督灸联合补肾祛寒化湿方治疗强直性脊柱炎的临床疗效及对患者血清CTX-I、DKK1水平的影响
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河南省中医药科学研究专项课题(2018ZY2016)


Clinical Effect of Moxibustion at Governor Vessel Combined with Bushen Quhan Huashi Prescription for Ankylosing Spondylitis and Its Effect on Levels of CTX- I and DKK1 in Serum
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    摘要:

    目的:观察督灸联合补肾祛寒化湿方对强直性脊柱炎(AS) 的临床疗效及对患者血清Ⅰ-型胶原蛋白C 末端肽(CTX-Ⅰ)、Dickkopf1 蛋白(DKK1) 水平的影响。方法:选取160 例AS 患者,按信封抽签法分为A 组、B 组、C 组及D 组,每组40 例。A 组给予常规西药对症治疗,B 组在A 组基础上联合督灸治疗,C 组在A 组基础上联合补肾祛寒化湿方治疗,D 组在A 组基础上给予督灸联合补肾祛寒化湿方治疗,疗程均为3 个月。比较4 组中医证候积分、治疗前后症状改善情况及血沉(ESR)、C-反应蛋白(CRP)、CTX-Ⅰ、DKK1 水平。结果:治疗后,4 组中医证候积分均较治疗前降低(P<0.05),中医证候积分从低至高依次为D 组、C 组、B 组、A 组,D 组中医证候积分明显低于A 组、B 组及C 组(P<0.05)。治疗后,4 组胸廓活动度均较治疗前增大(P<0.05),胸廓活动度从大到小依次为D 组、C 组、B 组、A 组;4 组枕墙距、指地距均较治疗前缩小(P<0.05),巴氏强直性脊柱炎活动指数(BASDAI) 及巴氏强直性脊柱炎功能指数(BASFI) 均较治疗前降低(P<0.05),D 组枕墙距、指地距、BASDAI 及BASFI 均低于A 组、B 组及C 组(P<0.05),B 组及C 组枕墙距、指地距、BASDAI 及BASFI均低于A 组(P<0.05)。治疗后,4 组ESR、CRP、CTX-Ⅰ、DKK1 水平均较治疗前降低(P<0.05),D 组ESR、CRP、CTX-Ⅰ、DKK1 水平均低于A 组、B 组及C 组(P<0.05),B 组及C 组ESR、CRP、CTX-Ⅰ、DKK1 水平均低于A 组(P<0.05)。结论:督灸联合补肾祛寒化湿方可减轻AS 患者的炎症反应,调节CTX-Ⅰ、DKK1 表达,改善机体活动功能。

    Abstract:

    Abstract: Objective: To observe the clinical effect of moxibustion at governor vessel combined with Bushen Quhan Huashi prescription for ankylosing spondylitis(AS) and its effect on levels of C-terminal telopeptide of typeⅠcollagen(CTX-I) and Dickkopf-1 protein(DKK1) in serum. Methods:A total of 160 cases of AS patients were selected and divided into group A,group B,group C and group D by envelope method,40 cases in each group. Group A was given routine symptomatic treatment of western medicine;group B was additionally treated with moxibustion at governor vessel based on the treatment of group A; group C was additionally treated with Bushen Quhan Huashi prescription based on the treatment of group A; group D was additionally treated with moxibustion at governor vessel and Bushen Quhan Huashi prescription based on the treatment of group A. All groups were treated for three months. The Chinese medicine syndrom score was compared among the four groups. The improvement of symptoms before and after treatment as well as levels of erythrocyte sedimentation rate(ESR), C- reactive protein(CRP), CTX- I and DKK1 were compared among the four groups. Results: After treatment, the Chinese medicine syndrome scores in the four groups were decreased when compared with those before treatment(P< 0.05);and the groups with the scores from low to high were group D,group C,group B and group A;the score in group D was significantly lower than those in group A,group B and group C(P<0.05). After treatment,thoracic mobility in the four groups were increased when compared with those before treatment(P<0.05);and the groups with the thoracic mobility from large to small were group D,group C,group B and group A;occiput-to-wall distance and finger-to-floor distance in the four groups were decreased when compared with those before treatment(P<0.05). Bath Ankylosing Spondylitis Disease Activity Index(BASDAI) and Bath Ankylosing Spondylitis Functional Index(BASFI) in the four groups were decreased when compared with those before treatment(P<0.05). After treatment, occiput- to- wall distance, finger- to- floor distance, BASDAI and BASFI in group D were lower than those in group A,group B and group C(P<0.05),and the four indexes in group B and group C were lower than those in group A(P<0.05). After treatment,levels of ESR,CRP,CTX-I and DKK1 in the four groups were decreased when compared with those before treatment(P<0.05);the four levels in group D were lower than those in group A,group B and group C(P<0.05),and the four levels in group B and group C were lower than those in group A(P<0.05). Conclusion: The therapy of moxibustion at governor vessel combined with Bushen Quhan Huashi prescription can relieve inflammatory reactions of AS patients, regulate the expression of CTX- I and DKK1, and improve body activity function.

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郭利娟,韩崇涛,阎晓霞,葛飞,赵永杰,徐迎锋,朱紫燕.督灸联合补肾祛寒化湿方治疗强直性脊柱炎的临床疗效及对患者血清CTX-I、DKK1水平的影响[J].新中医,2021,53(10):117-121

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  • 在线发布日期: 2021-05-24
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