针药并用对强直性脊柱炎伴骨量减少或骨质疏松症患者细胞因子的影响
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R593.23

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山西省基础研究项目自然科学基金项目(2013011057-5)


Effect of Needling Combined with Medicine on Cytokines in Patients with Ankylosing Spondylitis Concomitant with Osteopenia or Osteoporosis
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    摘要:

    目的:观察“双固一通”针法联合西药对强直性脊柱炎(AS) 伴骨量减少或骨质疏松症患者的治疗作用及其对白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α) 的调节作用,探讨其作用的可能机制。方法:将54 例AS伴骨量减少或骨质疏松症患者随机分为观察组与对照组。对照组口服碳酸钙D3 片、骨化三醇胶丸、利塞膦酸钠片、双氯芬酸钠。观察组在对照组治疗方案的基础上加用“双固一通”针法治疗,选取关元、足三里(双)、肾俞(双)、膈俞(双)、大杼(双)、委中(双) 及脊柱疼痛部位相应夹脊穴。记录治疗前后患者的中医证候积分,并检测血沉、C-反应蛋白(CRP)、IL-1、IL-6、TNF-α 及骨密度。结果:观察组总有效率88.46%,对照组65.38%,差异有统计学意义(P<0.05);观察组中医证候积分明显降低,优于对照组,差异有统计学意义(P<0.01);治疗后,与治疗前比较,2 组血沉(ESR)、CRP 都明显降低,差异均有统计学意义(P<0.01);治疗后,观察组ESR 下降明显优于对照组,差异有统计学意义(P<0.01);治疗后,2 组C-反应蛋白比较,差异无统计学意义(P>0.05);治疗后,2 组骨密度均提高,观察组优于对照组,差异有统计学意义(P<0.01,P<0.05)。治疗后,观察组与对照组IL-1、IL-6、TNF-α 均明显降低,差异均有统计学意义(P<0.01);观察组在降低IL-1、IL-6方面较对照组明显,差异均有统计学意义(P<0.05),TNF-α 差异无统计学意义(P>0.05)。结论:“双固一通”针法联合西药治疗AS 伴骨量减少或骨质疏松患者疗效确切,能减轻临床症状,减轻炎症反应,提高骨密度,改善生活质量。针药并用可以通过调节细胞因子水平治疗AS。

    Abstract:

    Abstract: Objective: To observe the curative effect of “double- reinforcing and one- unblocking” needling method combined with western medicine on patients with ankylosing spondylitis(AS) concomitant with osteopenia or osteoporosis, and its regulatory effect on interleukin- 1(IL-1),interleukin-6(IL-6),and tumor necrosis factor- α(TNF-α),and to discuss the possible mechanism of the effect. Methods: A total of 54 cases of AS patients concomitant with osteopenia or osteoporosis were randomly divided into the observation group and the control group. The control group was given the oral administration of calcium carbonate and vitamin D3 tablets, calcitriol soft capsules, risedronate sodium tablets and diclofenac sodium;the observation group was additionally treated with “double-reinforcing and one-unblocking” needling method based on the treatment of the control group,and Guanyuan point(CV 4),Zusanli point(ST 36)(double sides),Shenyu point(BL 23) (double sides), Geyu point(BL 17) (double sides), Dazhu point(BL 11) (double sides), Weizhong point(BL 40) (double sides), and relevant Jiaji points(EX- B2) in location of spinal pain were selected. The Chinese medicine syndrome scores before and after treatment were recorded. Erythrocyte sedimentation rate,the levels of C-reactive protein,IL-1,IL- 6, and TNF- α, as well as bone mineral density were detected. Results: The total effective rate was 88.46% in the observation group, and 65.38% in the control group, the difference being significant(P<0.05). The Chinese medicine syndrome scores in the observation group were significantly decreased, and better than those in the control group, the difference being significant(P<0.01). After treatment, erythrocyte sedimentation rates(ESR) and the levels of C- reactive protein(CRP) in the two groups were significantly decreased when compared with those before treatment,differences being significant(P<0.01). After treatment,the decrease of ESR in the observation group was significantly better than that in the control group,the difference being significant(P<0.01). After treatment,when compared the level of CRP between the two groups,there was no significance in the difference(P>0.05). After treatment,bone mineral densities in the two groups were increased;the density in the observation group was better than that in the control group,the difference being significant(P< 0.01, P<0.05). After treatment, the levels of IL- 1, IL- 6, and TNF- α in the two groups were significantly decreased, differences being significant(P<0.01). The decrease of levels of IL-1 and IL-6 in the observation group was more significant than that in the control group,the difference being significant(P<0.05). When compared the decrease of the level of TNF-α between the two groups,there was no significance in the difference(P>0.05). Conclusion:In treatment of patients with AS concomitant with osteopenia or osteoporosis,the therapy of “double- reinforcing and one- unblocking” needling method combined with western medicine has defined curative effect, which can relieve clinical symptoms and inflammatory response,improve bone mineral density and quality of life. Needling combined with medicine can treat AS by regulating the level of cytokines.

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周晓莉,秦文君,刘芳,乔平平,郭海龙.针药并用对强直性脊柱炎伴骨量减少或骨质疏松症患者细胞因子的影响[J].新中医,2020,52(20):123-127

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  • 在线发布日期: 2020-10-19
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