大椎麦粒灸结合柳氮磺吡啶及功能锻炼治疗早期强直性脊柱炎临床观察

黄志强　付长龙　苏昭元　苏稼夫　吴强

【摘 要】目的：探讨大椎麦粒灸结合柳氮磺吡啶及功能锻炼治疗早期强直性脊柱炎的临床疗效及作用机制。方法：将78例早期强直性脊柱炎患者随机分为大椎麦粒灸组和药物组，每组35例。药物组给予柳氮磺吡啶口服治疗，同時进行功能锻炼，大椎麦粒灸组在药物组治疗的基础上加用大椎麦粒灸。2组均治疗2个月。观察2组临床疗效，并检测2组治疗前后红细胞沉降率、血清肿瘤坏死因子-α及细胞间黏附分子-1的含量。结果：大椎麦粒灸组总有效率为88.6%，优于药物组的74.2%；治疗后2组红细胞沉降率、血清肿瘤坏死因子-α、细胞间黏附分子-1含量均下降（P < 0.05），大椎麦粒灸组下降更明显（均P < 0.05）。结论：大椎麦粒灸结合柳氮磺吡啶及功能锻炼治疗早期强直性脊柱炎，能显著改善患者的临床症状，降低血清炎性细胞因子水平，效果明显优于口服柳氮磺吡啶。

【关键词】 脊柱炎，强直性；大椎穴；麦粒灸；功能锻炼；肿瘤坏死因子-α；细胞间黏附分子-1

Clinical Observation of Treating Ankylosing Spondylitis in the Early Stage by Moxibustion with Seed-sized Moxa Cone on Dà Zhuī（DU 14） Combined with Sulfasalazine and Functional Exercise

HUANG Zhi-qiang，FU Chang-long，SU Zhao-yuan，SU Jia-fu，WU Qiang

【ABSTRACT】Objective：To investigate the clinical effect of moxibustion with seed-sized moxa cone on dà zhuī（DU 14）combined with sulfasalazine and functional exercise in the treatment of ankylosing spondylitis in the early stage.Methods：Seventy eight cases of patients with AS in the early stage were randomly divided into a moxibustion group and a medication group，35 cases in each.The medication group was given sulfasalazine orally and required functional exercise，while the moxibustion group，based on the treatment with sulfasalazine，was treated by moxibustion with seed-sized moxa cone on dà zhuī（DU 14）.The two groups were treated for 2 months.The curative effect of the two groups was observed and the erythrocyte sedimentation rate，and the contents of serum TNF-a and intercellular adhesion molecule-1 of the two groups were detected before and after treatment.Results：The total effective rate of the moxibustion group was 88.6%，better than the drug group 74.2%.After treatment，the erythrocyte sedimentation rate，and the contents of serum TNF-a and intercellular adhesion molecule-1 of the two groups decreased（P < 0.05），among which those of the moxibustion group decreased obviously（P < 0.05）.Conclusion：In the treatment of ankylosing spondylitis in the early stage，moxibustion with seed-sized moxa cone on dà zhuī（DU 14）combined with sulfasalazine and functional exercise can significantly improve the clinical symptoms of the patients and reduce the level of inflammatory factors in serum，whose effect is better than orally taking sulfasalazine.

【Keywords】 spondylitis，ankylosing；dà zhuī（DU 14）；moxibustion with seed-sized moxa cone；

functional exercise；TNF-a；intercellular adhesion molecule-1

强直性脊柱炎（ankylosing spondylitis，AS）是一种原因不明的血清阴性自身免疫性、慢性炎症性疾病[1]，以侵犯中轴骨骼为主[2]，早期常首先侵犯骶髂关节[3]，形成骶髂关节炎，逐步累及脊柱关节、外周关节及周围组织，故临床常以腰骶部疼痛、晨僵为首发症状，晚期可因韧带钙化、骨性融合等逐渐形成脊柱强直[4]。非甾体抗炎药、柳氨磺吡啶、糖皮质激素等是目前临床治疗AS的主要药物[5]，能减轻患者的疼痛、僵硬等不适症状，但这些药物有明显的胃肠道反应，且对心脑血管也有较大损害。研究一种能增效减药的治疗方法势在必行，艾灸治疗免疫性疾病有较大优势[6]。研究发现，血清中炎性细胞因子、致炎细胞因子与AS的发病密切相关[7]。……