Nghiem Francine Ton, Donohue John Patrick
Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
Curr Opin Rheumatol. 2008 Mar;20(2):203-7. doi: 10.1097/BOR.0b013e3282f56868.
Medical therapy of ankylosing spondylitis has improved dramatically with the advent of anti-tumor necrosis factor therapy, but nonpharmacologic therapies have long been employed to treat the condition. The purpose of this review is to summarize the most recent data to assess the role of exercise and nonpharmacologic therapies in ankylosing spondylitis.
We review six articles published since 2005. The most common outcome measures (validated scores from Bath group) were only formally utilized in two studies. Four of the six studies were randomized controlled trials. One study using balneotherapy did not reveal any significant improvement in the medium term. One study used a multimodal exercise program, which revealed some benefit. Two studies assessed short and long-term efficacy of an experimental exercise protocol and suggested a prolonged benefit. Two small studies looking at biologic markers suggested that exercise may impact cytokine production.
All studies we reviewed had small numbers of participants without a standardized control group and each study used different outcome measures. This review demonstrates the importance of continued emphasis on exercise therapy, the need for a standardized approach to exercise therapy, and a potential biologic effect. Exercise therapy should remain a mainstay of ankylosing spondylitis treatment complementing medical therapy.
随着抗肿瘤坏死因子疗法的出现，强直性脊柱炎的药物治疗有了显著改善，但非药物疗法长期以来一直用于治疗该疾病。本综述的目的是总结最新数据，以评估运动和非药物疗法在强直性脊柱炎中的作用。
我们回顾了2005年以来发表的6篇文章。最常见的结局指标（来自巴斯组的验证分数）仅在两项研究中正式使用。六项研究中有四项是随机对照试验。一项使用温泉疗法的研究在中期未显示出任何显著改善。一项研究使用了多模式运动计划，显示出一些益处。两项研究评估了一种实验性运动方案的短期和长期疗效，并表明有长期益处。两项观察生物标志物的小型研究表明，运动可能会影响细胞因子的产生。
我们回顾的所有研究参与者数量较少，且没有标准化的对照组，每项研究使用的结局指标也不同。本综述表明了持续强调运动疗法的重要性以及对运动疗法采取标准化方法和潜在生物学效应的必要性。运动疗法应仍然是强直性脊柱炎治疗的主要手段，作为药物治疗的补充。
