蜂针联合补肾通督法治疗强直性脊柱炎30例临床观察
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摘要
目的:观察蜂针联合中医补肾通督法治疗强直性脊柱炎的临床疗效。方法:将60例强直性脊柱炎患者按照随机数字表法分为治疗组和对照组,每组30例。对照组采用补肾通督法进行中药治疗,治疗组在对照组的基础上联合蜂针治疗。2组均以4周为1个疗程,治疗3个疗程。评估治疗前后2组患者的ASAS20评分,比较2组患者治疗前后红细胞沉降率(ESR)、胸廓活动度、腰椎活动度情况。结果:治疗组ASAS20达标率为86.67%,对照组达标率为53.33%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组ESR、胸廓活动度、腰椎活动度均较治疗前改善(P <0.05),且治疗组改善程度明显优于对照组(P <0.05)。结论:在补肾通督法中药治疗基础上,联合蜂针能够迅速有效地缓解强直性脊柱炎患者的脊柱疼痛、夜间疼痛、晨间僵硬等临床症状,也可明显改善患者的胸椎活动度与腰椎活动度,从而改变患者姿势,纠正畸形。
Objective:To observe the clinical efficacy of bee acupuncture combined with kidneytonifying and Du-unblocking therapy in the treatment of ankylosing spondylitis.Methods:Sixty patients with ankylosing spondylitis were randomly divided into a treatment group and a control group,30 cases in each group.The control group was treated with traditional Chinese medicine based on the principle of tonifying the kidney and dredging the governor.The treatment group was treated with bee acupuncture based on the treatment for the control group.Two groups were treated for 3 courses of treatment,4 weeks as a course.The ASAS20 scores of the two groups were evaluated before and after treatment.The improvement of ESR,thoracic and lumbar motility of the two groups before and after treatment were compared.Results:The standard-reaching rate of ASAS20 of the treatment group was 86.67%,and that of the control group was 53.33%.There was significant difference between the two groups(P < 0.05).After treatment,ESR,thoracic motion and lumbar motion of the two groups were improved compared with those before treatment(P < 0.05),and the improvement of the treatment group was significantly better than that of the control group(P < 0.05).Conclusion:Bee acupuncture combined with kidney-supplementing and Du-unblocking therapy can more effectively and quickly relieve the clinical symptoms of ankylosing spondylitis,such as spinal pain,night pain,morning stiffness,and can also significantly improve the activity of the thoracic spine and lumbar spine,thereby changing patients' posture and correcting deformities.
Objective:To observe the clinical efficacy of bee acupuncture combined with kidneytonifying and Du-unblocking therapy in the treatment of ankylosing spondylitis.Methods:Sixty patients with ankylosing spondylitis were randomly divided into a treatment group and a control group,30 cases in each group.The control group was treated with traditional Chinese medicine based on the principle of tonifying the kidney and dredging the governor.The treatment group was treated with bee acupuncture based on the treatment for the control group.Two groups were treated for 3 courses of treatment,4 weeks as a course.The ASAS20 scores of the two groups were evaluated before and after treatment.The improvement of ESR,thoracic and lumbar motility of the two groups before and after treatment were compared.Results:The standard-reaching rate of ASAS20 of the treatment group was 86.67%,and that of the control group was 53.33%.There was significant difference between the two groups(P < 0.05).After treatment,ESR,thoracic motion and lumbar motion of the two groups were improved compared with those before treatment(P < 0.05),and the improvement of the treatment group was significantly better than that of the control group(P < 0.05).Conclusion:Bee acupuncture combined with kidney-supplementing and Du-unblocking therapy can more effectively and quickly relieve the clinical symptoms of ankylosing spondylitis,such as spinal pain,night pain,morning stiffness,and can also significantly improve the activity of the thoracic spine and lumbar spine,thereby changing patients' posture and correcting deformities.
引文
[1]李一平.针刀联合补肾督、清湿热法治疗肾虚湿热型大偻的临床观察[D].哈尔滨:黑龙江中医药大学,2017.
[2]苏霞辉.蜂针疗法治疗肝郁气滞型乳腺增生病的临床疗效观察[D].广州:广州中医药大学,2010.
[3]北京协和医院.风湿免疫科诊疗常规[M].北京:人民卫生出版社,2012:85-87.
[4]VAN DER LINDEN S,VALKENBURG HA,CATS A.Evaluation of diagnostic criteria for ankylosing spondylitis.A proposal for modification of the New York criteria[J].Arthritis Rheum,1984,27(4):361-368.
[5]王承德,沈丕安,胡荫奇.实用中医风湿病学[M].2版.北京:人民卫生出版社,1996:693-705.
[6]FELDTKELLER E,KHAN MA,VAN DER HEIJDED,et al.Age at disease onset and diagnosis delay in HLA-B27 negative vs positive patients with ankylosing spondylitis[J].Rheumatol lnt,2003,23(2):61-66.
[7]BAKLAND G,NOSSENT HC,GRAN JT.Incidence and prevalence of ankylosing spondylitis in northern norway[J].Arthritis Rheum,2005,53(6):850-855.
[8]CORTES A,PULIT SL,LEO PJ,et al.Major histocompatibility complex associations of ankylosing complex associations of ankylosing spondylitis are complex and involve further epistasis with ERAP1[J].Nat Commun,2015,21(6):7146.
[9]BROWN MA,KENNA T,WORDSWORTH BP.Genetics of ankylosing spondylitis--insights into pathogenesis[J].Nat Rev Rheumatol,2016,12(2):81-91.
[10]夏晓龙,陈扬,张伟彬,等.强直性脊柱炎遗传相关基因的研究进展[J].风湿病与关节炎,2016,5(2):68-73.
[11]RUDWALEIT M,LANDEWéR,VAN DER HEIJDED,et al.The development of assessment of Spondyloarthritis international society classification criteria for axial spondyloarthritis(part I):classification of paper patients by expert opinion including uncertainty appraisal[J].Ann Rheum,2009,68(6):770-776.
[12]WARD MM,DEOEHAR A,AKL EA,et al.American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis[J].Arthritis Rheumatology,2016,68(2):282-298.
[13]刘念,沈嘉艳,许飞,等.强直性脊柱炎的中医诊疗进展[J].风湿病与关节炎,2018,7(12):73-76.
[14]顾军花,茅建春,周时高,等.陈湘君运用扶正法治疗强直性脊柱炎经验撷菁[J].上海中医药杂志,2008,42(3):16-17.
[15]矫健鹏,刘煊.魏品康从痰论治强直性脊柱炎经验探析[J].中华中医药杂志,2011,26(8):759-761.
[16]杨少祥,郑福增,孟庆良,等.强直性脊柱炎的中西医治疗研究进展[J].风湿病与关节炎,2017,6(7):77-80.
[17]韩励兵,王苏娜,段晓荣,等.近年来蜂针临床运用及研究进展[J].云南中医中药杂志,2013,34(3):70-72.
[18]张冰清,刘晓波.蜂毒的主要成分及药理作用的研究进展[J].药学研究,2016,35(3):172-174.
[19]OSMAN MS,MAKSYMOWYCH WP.An update on the use of tumor necrosis factor alpha inhibitors in the treatment of ankylosing spondylitis[J].Expert Rev Clin Immunol,2016,13(2):125-131.
[2]苏霞辉.蜂针疗法治疗肝郁气滞型乳腺增生病的临床疗效观察[D].广州:广州中医药大学,2010.
[3]北京协和医院.风湿免疫科诊疗常规[M].北京:人民卫生出版社,2012:85-87.
[4]VAN DER LINDEN S,VALKENBURG HA,CATS A.Evaluation of diagnostic criteria for ankylosing spondylitis.A proposal for modification of the New York criteria[J].Arthritis Rheum,1984,27(4):361-368.
[5]王承德,沈丕安,胡荫奇.实用中医风湿病学[M].2版.北京:人民卫生出版社,1996:693-705.
[6]FELDTKELLER E,KHAN MA,VAN DER HEIJDED,et al.Age at disease onset and diagnosis delay in HLA-B27 negative vs positive patients with ankylosing spondylitis[J].Rheumatol lnt,2003,23(2):61-66.
[7]BAKLAND G,NOSSENT HC,GRAN JT.Incidence and prevalence of ankylosing spondylitis in northern norway[J].Arthritis Rheum,2005,53(6):850-855.
[8]CORTES A,PULIT SL,LEO PJ,et al.Major histocompatibility complex associations of ankylosing complex associations of ankylosing spondylitis are complex and involve further epistasis with ERAP1[J].Nat Commun,2015,21(6):7146.
[9]BROWN MA,KENNA T,WORDSWORTH BP.Genetics of ankylosing spondylitis--insights into pathogenesis[J].Nat Rev Rheumatol,2016,12(2):81-91.
[10]夏晓龙,陈扬,张伟彬,等.强直性脊柱炎遗传相关基因的研究进展[J].风湿病与关节炎,2016,5(2):68-73.
[11]RUDWALEIT M,LANDEWéR,VAN DER HEIJDED,et al.The development of assessment of Spondyloarthritis international society classification criteria for axial spondyloarthritis(part I):classification of paper patients by expert opinion including uncertainty appraisal[J].Ann Rheum,2009,68(6):770-776.
[12]WARD MM,DEOEHAR A,AKL EA,et al.American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis[J].Arthritis Rheumatology,2016,68(2):282-298.
[13]刘念,沈嘉艳,许飞,等.强直性脊柱炎的中医诊疗进展[J].风湿病与关节炎,2018,7(12):73-76.
[14]顾军花,茅建春,周时高,等.陈湘君运用扶正法治疗强直性脊柱炎经验撷菁[J].上海中医药杂志,2008,42(3):16-17.
[15]矫健鹏,刘煊.魏品康从痰论治强直性脊柱炎经验探析[J].中华中医药杂志,2011,26(8):759-761.
[16]杨少祥,郑福增,孟庆良,等.强直性脊柱炎的中西医治疗研究进展[J].风湿病与关节炎,2017,6(7):77-80.
[17]韩励兵,王苏娜,段晓荣,等.近年来蜂针临床运用及研究进展[J].云南中医中药杂志,2013,34(3):70-72.
[18]张冰清,刘晓波.蜂毒的主要成分及药理作用的研究进展[J].药学研究,2016,35(3):172-174.
[19]OSMAN MS,MAKSYMOWYCH WP.An update on the use of tumor necrosis factor alpha inhibitors in the treatment of ankylosing spondylitis[J].Expert Rev Clin Immunol,2016,13(2):125-131.