脊柱三扳法联合塞来昔布对强直性脊柱炎患者胸腰椎活动和BMP/Smad信号通路的影响  

The Effect of Three Pull Method of Spine Combined with Celecoxib on the Activity of Thoracolumbar Vertebrae and BMP/Smad Signal Pathway in Patients with Ankylosing Spondylitis

作　　者：李嘉 付婷婷 李世坚 黄广平 李腾辉 刘向前 陈民 LI Jia;FU Ting-ting;LI Shi-jian;HUANG Guang-ping;LI Teng-hui;LIU Xiang-qian;CHEN Min(Department of Orthopedics,Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Institute of Geriatrics,Guangzhou,Guangdong,510080,China;Department of Traditional Chinese Medicine,Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Institute of Geriatrics,Guangzhou,Guangdong,510080,China;Department of Clinical Laboratory,Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences,Guangzhou,Guangdong,510080,China)

机构地区：[1]广东省人民医院/广东省医学科学院/广东省老年医学研究所正骨科,广东广州510080 [2]广东省人民医院/广东省医学科学院/广东省老年医学研究所中医科,广东广州510080 [3]广东省人民医院/广东省医学科学院检验科,广东广州510080

出　　处：《现代生物医学进展》2020年第23期4459-4463,共5页Progress in Modern Biomedicine

基　　金：广东省2017年度中医药局科研项目(20171003)。

摘　　要：目的:探讨脊柱三扳法联合塞来昔布对强直性脊柱炎(AS)患者胸腰椎活动和骨形态发生蛋白(BMP)/细胞信号转导分子(Smad)信号通路的影响。方法:选取2016年7月~2018年12月期间我院收治的AS患者150例,根据随机数字表法分为A组(n=50,给予脊柱三扳法治疗)、B组(n=50,给予塞来昔布治疗)和C组(n=50,给予脊柱三扳法联合塞来昔布治疗),比较三组患者疗效、胸腰椎活动指标、BMP/Smad信号通路相关指标及不良反应发生率。结果:C组治疗6个月后的临床总有效率为94.00%(47/50)高于A组的66.00%(33/50)、B组的72.00%(36/50)(P<0.05);C组治疗6个月后胸廓活动度、腰椎活动度均高于A组、B组(P<0.05),指-地距离短于A组、B组(P<0.05)。C组治疗6个月后BMP-Ⅰ受体、BMP-Ⅱ受体、Smad1、Smad4表达水平均低于A组、B组(P<0.05)。三组不良反应发生率比较差异均无统计学意义(P>0.05)。结论:脊柱三扳法联合塞来昔布治疗AS患者,疗效显著,可有效改善胸腰椎活动,且不增加不良反应发生率,其具体作用机制可能是通过调节BMP/Smad信号通路实现。Objective: To investigate the effect of three pull method of spine combined with celecoxib on the activity of thoracolumbar vertebrae and the signal pathway of bone morphogenetic protein(BMP)/Cell signal transducer(Smad) in patients with ankylosing spondylitis(AS). Methods: From July 2016 to December 2018, 150 patients with AS in our hospital were selcted, they were randomly divided into three groups: group A(n=50, treated with spine triple pull method), group B(n=50, treated with celecoxib) and group C(n=50, treated with spine triple pull method combined with celecoxib). The efficacy, thoracolumbar activity, BMP/Smad signal pathway related indicators and adverse reactions of the three groups were compared. Results: The total clinical effective rate of group C was 94.00%(47/50), which was higher than that of group A 66.00%(33/50) and group B 72.00%(36/50)(P<0.05). 6 months after treatment, the activity of lumbar vertebrae and thorax in group C were higher than those in group A and group B(P<0.05), and the distance between fingers and ground were shorter than that in group A and group B(P<0.05). 6 months after treatment, BMP-Ⅰrecipient,BMP-Ⅱ recipient, Smad1 and Smad4 in group C were lower than those in group A and group B(P<0.05). There was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05). Conclusion: The three pull method of spine combined with celecoxib in the treatment of patients with AS, the effect is significant, it can effectively improve the thoracolumbar activity, and does not increase the incidence of adverse reactions, the specific mechanism may be through the regulation of BMP/Smad signal pathway.

关 键 词：脊柱三扳法 塞来昔布 强直性脊柱炎 胸腰椎活动 BMP/Smad信号通路 

分 类 号：R593.23[医药卫生—内科学]