强直性脊柱炎达标治疗对其核心肌群功能的影响研究  

Study on the effect of treat-to-target on the function of core muscle groups in ankylosing spondylitis patients

作　　者：李敏[1] 吴晓惠[1] 梁翼[1] 沙湖[1] 王磊 杨茂益 陈倩 孙杰培 史友刚 张挥武 Li Min;Wu Xiaohui;Liang Yi;Sha Hu;Wang Lei;Yang Maoyi;Chen Qian;Sun Jiepei;Shi Yougang;Zhang Huiwu(Department of Rheumatology,Sichuan Orthopedic Hospital,Chengdu 610041,China;Chengdu Hedong Sports Medical Center,Sichuan 610330,China;School of Sports Medicine and Health,Chengdu Sports University,Sichuan 610041,China;Functional Laboratory of State Administration of Traditional Chinese Medicine,Chengdu 610041,China)

机构地区：[1]四川省骨科医院风湿骨关节病科,成都610041 [2]成都和动运动医疗中心,610330 [3]成都体育学院运动医学系,610041 [4]四川省骨科医院国家中医药管理局重点机能实验室,成都610041

出　　处：《中华风湿病学杂志》2019年第12期820-824,共5页Chinese Journal of Rheumatology

基　　金：四川省中医药管理局科学技术研究专项(2018LC025);成都中医药大学科技发展基金(YYZX1708)。

摘　　要：目的探讨AS达标治疗对脊柱核心肌群功能的影响。方法收集我院符合成都市大病医疗保险资助并完成治疗周期且临床达标的AS患者64例,分别收集其临床资料、强直性脊柱炎疾病活动度(ASDAS),并采用DAVID脊柱生物力学测训系统检测其脊柱力学功能,以及简易核心肌适能测试:八级腹桥、平板支撑、腹部静态肌耐力测试、背部静态肌耐力测试,采用自身前后配对t检验比较达标治疗前后差异,Spearman相关分析探讨AS患者ASDAS改变值(ΔASDAS)与其核心肌力功能改善值的相关情况。结果①达标AS患者在脊柱活动度自身前后比较中,后伸度(t=4.456,P<0.01)、前屈度(t=5.679,P<0.01)、向右旋转度(t=7.525,P<0.01)、向左旋转度(t=8.173,P<0.01)、向右侧屈度(t=10.08,P<0.01)、向左侧屈度(t=8.233,P<0.01),差异有统计学意义;在脊柱肌肉力量自身前后比较中,前屈力差异有统计学意义[(91±45)Nm与(97±40)Nm](t=6.247,P<0.01);②达标AS患者自身前后比较中,腹部静态肌耐力(t=2.553,P=0.013)差异有统计学意义;③ΔASDAS与Δ脊柱前屈度(r=0.481,P<0.01)、Δ脊柱向右侧屈度(r=0.450,P<0.01)、Δ脊柱向左侧屈度(r=0.430,P<0.01)、Δ脊柱向右旋转度(r=0.318,P=0.013)、Δ脊柱向左旋转度(r=0.318,P=0.013),Δ腹部肌耐力呈正相关(r=0.335,P=0.011)。结论抗炎达标治疗有助于AS患者改善脊柱核心肌群活动度和腹部肌力,但在后伸及旋转、侧弯的肌力以及肌平衡性改善中并无显著作用。Objective To investigate the effects of treat-to-target on the function of core muscle groups in ankylosing spondylitis(AS)patients.Methods The clinical data of 64 AS patients were collected.Clinical symptoms,ASDAS(ankylosing spondylitis disease activity score),and simultaneous detection of DAVID spine biomechanics training system,simple core muscle fitness test:Eight-grade abdominal bridge,PLANK exercise(flat support),Abdominal static muscle endurance test,Back static muscle endurance test were compared using paired t-test analysis and spearman correlation analysis.Results①For AS patients reaching the target,there were differences in the backward extension(t=4.456,P<0.01),forward flexion(t=5.679,P<0.01),right rotation(t=7.525,P<0.01),left rotation(t=8.173,P<0.01),right flexion(t=10.08,P<0.01),left flexion(t=8.233,P<0.01)compared to those before they achieved the treatment target.The muscle strength,the forward bending force[(91±45)Nm and(97±40)Nm](t=6.247,P<0.01)was also different when compared to those before reaching the target.②There were differences in abdominal static muscle endurance(t=2.553,P=0.013)after reaching the target compared to patients before they reached the treatment target.③ΔASDAS was positively correlated withΔanteflexion(r=0.481,P<0.01),Δright flexion(r=0.450,P<0.01),Δleft flexion(r=0.430,P<0.01),Δright rotation(r=0.318,P=0.013),Δleft rotation(r=0.318,P=0.013),Δleft rotation(r=0.318,P=0.013),Δabdominal muscle endurance(r=0.335,P=0.011).Conclusion Achieving target is helpful for AS patients to improve the activity of spinal core muscle group and abdominal muscle strength,but it has no significant effect on the improvement of muscle strength of extension and rotation,lateral bending and muscle balance.

关 键 词：脊柱炎 强直性 运动疗法 肌肉强度 

分 类 号：R593[医药卫生—内科学]