组疗效。结果:治疗后两组疗效比较,观察组总有效率为80.00%(24/30),优于对照组总有效率63.33%(19/30),差异具有统计学意义(P<0.05)。治疗后,观察组IL-17、TNF-α、CRP及ESR炎症因子水平较治疗前明显下降,差异具有统计学意义(P<0.05),关节活动度较治疗前明显改善,差异具有统计学意义(P<0.05);对照组IL-17、TNF-α及CRP较治疗前有所下降,差异无统计学意义(P>0.05),ESR较治疗前明显下降,差异具有统计学意义(P<0.05),关节活动度较治疗前有所改善,差异无统计学意义(P>0.05)。与对照组比较,观察组能有效降低炎症因子水平、改善患者关节活动度,差异具有统计学意义(P<0.05)。结论:长蛇灸能有效降低AS细胞炎症因子水平,进而改善AS患者的慢性炎症状态,其作用机制可能与长蛇灸具有抗炎作用有关;长蛇灸能有效改善AS关节功能活动度,防止关节畸形,降低致残率。

Objective:To investigate the effects of long-snake moxibustion on inflammatory factors and range of motion in patients with ankylosing spondylitis(AS).Methods:60 patients with AS were randomly divided into the observation group and the control group,with 30 cases in each group.The observation group was treated with long-stake moxibution(choosing two alternative sets of points,one was from DU14 to DU2,the other was cervical Jiaji points from C1 to sacroiliac joint;3 moxa per time,once every three days for 8 times)on the basis of Salazosulfapyridine(SASP);whereas the control group was treated with Celecoxib(100 mg/time,twice a day for a month)on the basis of SASP.The levels of interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)in peripheral blood were detected by ELISA,and the changes of C-reactive protein(CRP)and erythrocytes sedimentation rate(ESR)were detected by flow cytometry.The efficacy was compared between the two groups.Results:The total effective rate of the observation group was 80.00%(24/30),which was significantly higher than 63.33%(19/30)of the control group(P<0.05).The levels of IL-17,TNF-α,CRP and ESR were significantly decreased after the treatment compared with those before the treatment in the observation group(P<0.05);the range of motion was significantly improved after the treatment compared with that before the treatment in the observation group(P<0.05).The levels of IL-17,TNF-αand CRP were decreased after the treatment compared with those before the treatment in the control group,but there was no statistical difference between before and after the treatment(P>0.05);the level of ESR was significantly decreased after the treatment compared with that before the treatment in the control group(P<0.05);the range of motion was improved after the treatment compared with that before the treatment in the control group,the difference was not statistically significant(P>0.05).Compared with the control group,the observation group could effectively reduce the levels of inflammatory factors and improve the range of motion of the joints with statistical significance(P<0.05).Conclusion:Long-snake moxibustion can effectively reduce the levels of inflammatory factors in AS cells,and then improve the chronic inflammatory state in AS patients,which mechanism may be related to its anti-inflammatory effect.Long-snake moxibustion can effectively improve the functional mobility of AS joints,prevent the joint deformity and reduce the disability rate.