酉时雷火灸联合通督推拿法治疗强直性脊柱炎急性期患者的效果及对患者脊柱功能的影响

The effects of Youshi thunder-fire moxibustion combined with Tongdu massage on patients with ankylosing spondylitis acute stage and the impact on the spinal function of patients

关键词:  酉时  雷火灸  通督推拿法  强直性脊柱炎  急性期  脊柱功能

Key words:  Youshi  thunder-fire moxibustion  Tongdu massage method  ankylosing spondylitis  acute stage  spinal function

摘要:

[目的] 探讨酉时雷火灸联合通督推拿法治疗强直性脊柱炎（AS）急性期患者的疗效及对患者脊柱功能的影响。[方法] 选取2021年5月—2023年5月广州中医药大学惠州医院AS急性期住院患者96例，采用随机数字表法随机分为两组，对照组48例进行常规药物治疗，试验组48例在常规药物治疗的同时实施酉时雷火灸及通督推拿法。治疗两周后评估疗效。治疗前、治疗2周比较两组中医主症评分，根据枕墙距、Schober试验、胸廓活动度、晨僵时间综合评估患者脊柱功能，检测血沉（ESR）、C反应蛋白（CRP）、金属基质蛋白酶（MMP）-3、白介素（IL）-6、IL-1β、肿瘤坏死因子（TNF）-α。统计两组治疗期间不良反应发生率。[结果] 试验组临床疗效、证候疗效高于对照组（P＜0.05）。治疗2周时两组中医主症评分低于治疗前，试验组低于对照组（P＜0.05）；两组枕墙距小于治疗前，Schober试验、胸廓活动度大于治疗前，晨僵时间短于治疗前，试验组变化幅度更大（P＜0.05）；两组ESR、CRP、MMP-3、IL-6、IL-1β、TNF-α均降低，且试验组低于对照组（P＜0.05）。试验组不良反应发生率与对照组比较差异无统计学意义（P＞0.05）。[结论] 酉时雷火灸联合通督推拿法治疗AS寒湿痹阻证急性期效果显著，可有效减轻患者症状，改善脊柱功能，降低急性炎症反应，且安全性有保障。

Abstract:

[Objective] To explore the effects of Youshi thunder-fire moxibustion combined with Tongdu massage on patients with ankylosing spondylitis（AS） in acute stage and the effects on the spinal function of the patients. [Methods] A total of 96 patients with AS acute stage in our hospital from May 2021 to May 2023 were selected and divided into two groups by random number table method. 48 patients in the control group received conventional drug treatment，and 48 patients in the experimental group received Youshi thunder-fire moxibustion and Tongdu massage while receiving conventional drug treatment. The efficacy of the two groups was evaluated after two weeks of treatment. Before treatment and after 2 weeks of treatment，the scores of traditional Chinese medicine main symptoms were compared between the two groups，and the spinal function of patients was comprehensively evaluated according to occipital wall distance，Schober test，thoracic motion and morning stiffness time. Erythrocyte sedimentation rate（ESR），C-reactive protein（CRP），metallomatrix proteinase（MMP）-3，interleukin（IL）-6，IL-1β，tumor necrosis factor（TNF） -α were detected. The incidence of adverse reactions during treatment was analyzed. [Results] The curative effect of disease and syndrome in experimental group was higher than that in control group（P<0.05）. After 2 weeks of treatment，the scores of traditional Chinese medicine main symptoms in the experimental group were lower than those in the control group（P<0.05）. After 2 weeks of treatment，the occipital wall distance between the two groups was less than that before treatment，the Schober test and the thorax activity were more than that before treatment，and the morning stiffness time was shorter than that before treatment，and the change range of the experimental group was greater（P<0.05）. After 2 weeks of treatment，ESR，CRP，MMP-3，IL-6，IL-1β and TNF-α decreased in both groups，and the experimental group was lower than the control group（P<0.05）. There was no significant difference in the incidence of adverse reactions between experimental group and control group（P>0.05）. [Conclusion] Youshi thunder-fire moxibustion combined with Tongdu massage treatment of AS syndrome of cold and dampness impediment acute stage has a significant effect，which can effectively reduce the symptoms of patients，improve spinal function，reduce acute inflammatory response，and safety is guaranteed.