| 引用本文: |
温伟强，黄胜光，陈辉，谭宁，周汝云，朱辉军.子午流注蜂针对强直性脊柱炎的
疗效及机制研究[J].湖南中医药大学学报,2012,32(7):67-71[点击复制] |
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| 子午流注蜂针对强直性脊柱炎的
疗效及机制研究 |
| 温伟强，黄胜光，陈辉，谭宁，周汝云，朱辉军 |
| (广东医学院附属南山医院中医风湿科) |
| 摘要: |
| 目的观察子午流注蜂针对强直性脊柱炎(ankylosing spondylitis，AS)的疗效、安全性及对患者血清白细胞
介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、性激素水平的影响，探讨其产生疗效的机制。方法将120 例AS 患者随机分
为3 组，治疗组40 例采用子午流注加辨证取穴蜂针治疗，对照1 组40 例用辨证取穴蜂针治疗，对照2 组40 例用柳氮
磺胺吡啶(sulfasalazine，SSZ)、双氯芬酸钠治疗；3 组均以4 周为1 个疗程，3 个疗程后观察疗效，观测患者Bath 强直性
脊柱炎病情活动性指数(Bath AS disease activity index， BAS-DAI)、Bath 强直性脊柱炎功能指数(Bath AS functional
index，BASFI)、晨僵时间、全身疼痛和脊柱疼痛Likert 4 级积分、患者和医生的总体评价积分，测定血沉(erythrosedi
mentation，ESR)、C 反应蛋白(C-reactive protein，CRP)、血清IL-6、TNF-α、性激素水平，同时观察药物的不良反应。结
果治疗组和对照1 组、对照2 组总有效率分别为82.5%和72.5%、70.0%，对照组与治疗组比较差异有统计学意义(P<
0.05)；3 组治疗前后BAS－DAI、BASFI、晨僵时间、全身疼痛和脊柱疼痛Likert 4 级积分、患者和医生的总体评价积分等
观察指标有明显改善，ESR、CRP、IL-6、TNF-α、睾酮(T)明显下降，治疗前后差异有统计学意义(P<0.05)；治疗组的指标
下降值与对照组相比，差异有统计学意义(P<0.05)，3 组治疗前后雌二醇(E2)、促卵泡激素(FSH)均有上升趋势，3 组泌乳
素(PRL)、孕酮(P)、促黄体生成素(LH)治疗前后比较有下降趋势，但差异均无统计学意义(P>0.05)。不良反应的发生率治
疗组为10%，对照1 组为12.5%，对照2 组为30%。结论子午流注蜂针治疗AS 疗效显著，且不良反应较少。其疗效可
能与其抑制患者血清IL-6、TNF-α、T 有关。 |
| 关键词: 强直性脊柱炎 子午流注 蜂针治疗 白细胞介素 肿瘤坏死因子-α 性激素 临床观察 |
| DOI： |
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| 基金项目:深圳市科技计划资助项目（201003264）。 |
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| Effects and mechanism of bee-venom-acupuncture based onMidnight-Noon Ebb-Flow doctrine on ankylosing spondylitis |
| WEN Wei-qiang, HUANG Sheng-guang, CHEN Hui, TAN Ning, ZHOU Ru-yun, ZHU Hui-jun |
| (Department of Rheumatology of Traditional Chinese Medicine, Affiliated Nanshan Hospital of
Guangdong Medical College, Shenzhen, Guangdong) |
| Abstract: |
| Objective To observe the effects and safety of bee-venom-acupuncture based on
Midnight-Noon Ebb-Flow doctrine on ankylosing spondylitis (AS), and its impacts on IL-6， TNF-α
and sex hormone levels, and to explore its mechanisms. Methods 120 AS patients were randomly
divided into 3 groups: 40 patients in treatment group were treated with bee-venom-acupuncture
based on Midnight -Noon Ebb -Flow doctrine and syndrome differentiation; 40 patients
in control group A were treated with bee-acupuncture based on syndrome differentiation; and 40
patients in the control group B were treated with sulfasalazine(SSZ) and diclofenac sodium. A treat-ment course was 4 weeks. Before and after 3 courses, indexes were observed and recorded, such as
Bath AS disease activity index (BAS-DAI), Bath AS functional index (BASFI), duration of morning
stiffness, Likert’ 4-grade score of whole body pain and spinal pain, evaluation by doctors and patients,
the erythrosedi mentation (ESR), C-reactive protein (CRP), and the levels of IL-6, TNF-α and
sex hormones. Adverse effects of medicines were also observed. Results The total effective rate was
82.5%, 72.5% and 70.0% in treatment group, control group A and control group B respectively; the
statistic differences were significant (P <0.05). In 3 groups, indexes of BASDAI, BASFI, duration
of morning stiffness, Likert’ 4-grade score of whole body pain and spinal pain, evaluation by doctors
and patients were improved obviously after treatments; ESR, CRP, IL -6, TNF-α and Testosterone
were significantly decreased after treatments; the differences had statistic significance (P<0.05). Compared
with the date of controls, the treatment group also showed better results after treatments;
the differences between treatment group and control groups had significance (P<0.05). In 3 groups，
Estradiol and Follicle -stimulating hormones were increased after treatments; Prolactin, Progesterone
and Luteinizing hormones were decreased after treatments; but before and after treatments there
was no significant difference (P>0.05). The incidence rate of adverse effects in treatment group was
10%, while that in the control group A and B was 12% and 30% respectively. Conclusion Beevenom-
acupuncture based on Midnight-Noon Ebb-Flow doctrine presents significant efficacy on AS
with less adverse effects. The mechanism may be related to inhibition of IL-6, TNF-α and Testosterone
production. |
| Key words: ankylosing spondylitis Midnight-noon Ebb-flow doctrine bee-venom-acupuncture IL-6 TNF-α sex hormones clinical observation |
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