脊柱两侧大鱼际拨揉法治疗骨痹（强直性脊柱炎）肾虚督寒证的临床疗效观察

发布时间：2018-06-13 01:43

本文选题：脊柱两侧大鱼际拨揉法 + 强直性脊柱炎　；参考：《湖北中医药大学》2016年硕士论文

【摘要】：目的观察脊柱两侧大鱼际拨揉法治疗骨痹(强直性脊柱炎)肾虚督寒证的临床疗效,并初步探讨脊柱两侧大鱼际拨揉法治疗骨痹(强直性脊柱炎)肾虚督寒证的作用机理,为临床治疗骨痹(强直性脊柱炎)肾虚督寒证提供一个新的方法。方法骨痹(强直性脊柱炎)肾虚督寒证炎患者60例均来自湖北省中医院推拿科/康复医学科/疼痛科,符合本研究诊断标准、纳入标准。采用随机数字表将60例患者随机分为实验组和对照组,每组各30例,实验组采用脊柱两侧大鱼际拨揉法治疗,治疗7天为一个疗程,一共5个疗程,每个疗程之间休息2天;对照组用口服塞来昔布胶囊0.15g/qd、柳氮磺胺吡啶片0.25g/bid联合治疗,治疗7天为一个疗程,一共5个疗程。在治疗前后,对所有病例在病情活动方面均采用国际强直性脊柱炎评价工作组制定的ASAS20标准、Bath强直性脊柱炎病情活动指标(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、Bath强直性脊柱炎计量指数(BASMI)、全身和脊柱疼痛评分、PGA评分、中医证候积分评分,在ASDAS疾病活动情况方面进行比较;在情感类评分方面,通过对比两组患者治疗前后SDS(焦虑自评量表评分),SAS(抑郁自评量表评分)来评价两组不同的治疗对AS患者心理影响的疗效;实验室血生化指标方面,观察两组治疗前后ESR、CRP、ALP的指标变化。以上所有数据全部采用SPSS22.0统计软件进行统计分析。结果在病情活动方面:治疗组治疗一个月后随访的ASAS20达标率为:73%、中医证候疗效总有效率为70%,能够显著降低BASDAI、BASFI、BASMI、全身和脊柱疼痛评分、PGA评分、中医证候积分评分,并与对照组比较,差异有统计学意义(P0.01);在情感类评分方面:治疗一个月后随访实验组的患者SDS、SAS评分明显下降,与对照组比较,差异有统计学意义(P0.01);实验室血生化指标方面:实验组治疗后ESR、CRP、ALP显著下降,与对照组相比,差异有统计学意义(P0.05)。结论通过以上综合对比说明脊柱两侧大鱼际拨揉法治疗骨痹(强直性脊柱炎)肾虚督寒证远期疗效明显优于对照组。运用脊柱两侧大鱼际拨揉法治疗骨痹(强直性脊柱炎)肾虚督寒证能明显改善患者的临床症状,并且复发率低、完全无副作用、安全绿色,值得临床推广。
[Abstract]:Objective to observe the clinical effect of the treatment of kidney deficiency and the cold syndrome of bone arthralgia (ankylosing spondylitis), and to explore the mechanism of treating bone arthralgia (ankylosing spondylitis) with kidney deficiency and du cold syndrome. To provide a new method for the treatment of ankylosing spondylitis (ankylosing spondylitis). Methods Sixty patients with osteorrhea (ankylosing spondylitis) with kidney deficiency and cold syndrome were all from Tuina Department, Rehabilitation Medicine Department / pain Department, Hubei traditional Chinese Medicine Hospital, which met the diagnostic criteria of this study and were included in the criteria. 60 patients were randomly divided into experimental group (n = 30) and control group (n = 30). Experimental group (n = 30) was treated with thenar dipping and kneading on both sides of the spine. The treatment lasted 7 days as a course of treatment, with a total of 5 courses of treatment, with 2 days of rest between each course of treatment. The control group was treated with oral celecoxib capsule 0.15g / qdSalazepyridine tablet 0.25g/bid for 7 days as a course of treatment for a total of five courses. Before and after treatment, In all cases, the activity index of Bath ankylosing spondylitis was determined by the ASAS20 standard developed by the International working Group on the Evaluation of Ankylosing Spondylitis. The Bath ankylosing Spondylitis function Index (BASFI) and the Bath ankylosing Spondylitis Measurement Index (BASS20) were used in all cases. Total body and spinal pain score, PGA score, TCM syndromes score was compared in ASDAS disease activity, emotional score, By comparing the two groups of patients before and after treatment SDS (Self-Rating anxiety scale score) to evaluate the two groups of different treatment on the psychological impact of as patients, laboratory blood biochemical indicators, Before and after treatment, the changes of ALP in the two groups were observed. All the above data were analyzed by SPSS 2. 0 statistical software. Results in the aspect of disease activity: the ASAS20 reached the standard rate of 1 month after treatment in the treatment group, and the total effective rate of TCM syndrome was 70, which could significantly reduce the basic MIM, the PGA score and the TCM syndrome score of the whole body and spine pain score, and compared with the control group, and compared with the control group. The difference was statistically significant (P < 0.01). In affective score, the scores of SDSSAS in the experimental group were significantly lower than those in the control group after one month of treatment. The difference was statistically significant (P 0.01), and the blood biochemical index of the experimental group was significantly lower than that of the control group (P 0.05). Conclusion according to the above comprehensive comparison, the long-term curative effect of the treatment of bone arthralgia (ankylosing spondylitis) with kidney deficiency and cold syndrome is obviously better than that of the control group. The treatment of bone arthralgia (ankylosing spondylitis) with deficiency of kidney and cold syndrome can obviously improve the clinical symptoms with low recurrence rate, no side effects, safe and green, and worthy of clinical promotion.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R244.1

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