Pain in ankylosing spondylitis- the impact of the weather

The majority of patients suffering from rheumatic diseases relate their symptoms to the weather. So far, patients with ankylosing spondylitis have not been evaluted with respect to weather-sensitivity. In the present study the impact of weather conditions on pain was investigated in patients with ankylosing spondylitis. A group of 158 patients (125 male, 33 female, aged 53 +/- 5 yrs) suffering from ankylosing spondylitis for 22 +/- 8 yrs, who presented for a spa treatment at the Gasteiner Heilstollen, were interviewed by the examining physician about their individual experiences as to the influence of certain weather conditions on pain intensity: which weather conditions are the worst? Seventy-three percent of the patients claimed that their symptoms are influenced by the weather. Forty-one patients suffer most before a change to cold and humid (25 pat.) or to humid weather (16 pat.). Forty patients feel the worst pain during cold and humid (26 pat.) or during humid (14 pat.) weather. All changes of the weather (changes to both warm as well as cold) cause a deterioration in 23 patients. Eleven patients have most severe pain before (6 pat.) or during (5 pat.) cold weather. One patient claimed warm and dry weather aggravate his symptoms. The data show that in ankylosing spondylitis the share of weather-sensitive patients is similar to other rheumatic diseases. The results confirm the clinical impact of the issue.     

协同护理模式对强直性脊柱炎患者自我护理能力和生活质量的影响

目的：探讨协同护理对强直性脊柱炎患者自我护理能力和生活质量的影响。方法：选择强直性脊柱炎患者80例。采用随机数字表法分为试验组40例和对照组40例。试验组实施协同护理模式,对照组实施常规护理。干预后3个月,采用自我护理能力测定置表（ESCA）和生活质量量表（SF-36）比较两组干预效果。结果：干预后,试验组自我护理能力和生活质量得分与对照组相比,差异具有统计学意义（P〈0．05）。结论：应用协同护理模式能够显著提高强直性脊柱炎患者的自我护理能力和生活质量。     

The role of biologic agents in the therapy of ankylosing spondylitis

Ankylosing spondylitis is a chronic, inflammatory rheumatic disease which etiology and pathogenesis are not yet fully understood. The inflammation involves the spine and also the peripheral joints might be affected in some cases resulting in a progressive ankylosis, restricted mobility, significant disability, loss of productivity and decreased quality of life. Gene technology based new drugs of the past decade, the biologic agents, offer an alternative opportunity for the treatment of ankylosing spondylitis in comparison with the previous drugs with doubtful efficiency. In Hungary infliximab and etanercept has been registered for ankylosing spondylitis. The aim of this study was to evaluate the efficacy of infliximab and etanercept by the available randomised controlled trials. A systematic search of the literature was performed from 01. 01. 2000 to 08. 31. 2005. and the relevant publications were analysed following the concepts of evidence based medicine. 7 double blind, randomised, placebo controlled trials were identified, three for infliximab (n = 389) and four for etanercept (n = 431). Although the inclusion criteria, the duration of the trials and the primary endpoints were different, the results confirm that both drugs significantly decrease symptoms and disease activity, and this effect is sustained during the therapy, nevertheless half of the patients did not achieve the standardised criteria of 50% decrease in disease activity. Both agents are well tolerated by patients. The outcomes of long-term therapy are reassuring by open extension studies of three years. Guidelines for biologic therapy has been developed in Hungary determining the target patient group, the conditions of the therapy and also an arthritis centre network has been established. Though individual admission is feasible, biologic drugs are not under reimbursement in Hungary. High drug costs makes the implementation of this new therapeutic opportunity difficult in the daily medical practice.     

Willingness to accept risk in the treatment of rheumatic disease.

STUDY OBJECTIVE--The aim was to assess patients willingness to accept mortal risk in the drug treatment of chronic rheumatic disease. DESIGN--A non-random sample of consecutive patients were interviewed with a standardised survey instrument. SETTING--The study took place in the Royal National Hospital for Rheumatic Diseases, Bath, UK. PATIENTS--100 consecutive in- and out-patients aged 65 or less were interviewed, 50 with rheumatoid arthritis and 50 with ankylosing spondylitis. Mean age was 48 years with mean disease duration of 14 years. The rheumatoid arthritis group was mainly female (84%), v 26% in the ankylosing spondylitis group. MEASUREMENTS AND MAIN RESULTS--Risk preferences were elicited using the method of standard gamble in the context of a hypothetical new drug. Patients indicated the maximum percentage probability of mortality they regarded as acceptable to achieve four different levels of benefit: total cure (20.7%), relief of pain (16.9%), relief of stiffness (13.1%), return to normal functioning (14.5%). Rheumatoid arthritis patients displayed a higher (p less than 0.05) willingness to accept risk than ankylosing spondylitis patients for all gambles except relief of stiffness. Analysis of variance indicated that willingness to accept risk decreases with the duration of disease and increases with reductions in self assessed health status. CONCLUSIONS--Evaluative methods such as standard gamble can elicit useful risk-benefit preference data from patients to assist those who manage clinical risks.     

全髋关节置换术治疗20例强直性脊柱炎的临床效果观察

目的 观察人工全髋关节置换手术治疗20例强直性脊柱炎患者的临床效果.方法 选取某院收治的强直性脊柱炎患者20例,对其进行全髋关节置换术并对患者的临床资料进行回顾性调查研究,总结评价全髋关节置换术治疗强直性脊柱炎的临床效果.结果 患者的髋关节活动度等参数由手术前的平均48°提高到术后的平均160°.其余各项髋关节的活动度参数均有不同程度的改善(与术前相比差异具有统计学意义).对20例患者进行Harris评分,均由术前的平均30.39分提高到术后的93.75分,手术优良率为90.0％.结论 对强直性脊柱炎患者进行全髋关节置换术可显著改善髋关节活动范围,矫正髋关节畸形,改善患者的生活质量,该手术方式是目前治疗强直性脊柱炎的有效方法之一.     

补肾壮骨方治疗强直性脊柱炎患者100例疗效分析

目的探析补肾壮骨方对强直性脊柱炎患者的临床治疗效果。方法回顾性分析我院100例强直性脊柱炎患者的临床治疗经验,所有患者均用补肾壮骨方治疗,对比治疗前后强直性脊柱炎患者病情的改善情况。结果对比患者治疗前后的腰背酸痛积分和晨僵时间,差异显著,有统计学意义(P<0.05);对比患者治疗前后的血清C-反应蛋白和红细胞升降率,差异显著,有统计学意义(P<0.05)。结论补肾壮骨方对直性脊柱炎患者的治疗有一定的帮助作用,能够缓解患者的疼痛感,高效改善其病情,值得在临床中被广泛推广和应用。     

Content validity of the ASQoL for use in a non-radiographic axial spondyloarthritis population: a qualitative study

Quality of Life Research - The ankylosing spondylitis quality of life (ASQoL) instrument is widely used to assess health-related quality of life in patients with ankylosing spondylitis (AS). We...     

六味地黄汤加味治疗强直性脊柱炎的临床研究

目的观察六味地黄汤加味治疗肝肾不足、湿热痹阻型强直性脊柱炎(AS)的疗效和安全性。方法本研究采用临床随机对照试验方法。将64例符合标准的患者随机分成两组。治疗组:32例,口服六味地黄汤加味;对照组:32例,口服甲氨喋呤+柳氮磺吡啶,两组疗程均为3个月。结果经治疗,两组晨僵持续时间、Schober实验、胸廓扩张度、血沉(ESR)及C反应蛋白(CRP)等指标较治疗前均显著降低(P<0.05),并且治疗组改善程度明显大于对照组(P<0.05);治疗组不良反应发生率明显少于对照组(P<0.05)。结论六味地黄汤加味是治疗肝肾不足、湿热痹阻型强直性脊柱炎安全而有效的方法。     

86例强直性脊柱炎患者血清免疫球蛋白的变化探讨

目的探讨强直性脊柱炎（AS）患者免疫球蛋白水平的变化。方法以86例AS患者（疾病组）和80例健康人群（健康对照组）作为研究对象,采用免疫散射比浊法测定其血清中IgA、IgG、IgM的浓度。结果 AS患者血清IgA和Ig G水平显著高于健康对照组（P〈0.05）。免疫球蛋白变化以IgG异常为主,异常率为31.4%（27/86）;IgA异常率为17.4%（15/86）;IgM异常率为5.8%（5/86）。结论血清免疫球蛋白可作为强直性脊柱炎的重要炎症指标。     

自身免疫调节法控制强直性脊柱炎病情发展的临床应用

目的 探讨自身免疫调节法控制强直性脊柱炎病情发展的临床应用价值.方法 分析中西结合治疗强制性脊柱炎的理论,采用中西医结合进行基础治疗,结合自身免疫调节法进行辅助治疗.分析患者病情进展的速度及病情的稳定状况,进行观察组与对照组比较.结果 20例患者的病情进展速度及生活治疗状况优于以往的单纯基础治疗.结论 自身免疫调节法对强直性脊柱炎的治疗有一定的临床意义.     

肿瘤坏死因子拮抗剂（TNF-α）治疗强直性脊柱炎临床不良反应观察

目的：了解接受肿瘤坏死因子拮抗剂治疗强直性脊柱炎临床常见不良反应及少见不良反应。方法：本组选取了50例强直性脊柱炎患者接受肿瘤坏死因子拮抗剂（本组均选用上海中信科健公司产品益赛普）治疗,同时观察不良反应发生率及常见不良反应症状。结果：接受肿瘤坏死因子拮抗剂治疗的50例患者发生首次不良反应的有8例,中长期不良反应5例。结论：生物制剂治疗强直性脊柱炎是安全有效的,但应注意不良反应的发生及处置。     

脐带间充质干细胞移植治疗强直性脊柱炎患者的效果分析

目的探讨脐带间充质干细胞移植治疗强直性脊柱炎患者的临床效果。方法选取我院2016年2月至2019年1月收治的40例强直性脊柱炎患者,随机分为对照组和观察组各20例。对照组采用免疫及生物制剂治疗,观察组采用脐带间充质干细胞移植治疗,对比两组的临床治疗效果。结果观察组治疗总有效率高于对照组(P<0.05)。治疗后,观察组的血沉、细胞间黏附分子、血清TNF-α水平均低于对照组(P<0.05);治疗后1个月、3个月、6个月,观察组的疼痛程度评分、活动指数评分均低于对照组(P<0.05)。结论脐带间充质干细胞移植治疗强直性脊柱炎患者的效果显著,值得临床推广。     

Educational support groups of patients with ankylosing spondylitis: a preliminary report

Educational support groups (ESGs) for patients with ankylosing spondylitis were found to significantly (P less than 0.01) increase knowledge about the disease and its treatment. Compliance of participants with their prescribed exercise programs was improved, although the improvement did not achieve statistical significance. Compliance with prescribed application of heat to joints was not changed. Control patients showed no substantial changes in knowledge or compliance. Although analysis of pretest and posttest responses on a questionnaire did not indicate that the ESGs enhanced the patients' ability to cope with ankylosing spondylitis or their perception of the adequacy of family relationships with regard to the disease, verbal feedback concerning these areas was positive in most cases. Patients did not express negative feelings about the thought of meeting another person with ankylosing spondylitis whose disease was less severe or whose coping ability was greater or less than their own. Two patients who initially believed that they would feel threatened if they were to meet a more severely ill patient relinquished that concern after ESG participation.     

A prospective study of early diagnostic investigations in the diagnosis of ankylosing spondylitis

This study was designed to assess the relative values current of locally available investigations in the early diagnosis of inflammatory sacroiliitis. Consecutive patients attending routine rheumatology clinics in Aberdeen clinically considered by consultant rheumatologists to have inflammatory back disease but with insufficient criteria to firmly establish a diagnosis of ankylosing spondylitis were included. Patients were assessed using a standard questionnaire, clinical examination of spinal movements, plain radiology of the sacroiliac joints, computerised tomographic scanning of the sacroiliac joints and HLA-B27 typing. Patients were systematically followed up using repeated clinical and radiological examination for five years. Plain film evidence of grade 2 radiological sacroiliitis (bilateral or unilateral) was found to be the most reliable predictor for the development of ankylosing spondylitis satisfying the New York criteria at 5 year follow up. CT scanning and HLA-B27 typing were of no added value in this series and the clinical questionnaire lacked specificity. It is concluded that the combination of clinical history, examination and plain film radiology are currently reliable criteria for diagnosing the subsequent development of ankylosing spondylitis satisfying established criteria.     

血液光量子治疗对强直性脊柱炎患者免疫学指标的影响

目的观察血液光量子治疗(UBIO)对强直性脊柱炎(AS)患者免疫学指标的影响,为临床治疗强直性脊柱炎提供参考依据。方法将首次诊断强直性脊柱炎患者45例随机分为单纯服药组(n=22)和服药+UBIO治疗组(n=23),即2个组均常规服用柳氮磺胺嘧啶片,其中1个组在服药基础上给予血液光量子治疗。检测2个组患者的白细胞(WBC)、抗链球菌O(ASO)、C-反应蛋白(CRP)及血沉(ESR),一些相关急病学免疫球蛋白(IgG、IgA、IgM)、补体成分(C3、C4)。结果 2个组患者在治疗1个月后,白细胞升高,ASO、CRP水平及血沉下降,治疗前后组间比较差异均有显著性(P<0.05),组间比较差异无显著性(P>0.05)。治疗2个月和3个月后,服药+UBIO治疗组的WBC计数高于单纯服药组,ASO、CRP、ESR水平低于单纯服药组,差异有显著性(P<0.05)。治疗2个月后,服药+UBIO组IgG为(8.68±1.10)g/L,IgA为(3.10±0.58)g/L,明显低于单纯服药组〔IgG(9.08±1.11)g/L,IgA(3.78±0.58)g/L〕,差异有显著性(P<0.05);IgM、C3、C4水平组间差异无显著性(P>0.05)。治疗3个月后,服药+UBIO组IgG、IgA、IgM、C3、C4水平明显低于单纯服药组,差异均有显著性(P<0.05)。结论血液光量子治疗方法对改善AS患者的免疫功能有一定作用。     

The association between HLA antigens and the presence of certain diseases

The association between the presence or absence of two HLA antigens and coeliac disease, thyrotoxicosis and ankylosing spondylitis has been studied in patients and controls. The simple empirical logistic model and a refinement due to Dyke and Patterson have been used to examine which conditional associations are important.     

An investigation into the properties of klebsiella strains isolated from ankylosing spondylitis patients.

Thirty-nine strains of klebsiella isolated from ankylosing spondylitis patients were examined by the methods of Cowan & Steel (1974), those described by Edmondson et al. (1980) and by capsular typing. No significant difference was detected by any of these methods between these strains and those examined by other workers from non-ankylosing spondylitis patients and other environments.     

ERAP1结构与功能研究进展

内质网氨基肽酶1(endoplasmic reticulum aminopeptidase 1,ERAP1)是氨基肽酶M1家族中的一个多功能的酶,在血压调节、血管发生、细胞因子受体的胞外区脱落,以及对递呈至I型主要组织相容性抗原复合物(major histocompatibility complex class I,MHC I)的抗原肽的加工中发挥作用。ERAP1等位基因变异体与多种人类疾病相关,包括自身免疫性强直性脊柱炎(ankylosing spondylitis,AS)、糖尿病、子宫颈癌以及高血压等。     

益赛普联合沙利度胺用于难治性强直性脊柱炎的疗效研究

目的：分析益赛普联合沙利度胺用于治疗难治性强直性脊柱炎的临床治疗效果。方法：对2010年6月-2012年11月期间本院收治的55例难治性强直性脊柱炎患者的临床数据进行系统分析,随机将55例患者分成对照组和治疗组,对照组采用柳氮磺胺嘧啶（SASP）治疗,治疗组采取益赛普联合沙利度胺治疗,观察两组患者的C反应蛋白、外周关节肿胀数、疼痛数、扩胸度、枕壁试验、关节功能指数以及红细胞沉降率等指标的情况。结果：治疗组患者的各项指标情况在治疗后均高于对照组,临床缓解的时间为（40.1±2.2）d,优于对照组的（68.5±5.2）d,差异均具有统计学意义（P〈0.05）。结论：临床中使用益赛普联合沙利度胺治疗难治性强直性脊柱炎,能够有效缓解病症,有效控制复发,治疗效果显著,值得推广应用。     

六味地黄汤加味治疗强直性脊柱炎的临床研究

目的观察六味地黄汤加味治疗肝肾不足、湿热痹阻型强直性脊柱炎（As）的疗效和安全性。方法本研究采用临床随机对照试验方法。将64例符合标准的患者随机分成两组。治疗组：32例,口服六味地黄汤加味;对照组：32例,口服甲氨喋呤＋柳氮磺吡啶,两组疗程均为3个月。结果经治疗,两组晨僵持续时间、Schober实验、胸廓扩张度、血沉（ESR）及C反应蛋白（CRP）等指标较治疗前均显著降低（P〈005）,并且治疗组改善程度明显大于对照组（P〈0．05）;治疗组不良反应发生率明显少于对照组（P〈0．05）。结论六味地黄汤加味是治疗肝肾不足、湿热痹阻型强直性脊柱炎安全而有效的方法。