Abstract:

Objective　To assess the efficacy and safety of combining adalimumab with Guanzhong Li's bone injury school decompression and pain relief method in improving hip joint function in patients with ankylosing spondylitis (AS). Methods　This study was a randomized controlled trial. A total of 90 AS patients in Xi'an Fifth Hospital from May 2021 to May 2024 were selected and were divided into a control group and a treatment group with 45 cases in each group according to the random number table method. The ratios of male to female in the treatment group and the control group were 30:15 and 33:12; their ages were (32.6±7.4) and (33.1±7.8) years old; their body mass indexes were (24.3±3.5) and (24.1±3.3) kg/m²; their courses of disease were (2.83±0.42) and (2.86±0.51) years. The control group was treated with adalimumab by subcutaneous injection of 40 mg every two weeks for 4 weeks. The treatment group was combined with Guanzhong Li's bone injury school decompression and pain relief method once a week for 4 weeks on the basis of control group. The therapeutic effects of the two groups were observed, including Harris score, total range of passive motion, Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Function Index (BASFI) scores, and serum inflammatory factors before and after treatment, and the degree of difficulty in wearing shoes and socks after treatment. χ² test, rank sum test, and independent sample t test were used for statistical analysis. Results　The total effective rate of the treatment group was higher than that of the control group [95.56% (43/45) vs. 71.11% (32/45)] (P<0.05). After treatment, the Harris score and total range of passive motion in the treatment group were (86.29±1.43) points and (225.39±8.57)°, which were higher than those in the control group [(78.96±1.09) points and (204.23±7.32)°] (both P<0.05); the BASDAI and BASFI scores in the treatment group were (3.25±0.67) and (1.93±0.43) points, which were lower than those in the control group [(3.92±0.74) and (2.44±0.38) points] (both P<0.05); the levels of serum inflammatory factors and the degree of difficulty in wearing shoes and socks in the treatment group were also lower than those in the control group (all P<0.05). Conclusion　The combined treatment of adalimumab and Guanzhong Li's bone injury school decompression and pain relief method significantly enhances the hip joint function in patients with AS, underscoring its effectiveness and potential as a superior treatment modality.

Key words:

Ankylosing spondylitis,  , Adalimumab,  , Guanzhong Li's bone injury school decompression and pain relief method,  , Hip joint function, Pain

摘要：

目的　评估阿达木单抗联合关中李氏骨伤流派减压除痛法改善强直性脊柱炎（AS）患者髋关节功能的效果和安全性。方法　本研究为随机对照试验。选取西安市第五医院2021年5月至2024年5月90例AS患者，按随机数字表法分为对照组和治疗组各45例。治疗组和对照组的男女比分别为30∶15、33∶12；年龄分别为（32.6±7.4）、（33.1±7.8）岁；体重指数（BMI）分别为（24.3±3.5）、（24.1±3.3）kg/m²；病程分别为（2.83±0.42）、（2.86±0.51）年。对照组采用阿达木单抗治疗，皮下注射，每次40 mg，每两周一次；治疗组在对照组基础上联合关中李氏骨伤流派减压除痛法，每周一次。两组均治疗4周。观察两组疗效，治疗前后Harris评分、总被动活动度、强直性脊柱炎疾病活动指数（BASDAI）和强直性脊柱炎功能指数（BASFI）评分、血清炎症因子，治疗后穿鞋袜困难程度。采用χ²检验、秩和检验、独立样本t检验进行统计学分析。结果　治疗组的总有效率高于对照组［95.56%（43/45）比71.11%（32/45）］（P<0.05）。治疗后，治疗组的Harris评分和总被动活动度分别为（86.29±1.43）分和（225.39±8.57）°，均优于对照组的（78.96±1.09）分和（204.23±7.32）°（均P<0.05）；治疗组的BASDAI、BASFI评分分别为（3.25±0.67）、（1.93±0.43）分，均低于对照组的（3.92±0.74）、（2.44±0.38）分（均P<0.05）；治疗组的血清炎症因子水平和穿鞋袜困难程度低于对照组（均P<0.05）。结论　阿达木单抗联合关中李氏骨伤流派减压除痛法对AS患者髋关节功能的恢复有显著效果。

关键词:

强直性脊柱炎, 阿达木单抗, 关中李氏骨伤流派减压除痛法, 髋关节功能, 疼痛