穴位注射医用臭氧水治疗强直性脊柱炎的临床研究

发布时间：2018-01-12 10:43

本文关键词：穴位注射医用臭氧水治疗强直性脊柱炎的临床研究　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:评价穴位注射医用臭氧水治疗强直性脊柱炎(Ankylosing Spondylitise,AS)的有效性和安全性,为强直性脊柱炎的临床治疗提供新方法。方法:将78例AS病人随机分为臭氧水治疗组39例和药物对照组39例。臭氧水治疗组选取双侧风池穴、部分华佗夹脊穴及双侧骶髂关节间隙进行注射,臭氧水浓度为20μg/ml,3~5ml/穴、5ml/处,1次/周,12周为1疗程。药物对照组选用柳氮磺吡啶和西乐葆,柳氮磺吡啶第1周0.25g,Bid;第2周0.5g,Bid;第3周0.75g,Bid;第4周及以后1g,Bid。西乐葆0.2g,Bid。12周为1疗程。臭氧水治疗组和药物对照组在治疗前、治疗第4周后、治疗第8周后、治疗第12周后分别对患者进行Bath强直性脊柱炎疾病活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)评价,治疗前后检测血沉(ESR)、C-反应蛋白(CRP)及进行安全性评价。运用SPSS18.0软件进行统计分析,计量资料采用均数±标准差(？),计数资料采用例数及率描述。计量资料(年龄)组间比较采用两独立样本t检验,计量资料(组间各时间点评分)采用重复测量方差分析。计数资料(性别、例数)采用卡方(X~2)检验。所有检验以双侧P0.05为差异有统计学意义。结果:1、基线比较,臭氧水治疗组、药物对照组年龄、性别无统计学意义(P0.05),治疗前两组BASDSI、BASFI、ESR、CRP无统计学意义(P0.05),说明两组具有可比性。2、有效性比较,臭氧水治疗组、药物对照组第4周治疗后、第8周治疗后、第12周治疗后BASDAI评分、BASFI评分均较治疗前降低(均P0.05),ESR、CRP治疗后均较治疗前降低(均P0.05)。臭氧水治疗组第4周治疗后、第8周治疗后、第12周治疗后BASDAI、BASFI、第12周治疗后ESR、CRP与药物对照组比较无统计学意义(P0.05)。3、安全性比较,药物对照组有5例患者出现中度不良反应,安全性级别0级34例,2级5例。臭氧水治疗组患者未出现不良反应,安全级别均为0级。两组安全性比较差异有统计学意义(P0.05)。结论:医用臭氧水治疗强直性脊柱炎可明显降低患者病情活动度、改善患者功能状态,降低炎性指标ESR、CRP的水平。且安全性较高,无毒、副作用。综合有效性及安全性评价,医用臭氧水治疗强直性脊柱炎优于药物,是治疗本病安全、有效的新方法,值得临床推广应用。
[Abstract]:Objective: to evaluate the efficacy and safety of point injection of medical ozone water in the treatment of ankylosing Spondylitis (ASA). Methods: 78 patients with as were randomly divided into ozone water treatment group (39 cases) and drug control group (39 cases). Part of Huatuo Jiaji point and bilateral sacroiliac joint space were injected, the concentration of ozone water was 20 渭 g / ml ~ 3 渭 g 路ml ~ (-1) / 5 ml / min / once a week. The drug control group was treated with sulfasalopyridine and Celebrex at week 1, and 0.25 g Bididin at week 1. In the second week, 0.5g Bidi; In the third week, 0.75 g Bidder; 1 g Bid.Celebrex 0.2g Bid.12 weeks was a course of treatment. Ozone water treatment group and drug control group were treated before treatment, 4 weeks after treatment, 8 weeks after treatment. The activity index of Bath ankylosing spondylitis (Bath) was evaluated after 12 weeks of treatment. Before and after treatment, the erythrocyte sedimentation rate (ESR) was detected and the safety was evaluated. The statistical analysis was carried out by SPSS18.0 software, and the mean 卤standard deviation was used to measure the data. The counting data were described by the number of cases and the rate. Two independent samples t-test were used to compare the measured data (age) groups. The measurement data (time points between groups) were measured by repeated measurement ANOVA. Counting data (gender). The number of cases) was chi-square X2) test. All the tests were bilateral P0.05 as the statistical significance. Results: 1, baseline comparison, ozone water treatment group, drug control group age. There was no significant difference in sex (P 0.05) and no significant difference in CRP between the two groups before treatment, indicating that the two groups were comparable. 2. Effectiveness comparison, ozone water treatment group, drug control group after 4 weeks of treatment, 8 weeks after treatment, 12 weeks after the treatment of BASDAI score. The scores of BASFI were lower than those before treatment (P 0.05). The scores of BASFI in ozone water group were lower than those before treatment (P 0.05). After 12 weeks of treatment, there was no significant difference in the level of ESR-CRP between the control group and the control group (P 0.05. 3), and the safety of ESR CRP was not significantly higher than that of the control group (P < 0. 05). In the drug control group, there were 5 cases of moderate adverse reactions, 34 cases of safety grade 0 and 5 cases of grade 2, but no adverse reactions in the ozone water treatment group. The safety level was 0. The difference between the two groups was statistically significant (P 0.05). Conclusion: the treatment of ankylosing spondylitis with medical ozone water can significantly reduce the disease activity and improve the functional status of the patients. Reduce the level of inflammatory index ESR-CRP, and the safety of high, non-toxic, side effects. Comprehensive efficacy and safety evaluation, medical ozone treatment of ankylosing spondylitis is better than drugs, is safe to treat this disease. The effective new method is worth popularizing and applying in clinic.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

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