督脉悬灸结合针刺治疗寒湿痹阻型强直性脊柱炎临床研究

Clinical research of Du Mai Suspension Moxibustion combined with acupuncture in treating ankylosing spondylitis of cold-dampness obstruction type

目的观察督脉悬灸结合针刺治疗寒湿痹阻型强直性脊柱炎的临床疗效。方法选取2022年8月至2023年7月收治的60例寒湿痹阻型强直性脊柱炎患者为研究对象,按照随机数字表法分为2组,对照组30例采用西医常规治疗,治疗组30例采用督脉悬灸加针刺治疗。2组均治疗8周后统计疗效,比较2组治疗前后中医症状(包括关节肿胀、关节疼痛及晨僵)评分、免疫指标[包括免疫球蛋白A(IgA)、IgG及IgM]、炎症指标[包括红细胞沉降率(ESR)及C反应蛋白(CRP)]、焦虑自评表(SAS)、抑郁自评表(SDS)、强直性脊柱炎病情活动评价指数(BASDAI)评分及强直性脊柱炎关节功能指数(BASFI)评分变化情况。结果与本组治疗前比较,2组治疗后中医症状关节肿胀、关节疼痛及晨僵评分均降低(P<0.05),且治疗组治疗后关节肿胀、关节疼痛及晨僵评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后免疫指标IgA、IgG及IgM水平均降低(P<0.05),且治疗组治疗后IgA、IgG及IgM水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后炎症指标ESR及CRP水平均降低(P<0.05),且治疗组治疗后ESR及CRP水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后精神状态SAS评分及SDS评分均降低(P<0.05),且治疗组治疗后SAS评分及SDS评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后病情活动状态BASDAI评分及BASFI评分均降低(P<0.05),且治疗组治疗后BASDAI评分及BASFI评分均低于对照组(P<0.05)。治疗组总有效率93.33%(28/30),对照组总有效率70.00%(21/30),治疗组总有效率显著高于对照组(P<0.05)。结论督脉悬灸结合针刺治疗寒湿痹阻型强直性脊柱炎临床疗效确切,可明显缓解患者中医症状,改善免疫功能紊乱,抑制炎症反应和病情进展,减轻患者焦虑、抑郁情况。

Objective To analyze the effect of Du Mai Suspension Moxibustion combined with acupuncture on immune function and inflammatory reaction in ankylosing spondylitis(AS)of cold-dampness obstruction type.Methods Sixty AS patients(cold-dampness obstruction type)admitted from August 2022 to July 2023 were randomly assigned into treatment group(n=30)and control group(n=30).All patients were treated with conventional Western medicine,those in the treatment group were additionally treated with Du Mai Suspension Moxibustion plus acupuncture,the curative efficacy was statistically assessed after 8 weeks of treatment.Before and after treatment,the TCM syndrome(joint swelling,joint pain and morning stiffness)scores,the levels of immune indexes(immunoglobulin A[IgA],IgG and IgM),inflammatory indexes(erythrocyte sedimentation rate[ESR]and C-reactive protein[CRP]),the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)and Bath ankylosing spondylitis function index(BASFI)were included as comparators between the two groups.Results After treatment,patients in the both groups presented significantly decreased the scores of TCM syndrome scores,ESR,CPR,SAS/SDS,BASDAI/BASFI,and significantly lower the levels of IgA,IgG and IgM(all P<0.05).Moreover,compared with the control group,the treatment group showed more improvement in the scores of TCM syndrome scores,ESR,CPR,SAS/SDS,BASDAI/BASFI,as well as the levels of IgA,IgG IgM(all P<0.05).The total effective rate of the treatment group was significantly higher than that of the control group(93.33%[28/30]vs 70.00%[21/30],P<0.05).Conclusion Du Mai Suspension Moxibustion combined with acupuncture on immune function and inflammatory reaction in the treatment of AS(cold-dampness obstruction type)has a definite clinical effect,which can significantly alleviate TCM symptoms,improve immune dysfunction,inhibit inflammatory response and disease progression,and reduce anxiety and depression of patients.