摘要
目的:探究雷火灸联合基础药物治疗肾虚督寒型强直性脊柱炎(AS)的疗效及对胸廓活动度、枕墙距和细胞核因子-κB受体活化因子配体(RANKL)的影响。方法:选取肾虚督寒型AS患者60例,按随机数字表法,将所有AS患者均分为雷火灸组和常规组。常规组予柳氮磺吡啶和塞来昔布,雷火灸组在常规组基础上加予雷火灸,治疗4周。比较两组临床疗效、中医症状积分、Bath强直性脊柱炎活动及功能指数(BASDAI和BASFI评分)、体征指标(胸廓活动度、Schober试验、枕墙距)、炎症指标[RANKL、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)],记录两组治疗期间不良反应。结果:治疗后,雷火灸组临床有效率(86.67%)明显高于常规组(63.33%);治疗后,两组患者主症、次症积分均下降(P<0.05),且雷火灸组低于常规组(P<0.05);治疗后,两组BASDAI、BASFI评分均下降(P<0.05),且雷火灸组治疗后与常规组比较差异具有统计学意义(P<0.05);治疗后,雷火灸组胸廓活动度和Schober试验均上升(P<0.05),均高于常规组(P<0.05),枕墙距下降,低于常规组(P<0.05);治疗后,两组血清RANKL、IL-1β、IL-6均下降(P<0.05),且雷火灸组低于常规组(P<0.05);两组均未见明显不良反应。结论:雷火灸联合基础药物可提高肾虚督寒型AS临床疗效,缓解症状,改善胸廓活动度、枕墙距,降低炎症反应。
Objective:To explore the efficacy of thunder-fire moxibustion combined with basic drug therapy on ankylosing spondylitis(AS)of kidney deficiency and governor meridian cold type and its influence on thoracic activity,occiput-to-wall distance and RANKL.Methods:Totally 60 patients with AS of kidney deficiency and governor meridian cold type were selected and divided into thunder-fire moxibustion group and routine group by the random number table method.The routine group was treated with sulfasalazine and celecoxib while the thunder-fire moxibustion group was additionally given thunder-fire moxibustion on the basis of the routine group,and both groups were treated for 4 weeks.The clinical efficacy,scores of TCM symptoms,scores of Bath ankylosing spondylitis disease activity and function index(BASDAI and BASFI),physical signs(thoracic activity,Schober test,occiput-to-wall distance)and inflammatory indicators[receptor activator of nuclear factor-κB ligand(RANKL),interleukin-1β(IL-1β),interleukin-6(IL-6)]were compared between the two groups,and the adverse reactions during treatment were recorded in the two groups.Results:After treatment,the clinical effective rate in thunder-fire moxibustion group(86.67%)was significantly higher than that in routine group(63.33%).After treatment,the scores of primary and secondary symptoms were decreased in the two groups(P<0.05),and the scores were lower in thunder-fire moxibustion group than those in routine group(P<0.05).The BASDAI score and BASFI score in the two groups were decreased after treatment(P<0.05),and the scores in thunder-fire moxibustion group were significantly different from those in routine group(P<0.05).After treatment,the thoracic activity and Schober test in thunder-fire moxibustion group were all increased(P<0.05),and were higher than those in routine group(P<0.05).The occiput-to-wall distance in thunder-fire moxibustion group was lower than that in routine group(P<0.05).After treatment,serum levels of RANKL,IL-1βand IL-6 in the two groups were reduced(P<0.05),and the levels in thunder-fire moxibustion group were lower compared to routine group(P<0.05).There were no obvious adverse reactions in the two groups.Conclusion:Thunder-fire moxibustion combined with basic drug can enhance the clinical efficacy of AS of kidney deficiency and governor meridian cold type,relieve the symptoms,improve the thoracic activity and occiput-to-wall distance,and reduce the inflammatory response.
作者
王培
柳杨
安艳辰
孙艳艳
屈静
李敏
WANG Pei;LIU Yang;AN Yanchen;SUN Yanyan;QU Jing;LI Min(Beijing Luhe Hospital,Capital Medical University,Beijing 101199,China)
出处
《陕西中医》
CAS
2023年第6期789-793,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
北京市中医药科技发展资金资助项目(JJ-2020-56)。
关键词
强直性脊柱炎
雷火灸
肾虚督寒型
炎症反应
白细胞介素-1Β
Ankylosing spondylitis
Thunder-fire moxibustion
Kidney deficiency and governor meridian cold type
Inflammatory response
Interleukin-1β