穴位埋线夹脊穴辅助治疗对强直性脊柱炎患者肿瘤坏死因子-α的影响

目的观察穴位埋线夹脊穴对强直性脊柱炎（ankylosing spondylitis，AS）患者血清肿瘤坏死因子-α（TNF-α）水平的影响，探讨穴位埋线治疗AS的作用机制。方法采用随机数字表法将74例AS患者分为观察组和对照组，每组37例。对照组口服柳氮磺吡啶肠溶片0．5g，每日3次，疗程3个月；观察组在对照组口服西药的基础上穴位埋线夹脊穴，疗程3个月。3个月后比较疼痛视觉模拟评分（VAS）、Schober试验、枕墙距、胸廓活动度及血沉（ESR）、C反应蛋白（CRP）、TNF-α的变化。结果两组治疗后VAS、Schober试验、枕墙距、胸廓活动度，ESR、CRP及TNF-α均有明显改善，与本组治疗前比较，差异有统计学意义（P〈0．05，P〈0．01），且观察组较对照组改善明显（P〈0．05，P〈0．01）。结论穴位埋线夹脊穴辅助治疗能明显的控制AS症状体征，降低血清TNF-α水平，效果优于单纯口服西药。

Effect of Catgut Implantation at Acupoint on the Content of Tumor Necrosis Factor a of Patients with Ankylosing Spondylitis

Objective To observe the effect of catgut implantation at acupoint on the content of tumor necrosis factor α （TNF-α）,and to explore its mechanism for treatment of ankylosing spondylitis （AS）. Methods Seventy-four AS patients were randomly assigned to the observation group and the con- trol group by digit random table, 37 in each group. Patients in the control group took Sulfasalazine Enteric- coated Tablet （SECT）, 0.5 g each time, three times daily for 3 months. Those in the observation group additionally received catgut implantation at acupoint for 3 months. Changes of visual analogue scale （VAS）, Schober test, pillow wall distance, thoracic activity, erythrocyte sedimentation rate （ESR）, C reactive protein （CRP）, and TNF-α were compared after 3 months of treatment. Results There was obvious change in VAS, Schober test, pillow wall distance, thoracic activity, ESR, CRP, and TNF-α after treatment in the both groups, showing statistical difference when compared with before treat- ment （P 〈0.05, P 〈0.01 ）. The aforesaid indices were obviously improved after treatment in the observa- tion group （P 〈0.05, P 〈0.01 ）. Conclusion Catgut implantation at acupoint, as an assistant therapy, could significantly improve clinical symptoms and signs, decrease the level of TNF-α, and its effect was superior to that of oral SECT administration alone.