按脊松枢法结合蜂针治疗强直性脊柱炎的疗效观察
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摘要
【目的】观察按脊松枢法结合蜂针治疗强直性脊柱炎(AS)的临床疗效。【方法】将106例AS患者随机分为观察组68例和对照组38例。其中观察组给予按脊松枢法结合蜂针治疗,对照组给予口服塞来昔布胶囊治疗。2组均治疗12周。观察治疗前后患者脊柱痛、夜间痛评分和患者总体评估指数(PGA)、AS疾病活动指数(BASDAI)、AS功能指数(BASFI)、AS衡量指数(BASMI)及C反应蛋白(CRP)和血沉(ESR)的变化情况,采用ASAS20、ASAS40及BASDAI50标准及中医证候疗效评价标准进行综合评分并评价临床疗效。【结果】(1)观察组无脱落病例,对照组脱落4例,2组均无剔除及终止病例。(2)治疗4、12周后,2组患者脊柱痛、夜间痛、PGA均明显改善(P<0.01),且观察组的改善作用优于对照组(P<0.05或P<0.01)。(3)治疗4、12周后,2组患者BASDAI、BASFI、BASMI均明显改善(P<0.01),且观察组的改善作用优于对照组(P<0.05或P<0.01)。(4)治疗4、12周后,2组患者CRP、ESR均明显改善(P<0.01),但治疗后组间比较,差异无统计学意义(P> 0.05)。(5)治疗4、12周后,2组患者中医证候积分均明显改善(P<0.01),且观察组的改善作用优于对照组(P<0.05或P<0.01)。(6)治疗12周后,观察组达到ASAS20的例数优于对照组(P<0.05)。(7)治疗12周后,观察组总有效率为85.29%,对照组为61.76%,观察组的中医证候疗效优于对照组(P<0.01)。(8)试验过程中,观察组有5例过敏反应,对照组有6例胃部不适,对症处理后,症状缓解。随访未见不适。【结论】按脊松枢法结合蜂针治疗强直性脊柱炎有良好的临床疗效。
Objective To observe the clinical efficacy of Spine-pressing and Pivot-relaxing Therapy combined with Bee-venom therapy for the treatment of ankylosing spondylitis(AS). Methods One hundred and six patients with AS were randomly divided into observation group(68 cases)and control group(34 cases).The observation group was treated by spine-pressing and pivot-relaxing therapy combined with Bee-venom therapy, and the control group was treated with Celecoxibs orally, the treatment for the two groups lasting 12 weeks. Before and after treatment, the scores of spinal pain and night pain, Patients' Global Assessment(PGA), Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), Bath Ankylosing Spondylitis Functional Index(BASFI), and Bath Ankylosing Spondylitis Metrology Index(BASMI)were observed,and C-reactive protein(CRP)level and erythrocyte sedimentation rate(ESR)were detected. And then the comprehensive scoring was carried out with reference to ankylosing spondylitis 20(ASAS)20,ASAS40 and BASDAI50 as well as traditional Chinese medicine(TCM)syndromes to assess the curative effect. Results(1)There was no case in the treatment group dropped out,but there were 4 cases in the cotnrol group dropped out;there was no exclused case or terminating case in the two groups.(2)After treatment for 4,12 weeks,pinal pain,night pain,and PGA in the two groups were obviously improved(P<0.01),and the improvement in the observation group was superiro to that in the control group(P<0.05 or P<0.01).(3)After treatment for 4,12 weeks,BASDAI,BASFI and BASMI in the two groups were obviously improved(P<0.01),and the improvement in the observation group was superiro to that in the control group(P<0.05 or P<0.01).(4) After treatment for 4, 12 weeks, CRP and ESR in the two groups were obviously improved(P<0.01).(5)After treatment for 4,12 weeks,TCM syndrome scores in the two groups were obviously improved(P<0.01),and the improvement in the observation group was superiro to that in the control group(P<0.05 or P<0.01).(6)After treatment for 12 weeks, the amount of patients meeting the criteria of ASAS20 in the observation group was larger than that in the control group(P<0.05).(7)After treatment for 12 weeks, the total effective rate for TCM syndromes was 85.29% in the observation group, was 61.76% in the control group, the difference being significant(P<0.01).(8)During the trial, there were 5 cases of allergic reaction in the observation group,and were 6 cases of gastric discomfort. And then the symptoms were relieved after symptomatic treatment. No adverse reaction was found in the two groups during the follow-up. Conclusion Spine-pressing and pivot-relaxing therapy combined with bee-venom therapy has certain clinical efficacy for the treatment of AS.
Objective To observe the clinical efficacy of Spine-pressing and Pivot-relaxing Therapy combined with Bee-venom therapy for the treatment of ankylosing spondylitis(AS). Methods One hundred and six patients with AS were randomly divided into observation group(68 cases)and control group(34 cases).The observation group was treated by spine-pressing and pivot-relaxing therapy combined with Bee-venom therapy, and the control group was treated with Celecoxibs orally, the treatment for the two groups lasting 12 weeks. Before and after treatment, the scores of spinal pain and night pain, Patients' Global Assessment(PGA), Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), Bath Ankylosing Spondylitis Functional Index(BASFI), and Bath Ankylosing Spondylitis Metrology Index(BASMI)were observed,and C-reactive protein(CRP)level and erythrocyte sedimentation rate(ESR)were detected. And then the comprehensive scoring was carried out with reference to ankylosing spondylitis 20(ASAS)20,ASAS40 and BASDAI50 as well as traditional Chinese medicine(TCM)syndromes to assess the curative effect. Results(1)There was no case in the treatment group dropped out,but there were 4 cases in the cotnrol group dropped out;there was no exclused case or terminating case in the two groups.(2)After treatment for 4,12 weeks,pinal pain,night pain,and PGA in the two groups were obviously improved(P<0.01),and the improvement in the observation group was superiro to that in the control group(P<0.05 or P<0.01).(3)After treatment for 4,12 weeks,BASDAI,BASFI and BASMI in the two groups were obviously improved(P<0.01),and the improvement in the observation group was superiro to that in the control group(P<0.05 or P<0.01).(4) After treatment for 4, 12 weeks, CRP and ESR in the two groups were obviously improved(P<0.01).(5)After treatment for 4,12 weeks,TCM syndrome scores in the two groups were obviously improved(P<0.01),and the improvement in the observation group was superiro to that in the control group(P<0.05 or P<0.01).(6)After treatment for 12 weeks, the amount of patients meeting the criteria of ASAS20 in the observation group was larger than that in the control group(P<0.05).(7)After treatment for 12 weeks, the total effective rate for TCM syndromes was 85.29% in the observation group, was 61.76% in the control group, the difference being significant(P<0.01).(8)During the trial, there were 5 cases of allergic reaction in the observation group,and were 6 cases of gastric discomfort. And then the symptoms were relieved after symptomatic treatment. No adverse reaction was found in the two groups during the follow-up. Conclusion Spine-pressing and pivot-relaxing therapy combined with bee-venom therapy has certain clinical efficacy for the treatment of AS.
引文
[1]中华医学会风湿病学分会.强直性脊柱炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(8):557.
[2]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2001:119.
[3]李万瑶,张谅,袁凯.蜜蜂针刺法的探讨[J].针灸临床杂志,2012,28(3):63.
[4] Garrett S,Jenkinson T,Kennedy L G,et al. A new approach to defining disease status in ankylosing spondylitis:the Bath Ankylosing Spondylitis Disease Activity Index[J]. J Rheumatol,1994,21(12):2286.
[5] Bodur H, Ataman S, Rezvani A, et al. Quality of life and relatedvariables in patients with ankylosing spondylitis[J]. Qual Life Res,2011,20(4):543.
[6] Jenkinson T, Mallorie P A, Whitelock H C, et al. Defining spinal mobility in ankylosing spondylitis(AS):The Bath AS Metrology Index[J]. J Rheumatol,1994,21(9):1694.
[7] Solmaz D,Yildirim T,Avci O,et al. Performance characteristics of thesimplified version of ankylosing spondylitis disease activity score(SASDAS)[J]. Clin Rheumatol,2016,35(7):1753.
[8] Zochling J, Braun J. Assessment of ankylosing spondylitis[J].Clin Exp Rheumatol, 2005,23(5 Suppl 39):S133.
[9]张爱明,李青,蔡林,等.强直性脊柱炎临床病理分期与疼痛缓解程度的临床应用研究[J].生物骨科材料与临床研究,2016,13(3):61.
[10]张冰清.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.
[11]冯兴华,姜泉,刘宏潇,等.中医辨证治疗强直性脊柱炎的临床疗效评价[J].中国中西医结合杂志,2013,33(10):1309.
[12]于盈盈,茅建春.强直性脊柱炎的中医治疗进展[J].吉林中医药,2019,39(1):137.
[13]杨朔,贺守第,徐剑峰,等.黄胜光教授治疗强直性脊柱炎临床经验[J].湖南中医药大学学报,2018,38(7):762.
[14]张莹莹,邹玉琼,应奇峰,等.强直性脊柱炎156例骨丢失特点及相关因素分析[J].浙江医学,2011,33(3):331.
[15]聂蕊,李涯松.强直性脊柱炎异位骨化机制研究进展[J].中国骨质疏松杂志,2016,22(10):1353.
[2]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2001:119.
[3]李万瑶,张谅,袁凯.蜜蜂针刺法的探讨[J].针灸临床杂志,2012,28(3):63.
[4] Garrett S,Jenkinson T,Kennedy L G,et al. A new approach to defining disease status in ankylosing spondylitis:the Bath Ankylosing Spondylitis Disease Activity Index[J]. J Rheumatol,1994,21(12):2286.
[5] Bodur H, Ataman S, Rezvani A, et al. Quality of life and relatedvariables in patients with ankylosing spondylitis[J]. Qual Life Res,2011,20(4):543.
[6] Jenkinson T, Mallorie P A, Whitelock H C, et al. Defining spinal mobility in ankylosing spondylitis(AS):The Bath AS Metrology Index[J]. J Rheumatol,1994,21(9):1694.
[7] Solmaz D,Yildirim T,Avci O,et al. Performance characteristics of thesimplified version of ankylosing spondylitis disease activity score(SASDAS)[J]. Clin Rheumatol,2016,35(7):1753.
[8] Zochling J, Braun J. Assessment of ankylosing spondylitis[J].Clin Exp Rheumatol, 2005,23(5 Suppl 39):S133.
[9]张爱明,李青,蔡林,等.强直性脊柱炎临床病理分期与疼痛缓解程度的临床应用研究[J].生物骨科材料与临床研究,2016,13(3):61.
[10]张冰清.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.
[11]冯兴华,姜泉,刘宏潇,等.中医辨证治疗强直性脊柱炎的临床疗效评价[J].中国中西医结合杂志,2013,33(10):1309.
[12]于盈盈,茅建春.强直性脊柱炎的中医治疗进展[J].吉林中医药,2019,39(1):137.
[13]杨朔,贺守第,徐剑峰,等.黄胜光教授治疗强直性脊柱炎临床经验[J].湖南中医药大学学报,2018,38(7):762.
[14]张莹莹,邹玉琼,应奇峰,等.强直性脊柱炎156例骨丢失特点及相关因素分析[J].浙江医学,2011,33(3):331.
[15]聂蕊,李涯松.强直性脊柱炎异位骨化机制研究进展[J].中国骨质疏松杂志,2016,22(10):1353.