排刺温针联合中药熏洗治疗肾虚督寒型强直性脊柱炎的临床效果观察

Clinical Effect of Aligned Warm Needling Combined with Traditional Chinese Medicine Fumigation on Ankylosing Spondylitis of Kidney-deficiency Governor Meridian Cold

目的:观察排刺温针联合中药熏洗治疗肾虚督寒型强直性脊柱炎(AS)的临床效果。方法:选取2020年6月至2021年2月琼海市中医院收治的肾虚督寒型AS患者80例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组40例。对照组给予中药熏洗治疗,观察组给予排刺温针联合中药熏洗治疗。观察2组临床疗效,红细胞沉降率(ESR)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平,中医证候积分、脊柱疼痛视觉模拟评分(VAS)、Bath强直性脊柱炎病情活动指数(BASDAI)和Bath强直性脊柱炎功能指数(BASFI)及不良反应发生率。结果:观察组总有效率高于对照组(95.00%对比80.00%),差异有统计学意义(P<0.05);治疗后,观察组患者ESR、CRP、TNF-α水平、中医证候积分及VAS评分、BASDAI和BASFI评分分别为(21.18±2.65)mm/h、(18.72±2.48)mg/L、(9.19±2.15)ng/L、(2.89±0.61)分、(3.14±0.39)分、(2.56±0.33)分、(3.02±0.39)分,均低于对照组的(26.86±3.36)mm/h、(24.51±3.31)mg/L、(12.38±2.55)ng/L、(5.24±1.20)分、(4.03±0.50)分、(3.57±0.46)分、(4.10±0.52)分,差异有统计学意义(P<0.05);观察组不良反应发生率与对照组比较(7.50%对比10.00%),差异无统计学意义(P>0.05)。结论:排刺温针联合中药熏洗可以改善肾虚督寒型AS患者临床症状、体征及关节活动度,缓解疼痛,临床疗效确切,其机制可能是通过调节炎症介质水平,从而有效治疗AS。

Objective:To observe the clinical effect of aligned warm needling combined with traditional Chinese medicine(TCM)fumigation on ankylosing spondylitis(AS)of kidney-deficiency governor meridian cold.Methods:A total of 80 AS patients of kidney-deficiency governor meridian cold admitted to Qionghai Hospital of Traditional Chinese Medicine were enrolled as the research objects.According to random number table,they were divided into control group(40 cases,TCM fumigation)and observation group(40 cases,aligned warm needling combined with TCM fumigation).The clinical effect,levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α),TCM syndrome score,visual analogue scale(VAS),Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)and Bath Ankylosing Spondylitis Functional Index(BASFI),and adverse reactions in both groups were observed.Results:The total response rate of observation group was higher than that of control group(95.00%vs 80.00%,P<0.05).After treatment,levels of ESR,CRP and TNF-α,TCM syndrome score,VAS,BASDAI and BASFI in observation group were(21.18±2.65)mm/h,(18.72±2.48)mg/L,(9.19±2.15)ng/L,(2.89±0.61)points,(3.14±0.39)points,(2.56±0.33)points and(3.02±0.39)points,respectively,lower than those in control group[(26.86±3.36)mm/h,(24.51±3.31)mg/L,(12.38±2.55)ng/L,(5.24±1.20)points,(4.03±0.50)points,(3.57±0.46)points,(4.10±0.52)points,respectively,P<0.05].The difference in the incidence of adverse reactions between observation group and control group was not significant(7.50%vs 10.00%,P>0.05).Conclusion:Aligned warm needling combined with TCM fumigation can improve the clinical symptoms,signs and range of motion and relieve pain in AS patients of kidney-deficiency governor meridian cold,with significant clinical effect.The mechanism may be related to the regulation of inflammatory mediators,thereby effectively treating AS.