王迪 陈润祥

【摘 要】目的：观察腹针配合补肾强督祛寒汤治疗肾虚督寒型强直性脊柱炎的临床疗效。方法：将62例肾虚督寒型强直性脊柱炎患者随机分为治疗组和对照组，每组31例。治疗组给予腹针、补肾强督祛寒汤治疗;对照组给予美洛昔康及柳氮磺砒啶治疗。2组均以2周为1个疗程，共治疗4个疗程。观察2组临床疗效，以及治疗前后Bath强直性脊柱炎病情活动指数（BASDAI评分）、Bath强直性脊柱炎功能指数（BASFI评分）、枕墙距、胸廓活动度、脊柱活动度、Sch?ber试验、红细胞沉降率（ESR）、C反应蛋白（CRP）等。结果：治疗组临床缓解7例，显效14例，有效8例，无效2例，总有效率为93.55%;对照组临床缓解3例，显效10例，有效11例，无效7例，总有效率为77.42%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组BASDAI评分、BASFI评分、枕墙距、胸廓活动度、脊柱活动度、Sch?ber试验、ESR、CRP较治疗前均有改善（P < 0.05）;且治疗组优于对照组（P < 0.05）。结论：腹针配合补肾强督祛寒汤治疗肾虚督寒型强直性脊柱炎疗效确切，可明显改善患者临床症状和实验室指标等，值得临床推广。

【关键词】 强直性脊柱炎;肾虚督寒型;腹针;补肾强督祛寒汤;美洛昔康;柳氮磺砒啶;临床疗效

【ABSTRACT】Objective：To observe the clinical efficacy of abdominal acupuncture combined with Bushen Qiangdu Quhan Tang（补肾强督祛寒汤）in the treatment of ankylosing spondylitis due to kidney deficiency and cold attacking the governor vessel.Methods：Sixty-two patients with ankylosing spondylitis due to kidney deficiency and cold attacking the governor vessel were randomly divided into a treatment group and a control group，31 cases in each group.The treatment group was treated by abdominal acupuncture and Bushen Qiangdu Quhan Tang;The control group was treated with meloxicam and sulfasalazine.Both groups were treated for four courses of treatment，two weeks as one.The clinical efficacy，BASDAI score before and after treatment，BASFI score，occipital wall distance，thoracic range of motion，spinal range of motion，Sch?ber Test，ESR，CRP were observed.Results：In the treatment group，7 cases were relieved，14 cases were markedly effective，8 cases were effective and 2 cases were ineffective，the total effective rate was 93.55%;In the control group，3 cases were relieved，10 cases were markedly effective，11 cases were effective，and 7 cases were ineffective.The total effective rate was 77.42%.The difference between the two groups was statistically significant（P < 0.05）.After treatment，BASDAI score，BASFI score，occipital wall distance，thoracic range of motion，spinal range of motion，Sch?ber Test，ESR and CRP levels were improved in both groups（P < 0.05）;and the treatment group was better than the control group（P < 0.05）.Conclusion：Abdominal acupuncture combined with Bushen Qiangdu Quhan Tang has a definite curative effect in the treatment of ankylosing spondylitis due to kidney deficiency and cold attacking the governor vessel，which can significantly improve the clinical symptoms and laboratory indexes of the patients，it is worthy of clinical promotion.

【Keywords】 ankylosing spondylitis;kidney deficiency and cold attacking the governor vessel;abdominal acupuncture;Bushen Qiangdu Quhan Tang（補肾强督祛寒汤）;meloxicam;sulfasalazine;clinical efficacy

强直性脊柱炎（ankylosing spondylitis，AS）是一种结缔组织病，主要侵犯骶髂关节、脊柱关节、椎旁软组织及外周关节[1]。我国AS患病率约为0.3%，发病年龄通常在13～31岁[2]。郏县中医院针灸推拿二科采用腹针配合补肾强督祛寒汤治疗AS，现总结报道如下。

1 临床资料

1.1 一般资料 选取2018年1月至2021年1月在郏县中医院针灸推拿二科就诊的肾虚督寒型AS患者62例，按照随机数字表法分为治疗组和对照组，每组31例。治疗组男20例，女11例;年龄15～57岁，平均（34.53±6.66）岁;病程3～41年，平均（14.92±6.16）年。对照组男21例，女10例;年龄16～56岁，平均（34.39±6.53）岁;病程2～40年，平均（14.82±5.94）年。2组患者在性别、年龄、病程等方面比较，差异无统计学意义（P > 0.05），具有可比性。本研究通过郏县中医院伦理委员会审核批准。