中药熏蒸治疗强直性脊柱炎临床的研究.docVIP

PAGE \* MERGEFORMAT 1 中药熏蒸治疗强直性脊柱炎临床研究【摘要】 目的 观察中药熏蒸治疗强直性脊柱炎(AS)的临床疗效。方法 将60例AS患者分为熏蒸组(30例)、非熏蒸组(30例),分析患者治疗前后手指地间距、枕墙距、髋关节前屈、髋关节后伸的变化,观察熏蒸疗法对急性炎症指标血沉(ESR)、C反应蛋白(CRP)的影响；采用酶联免疫法测定治疗前后血清中肿瘤坏死因子α(TNF-α)及白细胞介素-10(IL-10)含量的变化,分析熏蒸疗法对炎性细胞因子表达的影响。结果 熏蒸组总有效率为90.0%,非熏蒸组为83.3%；熏蒸组显效率为66.6%,非熏蒸组显效率为33.3%；熏蒸组治疗后手指地间距、枕墙距、髋关节前屈、髋关节后伸均优于治疗前,差异有统计学意义；熏蒸组治疗后ESR、CRP及TNF-α均有显著下降,IL-10显著升高,与非熏蒸组比较,P＜0.05或P＜0.01。结论 中药熏蒸治疗AS具有较好的临床疗效。 【关键词】 强直性脊柱炎；中药熏蒸；临床疗效 Abstract：Objective To observe the clinical efficacy of traditional Chinese medicine fumigation in treating ankylosing spondylitis (AS). Methods Sixty patients were divided into fumigation group (30 cases) and non-fumigation group (30 cases), the treatment course was 20 days. The changes of finger pitch, pillow away from the wall, hip flexion, hip extension of the patients and the impact of fumigation on acute inflammation (ESR, CRP) were observed. Enzyme-linked immunosorbent assay was used to determine serum TNF-α and IL-10 before and after treatment to observe the effect of fumigation treatment on inflammatory cytokine expression. Results The total effective rate of treatment group was 90.0% and control group was 83.3%. The efficiency rate of the treatment group was 66.6% and control group was 33.3%. After treatment, finger pitch, pillow away from the wall, hip flexion, hip extension of the treatment group were better than before treatment, the difference was significant. ESR, CRP and TNF-α, IL-10 of the treatment group were significantly decreased compared with the control group (P＜0.05 or P＜0.01). Conclusion Chinese medicine fumigation treatment has good clinical effect on AS. Key words：ankylosing spondylitis；Chinese medicine fumigation；clinical efficacy 强直性脊柱炎(AS)是以中轴关节慢性炎症为主、原因不明的全身性疾病,其特点为几乎全部累及骶髂关节,常发生椎间盘纤维及其附近韧带钙化和骨性强直。AS患者血清中常有炎性细胞因子异常升高,而外周血中抗炎性细胞因子则通常维持在较低的水平,使外周血中细胞因子类型向炎性表达偏移。据此推测,AS的发病与炎性细胞因子增多、抗炎性细胞因子相对减少有关。中药熏蒸疗法是一种传统的中医外治疗法,对AS具有较好疗效。为了探索其的作用机制,本研究观察熏蒸疗法对AS患者的临床疗效及对炎性指标血清肿瘤坏死因子α(TNF-α)、白细胞介素-10 (IL-10)的影响。