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
|
摘要
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.
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.
引文
[1]邹玉明,蔡颜荣,徐卫东.强直性脊柱炎发病过程中炎症与骨化的关系[J].中国矫形外科杂志,2015,23(7):632-636.
[2]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):557-559.
[3]叶俏,杜瑛媛,顾旭东,等.强直性脊柱炎患者血清白介素1、2、6及肿瘤坏死因子-测定的意义[J].中华物理医学与康复杂志,2008,30(3):162-164.
[4]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):557-559.
[5] 1988年全国中西医结合风湿类疾病学术会议修订.强直性脊柱炎疗效评定标准[J].中国中西医结合杂志,1989,9(1):52-53.
[6]吴绪平,沈玉杰.中华内热针临床诊断与治疗[M].北京:中国医药科技出版社,2015:191-196.
[7]纪哲,申鹏飞.芒针针刺夹脊穴与督脉穴治疗中风后痉挛性瘫痪[J].黑龙江中医药,2014,2(6):51-53.
[8]赵青华,李育文,郭守环.多针浅刺、拔罐配合生姜片外擦股外侧皮神经炎26例[J].河北中医,2009,31(10):1527.
[9] Dowthwaite GP,Edwards JCW,Pitsillides AA. An essentialrole for the interaction between hyaluronan and hyaluronanbinding proteins during joint develop pment[J].Histochem,1998,46(5):641-651.
[10] Lainer DT,Brahn E.New anti angiogenic strategies for thetreatment of proliferative synovitis[J]. Expert Opin InvestigDrugs,2005,14(1):1-17.
[11]王飞,高谦,王刚,等.软组织内热治疗针体外温度变化的特点分析[J].解放军医学院学报,2010,31(1):78-79.
[12]缪鸿石.电疗与光疗[M].上海:上海科学技术出版社,1979:38-240.
[13]杨志丽,高谦,王刚,等.软组织内热针与银质针对大鼠骨骼肌慢性损伤后SOD、MDA水平的影响[J].中华保健医学杂志,2011,13(1):28-30.
[14]金粉勤,薛锋.膝骨关节炎患者血清TNF-a与IL-6水平检测分析[J].中国实验诊断学,2014,18(3):461-463.
[2]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):557-559.
[3]叶俏,杜瑛媛,顾旭东,等.强直性脊柱炎患者血清白介素1、2、6及肿瘤坏死因子-测定的意义[J].中华物理医学与康复杂志,2008,30(3):162-164.
[4]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):557-559.
[5] 1988年全国中西医结合风湿类疾病学术会议修订.强直性脊柱炎疗效评定标准[J].中国中西医结合杂志,1989,9(1):52-53.
[6]吴绪平,沈玉杰.中华内热针临床诊断与治疗[M].北京:中国医药科技出版社,2015:191-196.
[7]纪哲,申鹏飞.芒针针刺夹脊穴与督脉穴治疗中风后痉挛性瘫痪[J].黑龙江中医药,2014,2(6):51-53.
[8]赵青华,李育文,郭守环.多针浅刺、拔罐配合生姜片外擦股外侧皮神经炎26例[J].河北中医,2009,31(10):1527.
[9] Dowthwaite GP,Edwards JCW,Pitsillides AA. An essentialrole for the interaction between hyaluronan and hyaluronanbinding proteins during joint develop pment[J].Histochem,1998,46(5):641-651.
[10] Lainer DT,Brahn E.New anti angiogenic strategies for thetreatment of proliferative synovitis[J]. Expert Opin InvestigDrugs,2005,14(1):1-17.
[11]王飞,高谦,王刚,等.软组织内热治疗针体外温度变化的特点分析[J].解放军医学院学报,2010,31(1):78-79.
[12]缪鸿石.电疗与光疗[M].上海:上海科学技术出版社,1979:38-240.
[13]杨志丽,高谦,王刚,等.软组织内热针与银质针对大鼠骨骼肌慢性损伤后SOD、MDA水平的影响[J].中华保健医学杂志,2011,13(1):28-30.
[14]金粉勤,薛锋.膝骨关节炎患者血清TNF-a与IL-6水平检测分析[J].中国实验诊断学,2014,18(3):461-463.