督灸联合塞来昔布胶囊治疗强直性脊柱炎肾阳亏虚证的疗效观察

刘怀省　乔登朝　韩文朝　王少华

【摘 要】目的：观察应用督灸联合塞来昔布胶囊治疗强直性脊柱炎肾阳亏虚证的临床疗效。方法：选取强直性脊柱炎肾阳亏虚证患者60例，随机分为督灸组、西药组及联合组，每组20例。督灸组给予隔姜督灸治疗；西药组给予塞来昔布胶囊口服；联合组给予隔姜督灸联合塞来昔布胶囊口服治疗；3组均治疗3个月。治疗后应用国际强直性脊柱炎评估工作组（ASAS）制定的疗效评价因子及中医证候评分进行临床疗效对比，同时进行安全性评价。结果：3组患者治疗后ASAS疗效评价因子及中医证候评分较治疗前均有显著改善（P < 0.05），治疗后3组患者PGA评分、脊柱活动度、枕墙距、晨僵时间、红细胞沉降率、中医证候积分、中医证候疗效的比较，联合组优于其他2组，差异有统计学意义（P < 0.05）；3组患者均未出现严重的不良反应。结论：督灸联合塞来昔布胶囊治疗强直性脊柱炎肾阳亏虚证疗效显著，安全有效，具有较高的临床价值。

【关键词】 脊柱炎，强直性；督灸；肾阳亏虚证；塞来昔布

Observation of the Therapeutic Effect of Du-moxibustion Combined with Celecoxib Capsules in the Treatment of Ankylosing Spondylitis with Kidney Yang Deficiency

LIU Huai-sheng，QIAO Deng-chao，HAN Wen-chao，WANG Shao-hua

【ABSTRACT】Objective：To observe the clinical efficacy of du-moxibustion（moxibustion on du mai） combined with Celecoxib Capsules in the treatment of ankylosing spondylitis with kidney yang deficiency.Methods：Sixty cases of ankylosing spondylitis with kidney yang deficiency syndrome were randomly divided into a du-moxibustion group，a western medicine group and a combined group，20 cases in each group.The du-moxibustion group was treated with moxibustion on ginger，and the western medicine group was treated with Celecoxib Capsules.The combined group was treated with above two methods.The three groups were treated for 3 months.After treatment，therapeutic evaluation factors made by ASAS and TCM syndrome scores were used to compare the efficacies，and safety evaluation was carried out at the same time.Results：After treatment，the therapeutic evaluation factors and TCM syndrome scores of the three groups were significantly improved than those before treatment（P < 0.05）.The PGA score，spinal mobility，pillow wall distance，morning stiffness time，erythrocyte sedimentation rate，TCM syndrome score，TCM syndrome of the combined group were better than those of the other two groups，and the difference was statistically significant（P < 0.05）.There were no serious adverse reactions in the three groups.Conclusion：Du-moxibustion combined with Celecoxib Capsules in the treatment of ankylosing spondylitis with kidney yang deficiency syndrome is effective and safe，and has a high clinical value.

【Keywords】 spondylitis，ankylosing；

Du-moxibustion；kidney yang deficiency syndrome；celecoxib

強直性脊柱炎（ankylosing spondylitis，AS）是一种发病于脊椎的慢性进行性炎症性疾病，主要病变为脊柱附着点和骶髂关节的炎症[1]。本病的发病原因及机理目前尚不完全明确，但是与组织相容抗原HLA-B27相关，AS患者HLA-B27阳性率可达88%～96%[1]。AS属于慢性病，受累关节的破坏程度随病程而加重，严重者关节功能丧失，极大地降低了患者的生活质量。对于本病西医治疗主要应用非甾体抗炎药、改善病情抗风湿药及糖皮质激素，但不容忽视的是长期应用这些药物会带来明显的毒副作用，生物制剂虽对AS活动期疗效显著，但是价格高昂，限制了其在临床上的应用。随着中医药对本病的认识及探索逐步深入，治疗方法及药物也较前大幅增加。但本病属于难治性疾病，目前尚无特效的治疗方法，单纯的西医或中医治疗方法难以取得理想的效果，所以国际强直性脊柱炎评估工作组（ASAS）及中华医学会风湿病学分会在AS的治疗指南中均指出，应该遵循药物治疗联合非药物治疗的原则[2-3]。……