1.首都医科大学附属北京中医医院疾控处,北京 100101
2.首都医科大学附属北京中医医院风湿科,北京 100101
张硕,女,37岁,硕士,主管康复治疗师。研究方向:风湿病康复。
张秦,E-mail:qingzhang1974@126.com
收稿:2024-12-02,
纸质出版:2025-12-25
移动端阅览
张硕,张秦.捏脊通督法结合髋关节功能训练治疗强直性脊柱炎的临床效果观察[J].北京中医药,2025,44(12):1526-1530.
ZHANG Shuo,ZHANG Qin.Clinical efficacy of spine-pinching and governor vessel-dredging method combined with hip joint functional exercise in treatment of ankylosing spondylitis[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(12):1526-1530.
张硕,张秦.捏脊通督法结合髋关节功能训练治疗强直性脊柱炎的临床效果观察[J].北京中医药,2025,44(12):1526-1530. DOI: 10.16025/j.1674-1307.2025.12.005.
ZHANG Shuo,ZHANG Qin.Clinical efficacy of spine-pinching and governor vessel-dredging method combined with hip joint functional exercise in treatment of ankylosing spondylitis[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(12):1526-1530. DOI: 10.16025/j.1674-1307.2025.12.005.
目的
2
观察捏脊通督疗法结合髋关节功能训练治疗强直性脊柱炎(AS)的临床效果。
方法
2
选取2022年1月—2024年1月首都医科大学附属北京中医医院风湿科收治的AS患者69例,采用随机数字表法分为观察组35例、对照组34例。2组患者均行常规药物治疗和康复运动训练,观察组在此基础上给予通督捏脊疗法结合髋关节功能训练治疗。2组均治疗12周为1个疗程,共治疗2个疗程。对比2组治疗前及治疗12、24周的AS中医证候评分,体征(枕墙距、指地距、颈椎活动度、胸廓活动度、Schober实验、晨僵时间)及功能活动度[巴斯强直性脊柱炎功能指数(BASFI)、疾病活动Bath指数(BASDAI)、视觉模拟量表(VAS)评分]。
结果
2
治疗12、24周后,观察组中医证候评分均较治疗前降低(
P
<
0.05);治疗24周后,对照组中医证候评分较治疗前降低(
P
<
0.05),观察组中医证候评分低于对照组(
P
<
0.05)。治疗24周后,观察组枕墙距、指地距、Schober实验、颈椎活动度、晨僵时间均优于治疗前(
P
<
0.05),且优于对照组(
P<
0.05)。治疗24周后,对照组指地距、晨僵时间优于治疗前(
P<
0.05)。治疗12、24周后,观察组BASFI、VAS评分均低于治疗前(
P
<
0.05);且治疗24周后,观察组BASFI、VAS评分均低于对照组(
P<
0.05)。治疗24周后,对照组BASFI、VAS评分均低于治疗前(
P<
0.05)。
结论
2
通督捏脊疗法结合髋关节功能训练可有效改善稳定期强直性脊柱炎僵硬状态,改善中医证候、症状体征,减少晨僵时间,提高患者生活质量。
Objective
2
To observe the clinical efficacy of spine-pinching and governor vessel-dredging method combined with hip joint functional exercise in patients with ankylosing spondylitis (AS).
Methods
2
A total of 69 AS patients admitted to the Department of Rheumatology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, from January 2022 to January 2024 were randomly divided using the random number table method into an observation group (
n
=35) and a control group (
n
=34). Both groups receiv
ed conventional medication and rehabilitation exercise training. On this basis, the observation group was additionally treated with spine-pinching and governor vessel-dredging method combined with hip joint functional exercise. Each treatment course lasted 12 weeks, with a total of 2 courses. AS traditional Chinese medicine (TCM) syndrome scores, physical signs (occiput-to-wall distance, finger-to-floor distance, cervical range of motion, thoracic range of motion, Schober test, morning stiffness duration), and functional activity scores [Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Visual Analogue Scale (VAS)] were compared before treatment and at 12 and 24 weeks of treatment.
Results
2
At 12 and 24 weeks, TCM syndrome scores in the observation group decreased compared with baseline (
P
<
0.05). At 24 weeks, TCM syndrome scores in the control group decreased compared with baseline (
P
<
0.05), and scores in the observation group were lower than those in the control group (
P
<
0.05). At 24 weeks, occiput-to-wall distance, finger-to-floor distance, Schober test, cervical range of motion, and morning stiffness duration in the observation group improved compared with baseline and were superior to the control group (
P
<
0.05). At 24 weeks, finger-to-floor distance and morning stiffness duration in the control group improved compared with baseline (
P
<
0.05). At 12 and 24 weeks, BASFI and VAS scores in the observation group decreased compared with baseline; at 24 weeks, these scores were lower than those in the control group (
P
<
0.05). At 24 weeks, BASFI and VAS scores in the control group decreased compared with baseline (
P
<
0.05).
Conclusion
2
Spine-pinching and governor vessel-dredging method combined with hip joint functional exercise can effectively improve stiffness in patients with stable-phase AS.
ZHANG S , PENG L , LI Q , et al . Spectrum of Spondyloarthritis Among Chinese Populations [J ] . Curr Rheumatol Rep , 2022 , 24 ( 8 ): 247 - 258 .
戴生明 , 鲍春德 , 邹和建 , 等 . 应用磁共振成像诊断和评估骶髂关节炎的专家共识 [J ] . 内科理论与实践 , 2023 , 18 ( 2 ): 65 - 69 .
北京中西医结合学会风湿病专业委员会 . 强直性脊柱炎长期管理专家共识(2021年) [J ] . 中国中西医结合杂志 , 2021 , 41 ( 12 ): 1426 - 1434 .
广东省药学会 . 风湿免疫疾病超药品说明书用药专家共识(之三):强直性脊柱炎 [J ] . 中国现代应用药学 , 2017 , 34 ( 3 ): 451 - 457 .
TAM LS , GU J , YU D . Pathogenesis of ankylosing spondylitis [J ] . Nature Reviews Rheumatology , 2010 , 6 ( 7 ): 399 - 405 .
VAN DER LINDEN S , VALKENBURG HA , CATS A . Evaluation of diagnostic criteria for ankylosing spondylitis. a proposal for modification of the New York criteria [J ] . Arthritis Rheum , 1984 , 27 ( 4 ): 361 - 368 .
RUDWALEIT M , VAN DER HEIJDE D , LANDEWÉ R , et al . The development of Assessment of spondyloarthritis international society classification criteria for axial spondyloarthritis (part II): validation and final selection [J ] . Ann Rheum Dis , 2009 , 68 ( 6 ): 777 - 783 .
郑筱萸 . 中药新药临床研究指导原则 [M ] . 北京 : 中国医药科技出版社 , 2002 : 110 - 119 .
GARRETT S , JENKINSON T , KENNEDY LG , et al . A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index [J ] . J Rheumatol , 1994 , 21 ( 12 ): 2286 - 2291 .
CALIN A , GARRETT S , WHITELOCK H , et al . A new approach to defining functional ability in ankylosing spondylitis: the development of the bath ankylosing spondylitis functional index [J ] . J Rheumatol , 1994 , 21 ( 12 ): 2281 - 2285 .
王会儒 , 陆敏华 . 强直性脊柱炎的功能锻炼 [M ] . 上海 : 上海交通大学出版社 , 2017 : 167 - 175 .
曲昆 , 马丛 , 刘晓光 , 等 . 太极强脊操干预强直性脊柱炎40例效果评价 [J ] . 北京中医药 , 2020 , 39 ( 6 ): 629 - 632 .
蔡东星 , 高潮铨 , 邱梓瑜 . 肌内效贴在慢性非特异性下腰痛康复中的应用进展 [J ] . 按摩与康复医学 , 2021 , 12 ( 6 ): 36 - 37 .
KUPPUSAMY S , NARAYANASAMY R , CHRISTOPHER JD . Effectiveness of mckenzie exercises and mat based pilates exercises in subjects with chronic non-specific low back pain: a comparative study [J ] . Scientific and Academic Publishing , 2013 ( 4 ): 47 - 54 .
羊璞 , 惠建荣 , 刘大钊 , 等 . “通脊养脉”针灸法治疗非特异性下腰痛可行性探析 [J ] . 中国中医急症 , 2020 , 29 ( 6 ): 1055 - 1057 .
王北 , 马丛 , 温博 , 等 . 从肝论治强直性脊柱炎应用探讨 [J ] . 北京中医药 , 2017 , 36 ( 10 ): 872 - 874 .
阎小萍 , 张烜 , 翁习生 . 常见风湿病及相关骨科疾病中西医结合诊治 [M ] . 北京 : 人民卫生出版社 , 2015 : 219 .
王承德 , 沈丕安 , 胡荫奇 . 实用中医风湿病学 [M ] . 2版 . 北京 : 人民卫生出版社 , 2009 : 693 .
王为兰 . 中医治疗强直性脊柱炎 [M ] . 2版 . 北京 : 人民卫生出版社 , 2003 : 52 - 66 .
南京中医学院 . 难经校释 [M ] . 2版 . 北京 : 人民卫生出版社 , 2009 : 75 .
姚斐 , 赵毅 , 蒋诗超 , 等 . 从足太阳膀胱经论治慢性疲劳综合征的理论依据 [J ] . 中国针灸 , 2015 , 35 ( 3 ): 295 - 298 .
张程 , 王雪峰 , 贾广良 , 等 . 探索脊背经穴在小儿脑性瘫痪中的临床辨治作用 [J ] . 中国针灸 , 2017 , 37 ( 9 ): 1001 - 1004 .
唐中生 , 罗亚非 , 张作涛 , 等 . 捏脊疗法的形态学依据探讨 [J ] . 按摩与康复医学 , 2010 , 1 ( 5 ): 42 - 44 .
PRIESKE O , MUEHLBAUER T , BORDE R , et al . Neuromuscular and athletic performance following core strength training in elite youth soccer: Role of instability [J ] . Scand J Med Sci Sports , 2016 , 26 ( 1 ): 48 - 56 .
朱霜菊 , 刘远婷 . 不同方向捏脊的作用效应探析 [J ] . 湖北中医杂志 , 2017 , 39 ( 6 ): 43 - 45 .
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