| Significance:Ankyloing spondylitis is a chronic inflammation of axial joints mainly connective tissue disease.It is clinical problems common among patients,and has a high genetic correlation,etiology and pathogenesis is yet to clear.This disease has a high rate of delayed diagnosis,and comparative onset of occult.Typical symptoms of AS are low back pain,morning stiffness,limitation of lumbar spine in all directions and reduce the degree of thoracic.This disease has different clinical manifestations and the lack of specific laboratory check indicators,clinical diagnosis and staging depends on the sacroiliac joint study of the radiation changes,if confirmed through X-ray examination at this time in patients with hip and spine functional activities have been limited,and quality of life of patients will drop.The pathological changes mainly involves in the sacroliliac joints,the spine and the hip joints...etc.This result in limitation of the fibrous or the bony ankylosis and malformation,affect the quality of life badly.It is a heavy social burden.The most common clinical X-ray showed that the hip joint or intervertebral joint space narrowing of the normal or mildly sick,but this time the patient's hip and spine has been limited function,and that there are discrepancies between X-ray and clinical symptoms of patients with AS,There are some patients are severe joint dysfunction, however,the X-ray show that there are still joints space existing and hare no bone bridge over the joints.We have put forward the "fibrous ankylosis" view that the spine and(or) peripheral joints with severe activity limitation,imaging study showed that:peripheral joint involvement,a clear gap narrowed,but not partial or complete fusion of spinal vertebrae or bone redundant form,neck,chest,lumbar spinal vertebrae are without a bone bridge formation.Consider early/medium-Events dysfunction in patients with AS are caused because of soft tissue lesions,are compared with the AS in terms of bony ankylosis,and consider joint fibrous ankylosis is not only the pathological results of AS,but also for the joint development of important bony ankylosis reasons,it will make the clinical treatment more specific-each stage adopt different and suitable treatment.Higher morbidity of this disease,its high rate of deformity are major violations of lesions to the hip or spine formed,because of its cause of the pathological and mechanism is not very clear,there is no satisfactory treatment,especially for tonic phase,the lack of effective means.Axial and peripheral joints and the progressive decline in kyphosis resulted in AS symptoms are the main factors,which is a pain, joint stiffness and muscle spasms caused.Long-term spasm of the mechanical role, which will hinder the blood circulation,together with the inflammatory response, vascular spasm itself can cause contraction and a vicious circle,this will inevitably lead to insufficient blood supply caused by the metabolism and increase the pain barrier.Since the sixties,soft tissue surgery applications of inherit the traditional silver needle,damage to soft tissue pain in the primary lesion tenderness point group as the acupuncture points,play a:similar soft tissue lysis role.We have to use silver needle therapy for the treatment of AS patients,it used to be used to treat the original injury caused by Trauma-induced joint dysfunction and Arthralgia caused by a variety of joint pain,because silver needle can play a similar soft tissue lysis role,be able to very good improvement in the situation of patients with limited joint function. Silver needle releasable fibrous ankylosis of the limited period of AS in patients with articular soft tissue adhesions,reducing client tendon inflammation,improve local blood circulation,is expected to increase in joint activities.Focus on resolving the AS patients with spine and hip joints dysfunction,improve quality of life of patients and reduce the occurrence of disability,through this research,to find an efficient,cheap and non-toxic method of treatment of AS and to be promoted.Objectives:Taking into account the current diagnosis and treatment of AS is hard to have a final diagnosis in the early stage and also hard to cure in the later stage, so we have to explore fibrous ankylosis period best method of treatment,and this period is an important pathological stage and a long time of AS.AS patients with hip joint involvement most common,accounting for about 50%.Hip joint involvement can be caused by typical flexion contracture deformities and poor prognosis disease, this is the most sensitive indicators of the disease and also one of the major causes of disability.Hip involvement outstanding performance for the limbs and activity limitation,followed by pain.Spinal function there is a risk factor are hip involvement, AS disability are two important reasons for hip and spinal dysfunction.Waist activity in patients with progressive decline is due to pain and lumbar muscle lesions,the pain may restrict to varying degrees of back muscle strength and range of activities, patients will the fear of moving because of pain,and the muscle atrophy and functional degradation,resulting in spondyloarthropathy decreased.In addition,the majority of clinical treatment to patients in this stage.At present,we also can not be fast-articular soft tissue to improve the activity limitation in patients with symptoms, the prevention of joint deformation and slow joint space narrowing.We adopt a partial silver needle treatment,efforts to improve function in patients with limited joint activities,to reduce the important parts of the body because bony ankylosis caused by disability occurred,thereby enhancing the quality of life,explore a new AS treatment.Methods:Early on there is no way to clinical improvement in patients with hip Express activity limitation and pain symptoms,In this study,we focused on the silver for AS patients with hip and spine dysfunction improved.A random collection of the South hospital patients with newly diagnosed 52 cases of AS,they have the necessary clinical data integrity.In accordance with the treatment sequence,using random number table is divided into silver needle group(26 cases) and control group(26 cases).All patients were in line with the 1984 revised diagnostic criteria for AS New York,which is fibrous ankylosis and relatively stable period of disease,mainly in patients with hip and spine dysfunction district,the use of pre-designed collection of medical data collection table of cases.Silver needle treatment group select parts of the waist and buttocks,according to joint-constrained regions,determine the lesion region tenderness point acupuncture group and the scope.The selected sites:the waist have along the pelvic iliac crest fate,after iliac spine and iliac crest fate inside the back 1/3 of muscle attachment,that is,the muscles around the sacroiliac joints skeleton attachment,as well as lumbar sacral vertebra 2 to 2 adjacent to the spinous process of the lamina;and the buttocks of the range of middle gluteal muscle and the gluteus minimus,iliotibial tract of the iliac wing attachment,ischial big hole on fate and the femoral intercondylar fossa,iliac spine following,the sacroiliac joint the outer edge and the upper part of is chialtuberosity.The control group,by combination of oral of salicylazosulfapyridine and Celebrex capsules.AS because of the efficacy evaluation system than the systemic lupus erythematosus and rheumatoid arthritis lag,there is currently no generally accepted criteria for AS effects.Reference to the international working group(ASAS) recommend the program,select the Bath ankylosing spondylitis functional index (BASFI) score,Bath ankylosing spondylitis disease activity index(BASDAI) score, Bath Ankylosing Spondylitis Spine Score(BASMI),extent of hip jonit expansion score,as target evaluation in this study,and the extent of hip jonit expansion score as the main target evaluation.Because of acute-phase reactants erythrocyte sedimentation rate and C-reactive protein assessment of the value of AS disease activity are still controversial,so the two cases included only as one of the indicators; The HLA-B27reference only as a diagnostic target due to non-diagnosis specific. Pre-treatment and treatment in the two treatments were recorded the evaluation target.The SPSS 13.0 use of statistical data,the AS patients were test age,gender, duration,baseline information on the balance.Analysis and Comparison of the two groups before treatment target of the observation,as well as before and after treatment with the target group of any significant differences,and then analysis of the target between the two groups to improve the extent of any significant difference.Results:AS patients were age,gender,disease duration showed no significant difference,the two groups of patients before treatment by the BASFI and BASDAI Of no significant difference test,that is,two groups of patients with AS before the functional activity of target and the target condition was no significant difference,two groups of patients that pre-treatment severity of the disease was Comparable.Two groups of patients with AS the target score after treatment than those with pre-treatment has significantly improved;Silver needle group before and after treatment to improve the target of the evaluation than the control group were significantly different,that is,the effect of the experimental group than the control group.Conclusion:At present,there is no breakthrough in the treatment of AS progress,the main principles of treatment are to control disease progression and improve clinical symptoms and reduce disability.Silver needle therapy on a relatively stable period of AS in patients with fibrous ankylosis period hip and spine as well as other functional indicators have improved significantly,it can be obvious release local soft-tissue.Silver needle aspiration in the region left much lacunar lesions, lacunar can happen is very full of blood vessels,thus a substantial increase in the blood,improve local blood circulation,By increasing the lesion area blood flow, silver needle could strengthen the organization of nutrition,living cells,enhance the ability to speed up the exclusion of the metabolic products and material-induced pain, and promote inflammation and tissue regeneration process of the dissipation effects. This study shows that silver needle therapy on the improvement of restricted joints is superior to conventional drug treatment.Through the soft tissue have lesioned,silver needle release the pressure to improve local blood circulation,nerve,partial blood vessels have been alleviated.Due to adhesions,scarring,contracture,joint dislocation, such as tiny cage mechanics caused by the dynamic balance disorders,silver needle can quickly mitigation,and then back muscle to eliminate muscle tension,stress can adjust the spine.The regional organizations to alleviate the pressure through silver needle,there is in favor of local tissue metabolism,accelerate tissue repair,thus restoring the body's dynamic equilibrium.Silver needle can not only release restricted joints and soft tissue adhesions,reducing client tendon inflammation,improve local blood circulation,a marked increase in the activities of joint degrees,play a similar soft tissue lysis role,be able to improve a very good joint function in patients with limited circumstances,while the analgesic effect of soft tissue can be greatly improved patient activities,to improve the quality of life of patients,have significant effect on reducing disability.To meet " the pain removed by loose,to loose could induced pain" so that the disease towards a good direction,provided a new way to the treatment of AS and give AS treatment brings new hope. |
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