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[针刺联合督脉灸对强直性脊柱炎早中期及骶髂关节骨髓水肿的影响]

[Effect on ankylosing spondylitis at early-middle stage and bone marrow edema of sacroiliac joint treated with acupuncture and governor vessel moxibustion].

作者信息

Ma Yao, Bu He, Chen Qing-Wei, Yan Hui-Ming, Zhang Xue, Lv Hong-Yan, Wang Zi-Xuan

机构信息

Department of Acupuncture-Moxibustion of TCM, Second Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science & Technology, Baotou 014030, China.

Imaging Center, Second Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science & Technology, Baotou 014030, China.

出版信息

Zhongguo Zhen Jiu. 2022 Sep 12;42(9):971-6. doi: 10.13703/j.0255-2930.20210925-k0001.

Abstract

OBJECTIVE

To observe the efficacy of the combined treatment with acupuncture and governor vessel moxibustion on ankylosing spondylitis (AS) at early-middle stage and investigate the effect on bone marrow edema of sacroiliac joint.

METHODS

Seventy patients of AS at early-middle stage were randomized into an observation group (35 cases) and a control group (35 cases, 1 case dropped off ). In the control group, the recombinant human tumor necrosis factor receptor-antibody of type Ⅱ fusion protein for injection was injected subcutaneously, 25 mg each time, once on every Monday and Friday, consecutively for 3 weeks. In the observation group, on the base of the intervention as the control group, acupuncture combined with governor vessel moxibustion were provided. Acupuncture was applied to Dazhui (GV 14), Changqiang (GV 1), Zhibian (BL 54), Baihui (GV 20), etc.; the thermal needling technique was adopted at Dazhui (GV 4) and Changqiang (GV 1) for promoting the circulation of the governor vessel, and the ginger-isolated moxibustion on the governor vessel was combined. Such intervention measure was provided once daily. One treatment session contained 7 treatments and 3 sessions were required. Before and after treatment, the scores of Spondyloarthritis Research Consortium of Canada (SPARCC), Bath ankylosing spondylitis disease activity index (BASDAI) and Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis patient global score (BAS-G) were observed in the two groups separately. The efficacy and adverse effects were assessed in the two groups after treatment.

RESULTS

The scores of SPARCC, BASDAI, BASFI and BAS-G were all reduced after treatment compared with those before treatment in the two groups (<0.05), and those in the observation group were lower than the control group (<0.05). The total effective rate was 97.1% (34/35) in the observation group, higher than 82.4% (28/34) in the control group (<0.05). There were 4 cases of gastrointestinal reactions and 1 case of skin rashes in the control group; and 3 cases of local skin redness and pruritus after governor vessel moxibustion, no any drug adverse effect was found in the observation group.

CONCLUSION

Based on the western medicine treatment, the combined therapy of acupuncture and governor vessel moxibustion may relieve bone marrow edema of sacroiliac joint in patients with AS at early-middle stage, control the progression of disease and improve the daily life activity. This therapy is relatively safe and effective.

摘要

目的

观察针督脉灸联合治疗对早中期强直性脊柱炎(AS)的疗效,并探讨其对骶髂关节骨髓水肿的影响。

方法

将70例早中期AS患者随机分为观察组(35例)和对照组(35例,脱落1例)。对照组皮下注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白,每次25mg,每周一、周五各1次,连续3周。观察组在对照组干预基础上,采用针刺联合督脉灸治疗。针刺选取大椎(GV14)、长强(GV1)、秩边(BL54)、百会(GV20)等穴;大椎(GV4)、长强(GV1)采用温针技术以通督脉,并配合督脉隔姜灸。每日1次,1个疗程7次,共治疗3个疗程。分别观察两组治疗前后加拿大脊柱关节炎研究联盟(SPARCC)评分、巴斯强直性脊柱炎疾病活动指数(BASDAI)、巴斯强直性脊柱炎功能指数(BASFI)及巴斯强直性脊柱炎患者整体评分(BAS-G)。治疗后评估两组疗效及不良反应。

结果

两组治疗后SPARCC、BASDAI、BASFI及BAS-G评分均较治疗前降低(<0.05),且观察组低于对照组(<0.05)。观察组总有效率为97.1%(34/35),高于对照组的82.4%(28/34)(<0.05)。对照组出现4例胃肠道反应、1例皮疹;观察组督脉灸后有3例局部皮肤发红瘙痒,未发现任何药物不良反应。

结论

在西医治疗基础上,针督脉灸联合治疗可缓解早中期AS患者骶髂关节骨髓水肿,控制病情进展,改善日常生活活动能力,且该疗法相对安全有效。

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