推拿经筋手法联合温肾通督汤治疗强直性脊柱炎疗效研究  

Curative effect study on massage manipulation combined with Wenshen Tongdu prescription for ankylosing spondylitis

作　　者：韩胜 邓素玲[2] 韩小飞 苏国磊 郑昊 HAN Sheng;DENG Suling;HAN Xiaofei;SU Guolei;ZHENG Hao(College of Orthopedics and Traumatology,Henan University of Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学骨伤学院,河南郑州450003 [2]河南省中医院,河南郑州450003

出　　处：《陕西中医》2023年第11期1628-1631,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家中医临床研究基地科研专项课题(2019JDZX045);第六批全国老中医药专家学术经验继承工作项目[人教发(2017)29号];全国名老中医药专家传承工作室建设项目[国中医药人教函(2022)75号];河南省中医药医药科学研究专项课题(2019ZY2149);河南省中医药医药科学研究专项课题(20-21ZY3013)。

摘　　要：目的:探讨推拿经筋手法联合温肾通督汤治疗强直性脊柱炎(AS)疗效。方法:选择90例AS患者,按随机数字表法分为研究组、对照组,各45例。对照组给予基础治疗,研究组在对照组基础上采用推拿经筋手法联合温肾通督汤。治疗后评价疗效、安全性,并比较治疗前后两组患者中医症状评分、功能指标、脊柱力学平衡性、疾病活动度指标。结果:研究组总有效率95.56%高于对照组的82.22%(P<0.05)。治疗后,研究组中医症状评分低于对照组(P<0.05)。研究组前屈或后伸幅度大于对照组,而左旋转或右旋转小于对照组(均P<0.05)。两组患者左侧屈或右侧屈比较,差异无统计学意义(P>0.05)。治疗后,两组LAIR-1 mRNA、ESR、Hs-CRP比较,差异有统计学意义(均P<0.05)。治疗6、12周后,研究组LAIR-1 mRNA高于对照组,ESR、Hs-CRP均低于对照组(均P<0.05)。研究组不良反应总发生率低于对照组(P<0.05)。结论:推拿经筋手法联合温肾通督汤治疗AS具有较好疗效及安全性,能改善患者中医症状、脊柱力学平衡性,促进脊柱功能恢复,改善疾病活动度。Objective:To study curative effect of massage manipulation combined with Wenshen Tongdu prescription for ankylosing spondylitis(AS).Methods:90 patients with AS were selected and randomly divided into study group(n=45)and control group(n=45).The control group were treated with basic treatment,and the study group treated with massage manipulation combined with Wenshen Tongdu prescription on the basis of the control group.After treatment,efficacy and safety were evaluated.The TCM symptom score,functional index,spinal mechanical balance and disease activity index were compared before and after treatment in the two groups.Results:The effective rate of the study group was 95.56%higher than 82.22%of the control group(P<0.05).The TCM symptom score of the study group was significantly lower than that in the control group(P<0.05).The flexion or extension of the study group were significantly higher than those in the control group,and the rotation of the right or left lower than those in the control group(all P<0.05).There was no significant difference between the right or left lateral flexion in the two groups(P>0.05).After treatment,the comparision of LAIR-1 mRNA,ESR,Hs-CRP between the two groups showed statistically significant differences(all P<0.05).After 6 and 12 weeks of treatment,levels of LAIR-1 mRNA in the study group were higher than that in the control group,and levels of ESR,Hs-CRP were lower than those in the control group(all P<0.05).The total incidence of adverse reactions in the study group was lower than that in the control group(P>0.05).Conclusion:Massage manipulation combined with Wenshen Tongdu prescription has good safety and efficacy in the treatment of AS.It can improve the symptoms of TCM and the balance of spinal mechanics,promoting recovery of spinal function and disease activity.

关 键 词：强直性脊柱炎 推拿经筋手法 温肾通督汤 功能指数 疾病活动度 

分 类 号：R593.23[医药卫生—内科学]