| 摘要: |
| 目的：观察通督针法联合温阳消痹汤热熨治疗强直性脊柱炎肾虚督寒证的临床效果。方法：将82 例强直性脊柱炎肾虚督寒证患者随机分为治疗组及对照组，每组各41 例。对照组给予萘丁美酮胶囊治疗，治疗组在对照组基础上给予通督针法、温阳消痹汤热熨治疗。比较2组临床疗效、中医证候总积分、指地距、枕墙距、胸廓活动度、脊柱情况［疼痛视觉模拟评分法（visual analogue scale，VAS）评分、巴氏强直性脊柱炎功能指数（Bath Ankylosing Spondylitis Functional Index，BASFI）评分、改良Stoke强直性脊柱炎脊柱评分（modified Stoke Ankylosing Spondylitis Spinal Score，mSASSS）］、血清C反应蛋白（C-reactive protein，CRP）水平、不良反应发生情况。结果：总有效率治疗组为95.12%（39/41），对照组为80.49%（33/41），2组比较，差异有统计学意义（P＜0.05)；治疗后，2组中医证候总积分、指地距、枕墙距、疼痛VAS评分、BASFI评分、mSASSS评分、血清CRP水平均较治疗前降低（P＜0.05或P＜0.01)，且治疗组低于对照组（P＜0.01)；2组胸廓活动度较治疗前增大，且治疗组大于对照组（P＜0.01)；不良反应发生率治疗组为4.88%（2/41），对照组为9.76%（4/41），2组比较，差异无统计学意义（P＞0.05）。结论：通督针法联合温阳消痹汤热熨有利于改善强直性脊柱炎肾虚督寒证患者临床症状，减轻脊柱疼痛，提高脊柱功能，减轻炎症反应，且不良反应少。 |
| 关键词: 强直性脊柱炎 肾虚督寒证 通督针法 温阳消痹汤 脊柱疼痛 脊柱功能 炎症反应 |
| DOI： |
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| Clinical effect of Tongdu acupuncture combined with hot compression therapy with Wenyang Xiaobi Decoction in treatment of ankylosing spondylitis：An analysis of 41 cases |
| LU Xing |
| (Jinan Hospital of Integrated Traditional Chinese and Western Medicine，Jinan 271100，Shandong，China) |
| Abstract: |
| Objective：To investigate the clinical effect of Tongdu acupuncture combined with hot compression therapy with Wenyang Xiaobi Decoction in the treatment of ankylosing spondylitis with kidney deficiency and back cold syndrome.Methods：A total of 82 patients with ankylosing spondylitis with kidney deficiency and back cold syndromewere randomly divided into treatment group and control group，with 41 patients in each group.The patients in the control group were given nabumetone capsules，and those in the treatment group were given Tongdu acupuncture and hot compression therapy with Wenyang Xiaobi Decoction in addition to the treatment in the control group.The two groups were compared in terms of clinical outcome，total traditional Chinese medicine （TCM) syndrome score，finger-to-floor distance，pillow-wall distance，thoracic range of motion，spine conditions （visual analogue scale ［VAS］ score，Bath Ankylosing Spondylitis Functional Index ［BASFI］ score，and modified stoke ankylosing spondylitis spine score ［mSASSS］)，the serum level of C-reactive protein （CRP)，and adverse reactions.Results：There was a significant difference in overall response rate between the treatment group and the control group ［95.12% （39/41) vs 80.49% （33/41)，P < 0.05］.After treatment，both groups had significant reductions in TCM syndrome score，finger-to-floor distance，pillow-wall distance，VAS score for spine pain，BASFI score，mSASSS score，and the serum level of CRP （P < 0.05 or P < 0.01)，and the treatment group had significantly lower values than the control group （P < 0.01).After treatment，both groups had a significant increase in thoracic range of motion，and the treatment group had a significantly greater thoracic range of motion than the control group （P < 0.01).There was no significant difference in the incidence rate of adverse reactions between the treatment group and the control group ［4.88% （2/41) vs 9.76% （4/41)，P > 0.05］.Conclusion：For patients with ankylosing spondylitis with kidney deficiency and back cold syndrome，Tongdu acupuncture combined with hot compression therapy with Wenyang Xiaobi Decoction can effectively improve their clinical symptoms，reduce spine pain，improve spine function，and alleviate inflammatory response，with few adverse reactions. |
| Key words: ankylosing spondylitis kidney deficiency and back cold syndrome Tongdu acupuncture Wenyang Xiaobi Decoction spine pain spine function inflammatory response |
