补肾通督外治法治疗肾阳亏虚型强直性脊柱炎的疗效观察  

Clinical observation on treatment of patients with kidney-yang deficiency type ankylosing spondylitis by using Bushen Tongdu external treatment

作　　者：周星宇 王新义 张玉飞 王晓龙 张秀秀 刘圆圆 李鹏燕 田元生 ZHOU Xing-yu;WANG Xin-yi;ZHANG Yu-fei;WANG Xiao-long;ZHANG Xiu-xiu;LIU Yuan-yuan;LI Peng-yan;TIAN Yuan-sheng(Department of Pain and Rheumatology,Henan Integrated Medicine Hospital,Zhengzhou 450004,China;School of Acupuncture-Moxibustion and Tuina,Henan University Of Chinese Medicine,Zhengzhou 450046)

机构地区：[1]河南省中西医结合医院疼痛风湿科,郑州450004 [2]河南中医药大学针灸推拿学院,郑州450046

出　　处：《针刺研究》2025年第2期183-189,共7页Acupuncture Research

基　　金：河南省科技攻关项目(No.162102310371);2019年度河南省中医院科学研究专项课题(No.2019ZYBJ27);2021年第二批国家中医临床研究基地科研专项项目(No.2021JDZX2134);河南省中医药青苗人才培养项目(No.豫卫中医函[2021]16号)。

摘　　要：目的:观察补肾通督外治法对肾阳亏虚型强直性脊柱炎的疗效及其安全性。方法:肾阳亏虚型强直性脊柱炎患者随机分为观察组(36例,脱落4例)和对照组(36例,脱落3例)。观察组予补肾通督外治法治疗,即任督周天灸联合穴位埋线,1周/次,共8周;对照组予口服塞来昔布胶囊,0.2 g/次,1次/d,共8周。比较治疗前后两组患者Bath强直性脊柱炎疾病活动指数(BASDAI)评分,中医证候各项积分及总积分,血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、基质金属蛋白酶3(MMP-3)含量,并对疗效进行评定。结果:治疗后,两组患者中医单项证候晨僵、腰背活动受限积分均较本组治疗前降低(P<0.05),两组疗效相当;中医单项证候腰背冷痛、腰膝酸软无力、喜暖畏寒、得寒痛剧积分及中医证候总积分均降低(P<0.05),观察组低于对照组(P<0.05)。两组BASDAI评分及血清IL-6、TNF-α、MMP-3含量均降低(P<0.05),观察组低于对照组(P<0.05)。观察组总有效率为90.63%(29/32),高于对照组的75.76%(25/33,P<0.05)。结论:补肾通督外治法可明显改善肾阳亏虚型强直性脊柱炎患者中医证候,降低疾病活动度,减轻炎性反应,疗效显著,且安全性良好。Objective To observe and evaluate the effectiveness and safety of Bushen Tongdu(reinforcing the kidney-yang and regulating the Governor Vessel)external treatment for patients with kidney-yang deficiency type ankylosing spondylitis(AS).Methods Patients with Kidney-yang deficiency type AS were randomly divided into an observation group(36 cases,4 cases dropped out)and a control group(36 cases,3 cases dropped out).The observation group were received the Bushen Tongdu external treatment which was a combination of Ren Du Zhou-Tian moxibustion and acupoint embedding therapy,i.e.performing ginger-juice soaked nonwoven separated moxibustion first at the back covering the region from Dazhui(GV14)to Yaoshu(GV2)for 1 h,and then at the thoracoabdominal region covering the part from Tiantu(CV22)to Zhongji(CV3)for 1 h,followed by performing acupoint catgut embedding at one or two pairs of GV14,Shenshu(BL23),Dachangshu(BL25),Xuehai(SP10),and Zusanli(ST36),once a week,for 8 weeks.The control group received oral administration of salazosulfapyridine capsules(0.2 g/time),once a day for 8 weeks.Changes of the patients’conditions were evaluated by using traditional Chinese medicine(TCM)syndrome score(0 to 3 points for cold and painful lower back,morning stiffness,limited lumbar movement,soreness and weakness of waist and knees,etc.)and the total score(0 to 18 points),the Bath ankylosing spondylitis disease activity index(BASDAI)score(0 to 10 points for fatigue,physical discomfort caused by pain,swelling,or tenderness in the spine and peripheral joints,duration and severity of morning stiffness,etc).The therapeutic effect was assessed.The safety observation included fainting during acupuncture or moxibustion treatment,burn,etc.The contents of serum interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),and matrix metalloproteinase-3(MMP-3)were detected before and after the treatment.Results After 8 weeks of treatment,the TCM syndrome score,total score,BASDA score,contents of serum IL-6,TNF-αand MMP-3 were strikingly decreased in

关 键 词：补肾通督外治法 强直性脊柱炎 任督周天灸 穴位埋线 肾阳亏虚 

分 类 号：R246[医药卫生—针灸推拿学]