周天灸对寒湿痹阻型强直性脊柱炎疼痛症状及炎性因子的影响  

Effects of Zhoutian moxibustion on pain symptoms and inflammatory factors in patients with ankylosing spondylitis of cold-damp obstruction

作　　者：张玉飞 王新义 王雷生 唐迪 魏薇 田元生 ZHANG Yufei;WANG Xinyi;WANG Leisheng;TANG Di;WEI Wei;TIAN Yuansheng(Department of Pain and Rheumatology,Henan Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Zhengzhou 450004,China;Dengzhou City Hospital of TCM)

机构地区：[1]河南省中西医结合医院疼痛风湿科,郑州450004 [2]邓州市中医院

出　　处：《中国针灸》2024年第7期797-802,共6页Chinese Acupuncture & Moxibustion

基　　金：2021年河南省卫生健康委国家中医临床研究基地科研专项:2021JDZX2134;河南省中医药拔尖人才培养项目:豫中医科教[2021]15号;河南省中医药青苗人才培养项目:豫卫中医函[2021]16号;2023年河南省中医药科学研究专项:2023ZY2140。

摘　　要：目的:观察周天灸对寒湿痹阻型强直性脊柱炎患者临床疼痛症状及血清炎性因子含量的影响。方法:将84例寒湿痹阻型强直性脊柱炎患者随机分为周天灸组(42例,脱落2例)和督灸组(42例,脱落2例,中止1例)。两组均予口服柳氮磺吡啶肠溶片作为基础治疗。督灸组采用艾灸箱于督脉大椎至腰阳关范围施灸,每次1 h;周天灸组于督灸组基础上,采用艾灸箱于任脉天突至中极范围施灸,每次艾灸2 h。两组均隔3 d治疗1次,每周2次,连续治疗9周。分别于治疗前和治疗第3、6、9周观察两组患者疼痛症状积分,采用ELISA法检测患者治疗前后血清白细胞介素-1β(IL-1β)、白细胞介素-18(IL-18)和肿瘤坏死因子-α(TNF-α)含量,并于治疗后评定两组临床疗效。结果:除治疗第3周外周关节疼痛积分外,治疗第3、6、9周,两组患者疼痛症状积分总分及各分项积分均较治疗前降低(P<0.05);治疗第3、6、9周,周天灸组患者疼痛症状积分总分及腰骶疼痛、脊背疼痛、关节冷痛、活动受限积分均低于督灸组(P<0.05)。治疗后,两组患者血清IL-1β、IL-18、TNF-α含量均较治疗前降低(P<0.05),且周天灸组低于督灸组(P<0.05)。周天灸组总有效率为90.0%(36/40),高于督灸组的76.9%(30/39,P<0.05)。结论:周天灸可有效改善寒湿痹阻型强直性脊柱炎患者各类疼痛症状,降低炎性因子表达。Objective To observe the effects of Zhoutian moxibustion on pain symptoms and serum inflammatory factors in patients with ankylosing spondylitis of cold-damp obstruction.Methods Eighty-four patients with ankylosing spondylitis of cold-damp obstruction were randomly divided into a Zhoutian moxibustion group(42 cases,2 cases dropped out)and a governor vessel moxibustion group(42 cases,2 cases dropped out,1 case discontinued).Both groups were given oral administration of sulfasalazine enteric-coated tablets as basic treatment.The governor vessel moxibustion group was treated with moxibustion box from Dazhui(GV 14)to Yaoyangguan(GV 3),one hour per treatment;the Zhoutian moxibustion group was treated with moxibustion box from Tiantu(CV 22)to Zhongji(CV 3)in addition to the governor vessel moxibustion group,two hours per treatment.Both groups were treated once every 3 days,twice a week,for a total of 9 weeks.The pain symptom scores of the two groups were observed before treatment and at the 3rd,6th,and 9th weeks into treatment.ELISA was used to detect the levels of serum interleukin(IL)-1β,IL-18,and tumor necrosis factor-α(TNF-α)before and after treatment,and the clinical efficacy of the two groups was evaluated after treatment.Results Except for the joint pain scores at the 3rd week into treatment,the total scores and the each sub-item score of pain symptom in the two groups were lower than those before treatment at the 3rd,6th,and 9th weeks into treatment(P<0.05);at the 3rd,6th,and 9th weeks into treatment,the total scores of pain symptom and the scores of lumbar sacral pain,back pain,joint cold pain,and limited mobility in the Zhoutian moxibustion group were lower than those in the governor vessel moxibustion group(P<0.05).After treatment,the levels of serum IL-1β,IL-18 and TNF-αin both groups were lower than those before treatment(P<0.05),and the levels of serum IL-1β,IL-18,and TNF-αin the Zhoutian moxibustion group were lower than those in the governor vessel moxibustion group(P<0.05).The total effective ra

关 键 词：强直性脊柱炎 寒湿痹阻型 艾灸 周天灸 督脉灸 疼痛症状 炎性因子 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学]