中西医结合治疗强直性脊柱炎的研究进展

Research Progress on Integrated Traditional Chinese and Western Medicine Treatment of Ankylosing Spondylitis

摘要: 强直性脊柱炎(Ankylosing Spondylitis, AS)是一种以骶髂关节和脊柱慢性炎症为主的自身免疫性疾病，主要表现为腰背疼痛、关节强直及活动受限，严重者可导致脊柱畸形和功能障碍。流行病学数据显示，全球范围内，此病的患病率约为0.1%~1.4%，且多发生于青壮年男性。西医治疗以非甾体抗炎药和物理治疗为主，虽能快速缓解炎症，但长期使用可能引发胃肠道损伤、增加感染风险及耐药性等问题。中医认为AS属“痹证”的范畴，病机多与肝肾亏虚、气血不足、寒湿痹阻相关，治疗常采用补肾强骨、祛风除湿的中药内治及针灸、推拿等外治法，安全性较高，但存在起效缓慢、疗效个体差异大等缺点。中西医结合治疗通过整合西医抗炎镇痛与中医整体观念的优势，可协同改善症状、延缓疾病进展，并减少药物副作用，已成为当前临床研究的重点方向。本文系统综述中西医结合治疗的机制与进展，以期为优化AS治疗方案提供科学依据。

Abstract: Ankylosing spondylitis (AS) is an autoimmune disease mainly characterized by chronic inflammation of the sacroiliac joints and spine. It is mainly manifested as lower back pain, joint stiffness, and limited mobility. In severe cases, it can lead to spinal deformities and functional disorders. Epidemiological data shows that the prevalence of this disease worldwide is about 0.1%~1.4%, and it mostly occurs in young and middle-aged men. Western medicine mainly uses nonsteroidal anti-inflammatory drugs and physical therapy for treatment. Although they can quickly relieve inflammation, long-term use may cause gastrointestinal damage, increase the risk of infection, and develop drug resistance. Traditional Chinese medicine believes that AS belongs to the category of “Bi Syndrome”, and its pathogenesis is mostly related to liver and kidney deficiency, deficiency of qi and blood, and cold dampness arthralgia. Internal treatment of traditional Chinese medicine, such as tonifying the kidney and strengthening the bone, dispelling wind and removing dampness, as well as external treatment such as acupuncture and moxibustion and massage, are often used for treatment, with high safety, but there are shortcomings such as slow onset and large individual differences in efficacy. Integrated traditional Chinese and Western medicine treatment, by integrating the advantages of Western anti-inflammatory and analgesic medicine with the holistic concept of traditional Chinese medicine, can synergistically improve symptoms, delay disease progression, and reduce drug side effects. It has become a key direction in current clinical research. This article systematically reviews the mechanisms and progress of integrated traditional Chinese and Western medicine treatment, in order to provide scientific basis for optimizing AS treatment plans.