Observation On The Clinical Effect Of "Wen Yang And Tong Du" Theory In Ankylosing Spondylitis Of Kidney Deficiency And Du Meridian Cold Type

Objective:To explore the application of the theory of "Wen Yang Tong Du" in the treatment of ankylosing spondylitis(AS)of kidney deficiency and Du meridian cold syndrome,and to observe the clinical effect of Kidneytonifying and strengthening the governor vessel zigao combined with Ren Du moxibustion combined with SASP in the treatment of AS,and further clarify the safety and advantages of Kidney-tonifying and strengthening the governor vessel zigao combined with Ren Du moxibustion based on "Wen Yang Tong Du" theory,which is worthy of clinical promotion and application of a safer and effective method.Methods:A total of 65 patients with AS(diagnosed by traditional Chinese medicine:dyphosis,kidney deficiency and Du meridian cold syndrome)were selected from the rheumatology outpatient department and disease area of Yantai traditional Chinese medicine hospital,Affiliated Hospital of Shandong University of traditional Chinese medicine,from December 2017 to March2019.They were randomly divided into treatment group and control group.The two groups were treated with SASP,and the treatment group was treated with Kidney-tonifying and strengthening the governor vessel zigao combined with Ren Du moxibustion.To observe the clinical efficacy by analyzing and comparing the changes of CRP,ESR,spinal activity,BASDAI,BASFI scores and TCM syndrome scores.Results:Among the 65 patients,41 males and 24 females,were observed in this study.The oldest age is 61 years,the youngest is 19 years,the average age was 34.86 years;the longest course was 15 years,the shortest was 0.5years,the average course of disease was 5 years;CT grading of bilateral sacroiliac joint was mainly grade II and grade III.The age,gender,course of disease and CT grade of bilateral sacroiliac joint of the two groups were compared statistically(P>0.05).1.The ESR and CRP: After 12 and 24 weeks of treatment,CRP and ESR in the two groups were significantly lower than before treatment,and there was a significant difference between the two groups(P<0.05).Compared with the two groups,the reduction level of CRP and ESR in the treatment group was better(P<0.05).2.Spinal activity: After 24 weeks of treatment,there were statistically significant differences between the treatment group and the control group in the improvement of the range of motion of the thorax and finger ground distance(P<0.05).After treatment,the two groups’ occipital wall distance was improved,and the difference between the treatment group and the treatment group was statistically significant(P < 0.05).While the difference between the two groups before and after treatment in the control group was not statistically significant(P>0.05).The activity of spine was improved in both groups,but the effect of treatment group was better.3.BASDAI and BASFI scores: After 24 weeks of treatment,BASDAI and BASFI scores in the two groups were lower than those before treatment,with significant difference(P<0.05),and the effect of the treatment group was better.Compared with the two groups,the comprehensive treatment effect of the treatment group was better(P<0.05).4.TCM syndrome scores comparison: After 24 weeks of treatment,both the two groups had better scores than before,and the difference was significant(P<0.05).After treatment,the advantage of the treatment group was more obvious(P<0.05).5.Efficacy evaluation:(1)Improvement of TCM syndrome efficacy: In the treatment group,the total effective rate was 33 cases,the ineffective rate was 2 cases,the total effective rate was 94.3%,the ineffective rate was 5.7%;In the control group,the total effective rate was 26 cases,the ineffective rate was 4 cases,the total effective rate was 86.7%,the ineffective rate was 13.3%.After 24 weeks of treatment,the symptoms and signs of the two groups were improved.The therapeutic effect of Kidneytonifying and strengthening the governor vessel zigao combined with Ren Du moxibustion combined with sulfasalazine(SASP)was better than that of Western medicine alone(P<0.05).(2)Clinical efficacy: In the treatment group,there were 35 cases,33 cases of total effectiveness,94.3% of total effectiveness,2 cases of ineffectiveness,5.7% of ineffectiveness;in the control group,there were 30 cases,19 cases of total effectiveness,63.3%of total effectiveness,11 cases of ineffectiveness,36.7% of ineffectiveness.After 24 weeks of treatment,the clinical effect of the two groups was obvious,the treatment group was better than that of Western medicine group(P<0.05).6.Safety comparison: A total of 5 adverse reactions occurred during the whole experiment.In the treatment group,there were 2 cases with mild skin damage caused by moxibustion;in the control group,there were 3 cases with mild reversible drug-induced liver damage.Comprehensive treatment of TCM is relatively safer.Conclusion:1.Kidney-tonifying and strengthening the governor vessel zigao combined with Ren Du moxibustion + SASP and SASP alone in the treatment of AS has obvious curative effect.2.Kidney-tonifying and strengthening the governor vessel zigao combined with Ren Du moxibustion can reduce disease activity,alleviate CRP / ESR level,improve TCM syndrome and spinal joint activity,with more prominent effect.3.The comprehensive treatment(Kidney-tonifying and strengthening the governor vessel zigao + Ren Du moxibustion + SASP)is more effective and safer than western medicine alone,which is worth popularizing.