王滔　柳玉佳　皮桂芳　邹婵　刘丹　冯进

〔摘要〕 目的 观察督灸联合游泳操治疗强直性脊柱炎（ankylosing spondylitis， AS）的临床疗效及对生活质量的影响。方法 将60例AS（腎虚督寒型）患者随机分为观察组和对照组，每组30例。对照组口服塞来昔布胶囊（每次0.2 g，2次/d）、柳氮磺吡啶肠溶片（每次1 g，2次/d）联合督灸治疗，观察组在对照组基础上联合游泳操锻炼。4周为1个疗程。治疗1 个疗程后观察两组临床疗效以及治疗前后中医证候积分、视觉模拟评分法（visual analogue scale， VAS）疼痛程度、健康调查简表（the MOS item short from health survey， SF-36）生活质量的变化。结果 两组疗效评价，观察组总有效率达86.7%，高于对照组的73.3%，差异有统计学意义 （P<0.05）。两组患者治疗后中医证候积分、VAS评分均较同组治疗前明显降低（P<0.05），生活质量评分均较同组治疗前明显改善（P<0.05），且治疗后观察组中医证候积分、VAS评分均低于对照组，生活质量评分高于对照组，差异均有统计学意义（P<0.05）。结论 督灸联合游泳操对AS具有较好的治疗作用，对改善症状、减轻疼痛、提高生活质量方面有显著作用，值得临床推广应用。

〔关键词〕 强直性脊柱炎;督灸;游泳操;临床观察

〔中图分类号〕R248        〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.03.012

〔Abstract〕 Objective To observe the clinical efficacy of Du-moxibustion combined with swimming exercise in the treatment of ankylosing spondylitis （AS） and its impact on the quality of life. Methods 60 AS patients were randomly divided into the observation group and the control group， 30 cases in each group. The control group was given celecoxib capsules （0.2 g， twice daily）， sulfasalazine enteric coated tablets （1 g， twice daily） and Du-moxibustion， while the observation group was given swimming exercise on the basis of the control group. Four weeks as a course of treatment. After one course of intervention， the clinical efficacy， traditional Chinese medicine （TCM） syndrome score， visual analogue scale （VAS） pain degree， and the MOS item short from health survey （SF-36） quality of life of the two groups before and after treatment were observed. Results The total effective rate of the observation group was 86.7%， which was higher than 73.3% of the control group （P<0.05）. After treatment， the TCM syndrome score and VAS score of the two groups were significantly lower than those of the same group before treatment （P<0.05）， and the quality of life score was significantly improved than that of the same group before treatment （P<0.05）. After treatment， the TCM syndrome score and VAS score of the observation group were lower than those of the control group， and the quality of life score of the observation group was higher than that of the control group， the differences were statistically significant （P<0.05）. Conclusion Du-moxibustion combined with swimming exercise has a good intervention effect on AS， and has a significant effect on improving symptoms， relieving pain and improving quality of life， which is worthy of clinical application.

〔Keywords〕  ankylosing spondylitis; Du-moxibustion; swimming exercise; clinical observation

强直性脊柱炎（ankylosing spondylitis， AS）属于一类全身性自身免疫性病变，此病主要临床表现为中轴关节慢性炎症，主要临床特征为腰背脊柱僵硬、疼痛，从而限制活动，目前尚未找到其确切病因[1-2]。AS的起病一般比较隐匿，我国60%的AS患者均有髋关节受累，15%～20%患者则出现髋关节骨性强直改变，甚至终身残疾，给患者的身心带来极大的痛苦，同时也给家庭和社会带来了严重的负担[3]。现今，对于AS，临床领域还没有研究出具备有效性的治愈方法[4]。近年来，本院采用督灸联合游泳操治疗AS，疗效较为满意，现将方法与结果报道如下。

1 资料与方法

1.1  一般资料

将2019年4月至2020年4月在湖南中医药大学第一附属医院风湿免疫科接受医治的60例AS患者，采用随机数字表法均等分为对照组、观察组。观察组女性3例，男性27例;年齡18～42（25.68±8.05）岁;病程2～9（2.83±1.95）年。……