不同温度内热针对强直性脊柱炎患者脊柱活动功能与炎症因子的影响

Effect of Internal Thermal Acupuncture at Different Temperatures on Spinal Activity and Inflammatory Factors in Patients with Ankylosing Spondylitis

目的观察脊柱活动功能与炎症因子含量的变化,探讨内热针治疗AS的最佳温度。方法将60例强直性脊柱炎患者随机分为低温组、中温组与高温组,每组各20例。各组患者均采用内热针治疗,分别运用42℃、45℃、50℃三种不同温度内热针,观察各组脊柱活动功能、血沉(ESR)与C型反应性蛋白(CRP)含量、白介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)含量的变化。结果与治疗前比较,各组改良Schober、脊柱活动度、胸廓活动度均增加,差异有统计学意义(P<0.05);与低温组治疗后比较,中温组与高温组差异有统计学意义(P<0.05);与高温组治疗后比较,中温组有统计学意义(P<0.05)。与治疗前比较,各组ESR、CRP含量均下降,差异有统计学意义(P<0.05);与低温组治疗后比较,中温组与高温组含量均下降,中温组差异有统计学意义(P<0.05),高温组在ESR比较中,差异有统计学意义(P<0.05);与高温组比较,中温组ESR、CRP含量变化差异有统计学意义(P<0.05)。各组患者治疗后IL-6、TNF-α水平均下降,与治疗前比较,差异均有统计学意义(P<0.05);与低温组治疗后比较,中温组与高温组含量下降,差异有统计学意义(P<0.05);与中温组治疗后比较,高温组下降更明显,但差异无显著统计学意义(P>0.05)。结论内热针能显著改善强直性脊柱炎的脊柱运动功能,可以通过下调患者血清中IL-6的表达,抑制炎症因子的生成,延缓强直性脊柱炎的发展。

Objective To observe the changes of spinal activity function and inflammatory factors, and explore the best temperature of AS for the treatment of internal thermal acupuncture. Methods 60 cases of patients with ankylosing spondylitis were randomly divided into group A, group B and group C, 20 cases in each group. All groups were treated with internal thermal acupuncture at 42℃, 45℃, 50℃. The changes of spinal activity, ESR and CRP content, IL-6 and TNF-α were observed, and the best temperature for the treatment of ankylosing spondylitis was explored. Results Compared with before treatment, the improved Schober, spinal activity and thoracic activity were all increased, and the difference was statistically significant(P<0.05).Compared with group A, the improved Schober, spinal mobility and thoracic activity of group B and group C were increased,and the difference of group C was statistically significant(P<0.05). Compared with group C, the improvement of Schober, spinal activity and chest activity in group B were statistically significant(P<0.05). Compared with before treatment, the content of ESR and CRP decreased in all groups, and the difference was statistically significant(P<0.05). Compared with group A, the content of ESR and CRP in group B and group C decreased, and the difference in group B was statistically significant(P<0.05),and the difference was statistically significant in group C. There was no significant difference in the content change value(P<0.05). The levels of IL-6 and TNF-α in each group were decreased after treatment, and the difference was statistically significant compared with those before treatment(P<0.05). Compared with group A, the content of group B and group C decreased, the difference was statistically significant(P<0.05), and the decrease of group C was more obvious than that in group B,but there was no significant difference between group A and group B(P>0.05). Conclusion Internal thermal acupuncture can significantly improve the spinal movement function of ankylosing spondylitis. By reducing the expression of IL-1 and IL-6 in serum and inhibiting the formation of inflammatory factors, it can delay the development of ankylosing spondylitis.