督灸联合中药治疗寒湿痹阻型强直性脊柱炎的随机对照试验OA

Objective To observe the clinical efficacy of Governor Vessel moxibustion combined with Qiang Du Wen Jing Qu Shi decoction in the treatment of ankylosing spondylitis with cold-dampness Bi-obstruction syndrome.Method Ninety patients with ankylosing spondylitis of cold-dampness Bi-obstruction syndrome were randomly assigned into a combination group,a herbal medicine group,and a control group using a random number table method,with 30 patients in each group.The control group received oral Sulfasalazine enteric-coated tablets.The herbal medicine group received oral administration of Qiang Du Wen Jing Qu Shi decoction.The combination group received Governor Vessel moxibustion combined with oral administration of Qiang Du Wen Jing Qu Shi decoction.The TCM syndrome scores,pain visual analog scale(VAS)scores,Bath ankylosing spondylitis disease activity index(BASDAI)scores,Bath ankylosing spondylitis functional index(BASFI)scores,and changes in serum tumor necrosis factor-α(TNF-α),Dickkopf-related protein-1(DKK-1),β-catenin,and peripheral blood miR-29a levels were observed before and after treatment in the three groups.Result After treatment,TCM syndrome scores,pain VAS scores,BASDAI scores,BASFI scores,and serum levels of TNF-α,DKK-1,and β-catenin decreased compared with baseline in all three groups(P＜0.05),while the relative expression level of peripheral blood miR-29a increased compared with baseline(P＜0.05).After treatment,intergroup comparisons showed that the combination group and the herbal medicine group had better outcomes than the control group in terms of TCM syndrome scores,pain VAS scores,BASDAI scores,BASFI scores,serum TNF-α,DKK-1,and β-catenin levels,and relative expression levels of peripheral blood miR-29a(P＜0.05).Furthermore,the combination group showed superior outcomes compared with the herbal medicine group(P＜0.05).No obvious adverse reactions occurred in any of the three groups during treatment.Conclusion Governor Vessel moxibustion combined with Qiang Du Wen Jing Qu Shi decoction has better efficacy than oral administration of Qiang Du Wen Jing Qu Shi decoction alone in the treatment of ankylosing spondylitis with cold-dampness Bi-obstruction syndrome.It can effectively improve clinical symptoms and relieve pain.Its mechanism may be related to reducing serum TNF-α,DKK-1,and β-catenin levels and inhibiting miR-29a expression in peripheral blood.