导言
强直性脊柱炎（简称AS）是一种持续性的慢性炎症性病症，被归类于风湿性免疫系统疾病。它主要攻击脊柱和骶髂关节，造成持续的疼痛和僵硬感。随着疾病的进展，炎症有可能促进脊柱内部分关节的融合，进而引起脊柱变硬，这种现象通常被称作“竹节脊”。尽管强直性脊柱炎对脊柱的影响最为明显，但它也可能影响到大型关节（如髋关节）以及一些非关节结构。
01
强直性脊柱炎的典型症状
AS的症状因个体差异而异，主要表现为：
1. 持续的腰背部疼痛和僵硬，特别是在夜间或长时间休息后更为严重，而进行适度活动后可获得缓解。
2. 脊柱变得僵硬且活动范围受限。
3. 疼痛可能上行至颈部或下行至臀部和大腿。
4. 一些病例中，患者可能遭受外围关节炎症，特别是下肢的大关节。
5. 非关节性症状可能包括眼炎、皮疹、肠炎和心血管问题。
02
强直性脊柱炎的治疗方法
虽然强直性脊柱炎（AS）目前尚无法彻底治愈，但通过一系列综合性治疗措施，可以有效地控制症状，改善患者的生活质量，并延缓疾病的进展。以下是治疗AS的几种方法：
一、非药物治疗：
1.物理疗法：物理治疗师将根据患者的具体情况设计个性化的锻炼计划，旨在维持或提升脊柱的柔韧性，增强肌肉力量，以减轻疼痛和僵硬。常用的物理治疗手段包括热疗、艾灸、冷敷、电刺激和超声波治疗等。
2.功能性锻炼：旨在提升患者的日常生活功能，包括拉伸、增强和有氧运动。特别推荐游泳和水上健身，因为水的浮力可减少关节的负担。
二、药物治疗：
1.非甾体抗炎药（NSAIDs）：作为控制AS症状的首选药物，能够有效缓解疼痛和炎症。需注意长期使用可能带来的胃肠道和肾脏副作用。
2.生物制剂：适用于对NSAIDs无效的患者，通过针对性抑制炎症介质（如肿瘤坏死因子[TNF]和白细胞介素17[IL-17]），减少炎症。包括TNF阻断剂（如恩替卡普、阿达木单抗）和IL-17抑制剂（如西库昔单抗）。
3.JAK抑制剂：针对JAK-STAT信号传导路径的新兴治疗选择，适合一部分对TNF抑制剂无反应的患者。
4.其他药物：包括传统的疾病修饰性抗风湿药（DMARDs），如硫唑嘌呤和甲氨蝶呤，主要用于治疗伴随外周关节炎的AS。小剂量的糖皮质激素可用于短期内控制炎症。
三、手术治疗：
1.针刀治疗：一种结合了针灸和小刀疗法的中医治疗手段，近年来在治疗强直性脊柱炎（AS）中显示出一定的疗效和优势。这种方法结合了中医经络学说和现代解剖学、病理学原理，通过特制的针刀直接作用于患者病变的肌肉、筋膜和关节等部位，旨在疏通经络、活血化瘀、缓解疼痛和改善关节功能。
有以下症状的患者可以采用针刀治疗：
①强直性脊柱炎患者中的腰背部疼痛、僵硬等症状，特别是对传统治疗效果不佳的患者。
②患者存在肌肉痉挛、筋膜粘连或关节功能受限等情况。
2.外科手术：在AS导致严重关节损伤或畸形，且非药物及药物治疗均无效时，可能需要考虑手术，如髋关节或膝关节置换。
03
生活方式和自我管理
1.戒烟：吸烟可加重AS病情，戒烟对疾病控制有益。
2.维持良好的坐姿和睡姿：有助于减轻脊柱负担，避免畸形。
3.定期进行物理治疗和锻炼：对于维持关节灵活性和肌肉力量，减少疼痛和僵硬十分重要。
05
结 语
强直性脊柱炎是一种需要长期面对的疾病，一定要早发现早治疗。通过综合运用药物治疗、适当的运动及生活方式调整，大多数患者能够有效地控制症状，延缓疾病进展，可以跟正常人一样工作和生活。
温馨提醒
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#8183ff;--weui-WHITE: rgba(255, 255, 255, .8);--weui-LINK: #7d90a9;--weui-TEXTGREEN: #259c5c;--weui-FG: #fff;--weui-BG: #000;--weui-TAG-TEXT-RED: rgba(250, 81, 81, .6);--weui-TAG-BACKGROUND-RED: rgba(250, 81, 81, .1);--weui-TAG-TEXT-ORANGE: rgba(250, 157, 59, .6);--weui-TAG-BACKGROUND-ORANGE: rgba(250, 157, 59, .1);--weui-TAG-TEXT-GREEN: rgba(6, 174, 86, .6);--weui-TAG-BACKGROUND-GREEN: rgba(6, 174, 86, .1);--weui-TAG-TEXT-BLUE: rgba(16, 174, 255, .6);--weui-TAG-BACKGROUND-BLUE: rgba(16, 174, 255, .1);--weui-TAG-TEXT-BLACK: rgba(255, 255, 255, .5);--weui-TAG-BACKGROUND-BLACK: rgba(255, 255, 255, .05)}}@media screen and (min-width:1024px) and (prefers-color-scheme:dark){body:not(.pages_skin_pc) .wx-root:not([data-weui-theme=light]),body:not(.pages_skin_pc) body:not([data-weui-theme=light]){--appmsgExtra-BG: #121212}}@media(prefers-color-scheme:dark){body:not([data-weui-theme=light]).my_comment_empty_data{background-color:#111}}body,.wx-root{--weui-BG-6: rgba(0, 0, 0, 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