运动针法联合西药治疗强直性脊柱炎的疗效观察及对BASFI、BASDAI评分的影响

Efficacy of kinematic acupuncture combined with western medicine in ankylosing spondylitis and its effect on BASFI and BASDAI score

目的 观察运动针法联合西药治疗强直性脊柱炎(ankylosing spondylitis, AS)肾虚督寒证的临床疗效及对巴氏强直性脊柱炎功能指数(Bath ankylosing spondylitis functional index, BASFI)、巴氏强直性脊柱炎疾病活动性指数(Bath ankylosing spondylitis disease activity index, BASDAI)评分的影响。方法 将78例AS肾虚督寒证患者分为观察组和对照组,每组39例。对照组给予吲哚美辛缓释胶囊和柳氮磺吡啶肠溶片治疗,观察组在对照组治疗基础上加用运动针法治疗。观察两组临床疗效、不良反应,治疗前后临床症状(胸廓活动度、晨僵时间、Schober试验、疼痛关节数)、炎症相关指标[C反应蛋白(C-reactive protein, CRP)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)、白介素-17(interleukin-17, IL-17)]、中医证候积分、BASFI和BASDAI评分的变化。结果 观察组总有效率为89.7%,高于对照组的69.2%(P<0.05);两组治疗后临床症状、炎症相关指标、中医证候积分、BASFI和BASDI评分均改善(P<0.05),且观察组优于对照组(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 运动针法联合西药治疗强直性脊柱炎肾虚督寒证疗效好,能明显改善BASFI、BASDAI评分。

Objective To observe the clinical efficacy of kinematic acupuncture combined with western medicine in the treatment of ankylosing spondylitis(AS) with kidney deficiency and Governor Vessel Cold syndrome and its effect on the Bath ankylosing spondylitis functional index(BASFI) and Bath ankylosing spondylitis disease activity index(BASDAI) score. Method A total of 78 AS patients with Kidney Deficiency and Cold-Governing syndrome were divided into an observation and a control groups, with 39 case in each group. The control group was given indomethacin sustained-release capsule, sulfasalazine enteric-coated tablets treatment, and the observation group was given kinematic acupuncture therapy in addition to the treatment used in the control group. Clinical efficacy, adverse reactions, clinical symptoms(activity of thoracic cage, duration of morning stiffness, Schober test, number of painful joints) before and after treatment, inflammation related indicators [C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), interleukin-17(IL-17)], TCM syndrome score and change in BASFI and BASDAI score were observed between the two groups. Result The total effective rate of the observation group was 89.7%, which was higher than that of the control group(69.2%)(P<0.05);after treatment, the clinical symptoms, inflammation related indicators,TCM syndrome score, BASFI and BASDI score were improved in both groups(P<0.05), and they were better in the observation group than in the control group(P<0.05);There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion The combination of kinematic acupuncture and western medicine has good efficacy in treating AS with kidney deficiency and cold-governing syndrome, and can significantly improve BASFI and BASDAI score.