督脉隔姜灸联合康复操改善强直性脊柱炎患者关节功能的观察
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摘要
目的探讨督脉隔姜灸联合康复操改善强直性脊柱炎患者关节功能的效果。方法强直性脊柱炎患者40例分成对照组(n=20)和观察组(n=20)。治疗期间,对照组患者给予常规护理和功能锻炼,观察组在对照组的基础上给予督脉隔姜灸联合康复操。干预前和干预后3个月,分别测量患者C-反应蛋白(CRP)和红细胞沉降率(ESR),观察记录患者胸廓活动度、夜间视觉模拟评分法(VAS)评分、Bath强直性脊柱炎病情活动性指数(BASDAI)评分和Bath强直性脊柱炎功能性指数(BASFI)评分。结果干预后3个月,观察组CRP和ESR水平低于对照组(P<0.01)。观察组胸廓活动度较对照组增大(P<0.01)。2组夜间VAS、BASDAI和BASFI均较干预前降低,且观察组改善幅度优于对照组(P<0.01)。结论督脉隔姜灸联合康复操可以进一步改善强直性脊柱炎患者的关节功能。
Objective To investigate the effect of ginger moxibustion combined w ith rehabilitation gymnastics on joint function of patients w ith ankylosing spondylitis( AS). Methods Totally 40 AS patients w ere assigned to the observation group( n = 20) and the control group( n =20). Patients in both tw o groups received routine care and functional training during treatment,and those in the observation group w ere given ginger moxibustion combined w ith rehabilitation gymnastics. The serum level of C-reactive protein( CRP) and erythrocyte sedimentation rate( ESR) were measured before and three months after intervention. The thoracic Range of Motion( ROM),Visual Analogue Scale( VAS) on pain during night,Bath Ankylosing Spondylitis Disease Activity Index( BASDAI) and Bath Ankylosing Spondylitis Functional Index( BASFI) w ere assessed and compared betw een tw o groups. Results At three months after treatment,the level of CRP and ESR w ere low er in the observation group than those in the control group( P < 0. 01).Patients in the observation group had a better improvement of thoracic ROM compared w ith that of controls( P < 0. 01). The scores of VAS,BASDAI and BASFI w ere decreased in both tw o groups at three months after treatment,and w ere low er in the observation group than those in the control group( P < 0. 01). Conclusion The ginger moxibustion combined w ith rehabilitation gymnastics is potentially effective to improve the joint function of AS patients.
Objective To investigate the effect of ginger moxibustion combined w ith rehabilitation gymnastics on joint function of patients w ith ankylosing spondylitis( AS). Methods Totally 40 AS patients w ere assigned to the observation group( n = 20) and the control group( n =20). Patients in both tw o groups received routine care and functional training during treatment,and those in the observation group w ere given ginger moxibustion combined w ith rehabilitation gymnastics. The serum level of C-reactive protein( CRP) and erythrocyte sedimentation rate( ESR) were measured before and three months after intervention. The thoracic Range of Motion( ROM),Visual Analogue Scale( VAS) on pain during night,Bath Ankylosing Spondylitis Disease Activity Index( BASDAI) and Bath Ankylosing Spondylitis Functional Index( BASFI) w ere assessed and compared betw een tw o groups. Results At three months after treatment,the level of CRP and ESR w ere low er in the observation group than those in the control group( P < 0. 01).Patients in the observation group had a better improvement of thoracic ROM compared w ith that of controls( P < 0. 01). The scores of VAS,BASDAI and BASFI w ere decreased in both tw o groups at three months after treatment,and w ere low er in the observation group than those in the control group( P < 0. 01). Conclusion The ginger moxibustion combined w ith rehabilitation gymnastics is potentially effective to improve the joint function of AS patients.
引文
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[6]杜日兰.护理干预对幼年强直性脊柱炎病人生活质量的影响[J].护理研究,2014(33):4183-4185.
[7]CHAUDHARY M A,HSU B,MUSZBEK N,et al.PRM57 Developing BASDAI and BASFI Predictive Equations From Clinical Trial Data of Golimumab for Severe,Active Ankylosing Spondylitis in Adults[J].Value in Health 2012,15(7):A470.
[8]CALIN A,GARRETT S,WHITELOCK H,et al.A new approach to defining functional ability in ankylosing spondylitis:the development of the Bath Ankylosing Spondylitis Functional Index[J].J Rheumatol,1994,21(12):2281-2285.
[9]KANG J H,CHEN Y H,LIN H C.Comorbidity profiles among patients w ith ankylosing spondylitis:a nationw ide population-based study[J].Ann Rheum Dis,2015,69(6):1165-1168.
[10]张宝霞.强直性脊柱炎采用中医针灸综合治疗的机理及疗效分析[J].中医临床研究,2014,6(5):61-62.
[11]杨继国,刘源香,孙山,等.督灸治疗强直性脊柱炎对热像图的影响[J].山东中医杂志,2014,33(11):904-905.
[12]周子朋.督灸改善强直性脊柱炎脊柱僵痛临床研究[J].中医学报,2013,28(10):1603-1604.
[13]张彤,刘伟伟,马怀念,等.隔姜蒜督灸治疗强直性脊柱炎的临床研究[J].山东中医杂志,2013,32(12):897-900.
[14]李汝清,雷军,郎静,等.功能康复锻炼对强直性脊柱炎疾病评价指数的影响[J].中国临床保健杂志,2017,20(3):291-293.
[15]李坤鹏,黄烽.重视康复运动在强直性脊柱炎治疗中的关键作用[J].中华内科杂志,2017,56(9):635-638.
[16]邓蓉,梁燕,谭小波,等.强直性脊柱炎患者自我管理状况调查分析[J].华西医学,2015,30(1):115-118.
[17]岑琼.自我效能感理论应用于慢性病自我管理的研究进展[J].中华全科医学,2011,9(11):1780-1781.
[2]SMOLEN J S,BRAUN J,DOUGADOS M,et al.Extended report:Treating spondyloarthritis,including ankylosing spondylitis and psoriatic arthritis,to target:recommendations of an international task force[J].Ann Rheum Dis,2014,73(1):6-16.
[3]汪四海,刘健,张金山,等.强直性脊柱炎患者生活质量变化及其影响因素研究[J].中医药临床杂志,2011,23(6):519-521.
[4]祖娜,赵翠芳,刘慧.强直性脊柱炎的中医药治疗现状[J].中国临床医生杂志,2010,38(6):26-28.
[5]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.
[6]杜日兰.护理干预对幼年强直性脊柱炎病人生活质量的影响[J].护理研究,2014(33):4183-4185.
[7]CHAUDHARY M A,HSU B,MUSZBEK N,et al.PRM57 Developing BASDAI and BASFI Predictive Equations From Clinical Trial Data of Golimumab for Severe,Active Ankylosing Spondylitis in Adults[J].Value in Health 2012,15(7):A470.
[8]CALIN A,GARRETT S,WHITELOCK H,et al.A new approach to defining functional ability in ankylosing spondylitis:the development of the Bath Ankylosing Spondylitis Functional Index[J].J Rheumatol,1994,21(12):2281-2285.
[9]KANG J H,CHEN Y H,LIN H C.Comorbidity profiles among patients w ith ankylosing spondylitis:a nationw ide population-based study[J].Ann Rheum Dis,2015,69(6):1165-1168.
[10]张宝霞.强直性脊柱炎采用中医针灸综合治疗的机理及疗效分析[J].中医临床研究,2014,6(5):61-62.
[11]杨继国,刘源香,孙山,等.督灸治疗强直性脊柱炎对热像图的影响[J].山东中医杂志,2014,33(11):904-905.
[12]周子朋.督灸改善强直性脊柱炎脊柱僵痛临床研究[J].中医学报,2013,28(10):1603-1604.
[13]张彤,刘伟伟,马怀念,等.隔姜蒜督灸治疗强直性脊柱炎的临床研究[J].山东中医杂志,2013,32(12):897-900.
[14]李汝清,雷军,郎静,等.功能康复锻炼对强直性脊柱炎疾病评价指数的影响[J].中国临床保健杂志,2017,20(3):291-293.
[15]李坤鹏,黄烽.重视康复运动在强直性脊柱炎治疗中的关键作用[J].中华内科杂志,2017,56(9):635-638.
[16]邓蓉,梁燕,谭小波,等.强直性脊柱炎患者自我管理状况调查分析[J].华西医学,2015,30(1):115-118.
[17]岑琼.自我效能感理论应用于慢性病自我管理的研究进展[J].中华全科医学,2011,9(11):1780-1781.