秦旭, 王祺, 曾奇兵, 马璐, 王大朋, 陈雄, 李军, 张爱华. 温泉泡浴对人群类风湿相关指标及关节疼痛的改善作用[J]. 上海预防医学, 2021, 33(S1): 54-58. DOI: 10.19428/j.cnki.sjpm.2021.21187
引用本文: 秦旭, 王祺, 曾奇兵, 马璐, 王大朋, 陈雄, 李军, 张爱华. 温泉泡浴对人群类风湿相关指标及关节疼痛的改善作用[J]. 上海预防医学, 2021, 33(S1): 54-58. DOI: 10.19428/j.cnki.sjpm.2021.21187
QIN Xu, WANG Qi, ZENG Qi-bing, MA Lu, WANG Da-peng, CHEN Xiong, LI Jun, ZHANG Ai-hua. Effect of hot spring bathing on rheumatoid related indicators and joint pain[J]. Shanghai Journal of Preventive Medicine, 2021, 33(S1): 54-58. DOI: 10.19428/j.cnki.sjpm.2021.21187
Citation: QIN Xu, WANG Qi, ZENG Qi-bing, MA Lu, WANG Da-peng, CHEN Xiong, LI Jun, ZHANG Ai-hua. Effect of hot spring bathing on rheumatoid related indicators and joint pain[J]. Shanghai Journal of Preventive Medicine, 2021, 33(S1): 54-58. DOI: 10.19428/j.cnki.sjpm.2021.21187

温泉泡浴对人群类风湿相关指标及关节疼痛的改善作用

Effect of hot spring bathing on rheumatoid related indicators and joint pain

  • 摘要:
    目的观察贵州省典型温泉泡浴对关节疼痛和血清中抗角蛋白抗体(AKA)、抗核周因子抗体(APF)和抗环瓜氨酸肽抗体(CCP)的干预效果。
    方法筛选贵州省5个典型温泉地区160名有关节疼痛症状的人群为观察对象,进行为期4周的温泉泡浴干预,每天1次,每周5次,每次40~50 min。依据《天然温矿泉型温泉水资源地质勘查评价规范》(GB/T 13727—2016)中理疗天然矿泉水评价指标,结合地质类型,将5个典型温泉分为3种不同类型,即温度型温泉(水温 > 36 ℃)、偏硅酸型温泉(偏硅酸 > 50 mg/L)和温矿泉型温泉(溶解性总固体 > 1 000 mg/L)。采用WHO的疼痛分级标准对观察对象温泉泡浴干预前后关节疼痛程度进行评分。采用酶联免疫吸附法测定(ELISA)试剂盒检测温泉泡浴干预前后观察对象血清中的类风湿特异性诊断指标APF、AKA和CCP水平。
    结果干预前总体观察对象温泉泡浴者关节疼痛评分(分)为2.60±0.60,干预后总人群关节疼痛评分(分)降低(0.61±0.57,P < 0.05);干预前温度型、偏硅酸型和温矿泉型温泉泡浴者关节疼痛评分(分)分别为2.78±0.96、1.98±1.15和3.31±0.57;干预后上述3种温泉泡浴者关节疼痛评分(分)均降低(均P < 0.05),分别为0.50±0.65、0.48±0.74和0.85±0.90。干预前总体观察对象温泉泡浴者AKA(ng/L)和CCP(μg/mL)水平分别为34.89±16.06和107.58±10.40,干预后上述2个抗体指标均明显降低(均P < 0.05),分别为26.06±10.68和102.93±6.01;干预前温度型温泉泡浴者AKA(ng/L)为35.04±20.01,干预后AKA(ng/L)明显降低(26.61±7.54,P < 0.05);干预前偏硅酸型温泉泡浴者AKA(ng/L)和CCP(μg/mL)分别为31.09±17.26和106.51±10.13,干预后上述2个抗体指标均明显降低(均P < 0.05),分别为24.53±13.98和98.57±5.68;干预前温矿泉型温泉泡浴者AKA(ng/L)、APF(ng/mL)和CCP(μg/mL)水平分别为38.40±8.66、349.46±118.43和104.96±9.66,干预后上述3个抗体指标均明显降低(均P < 0.05),分别为34.00±7.55、269.38±127.55和101.65±3.04。
    结论贵州省典型温泉泡浴干预可改善关节疼痛症状; 3种类型温泉可不同程度地降低AKA、APF、CCP水平,温矿泉型温泉相对优于其他温泉类型。

     

    Abstract:
    ObjectiveTo observe the intervention effect of typical hot spring bathing in Guizhou province on joint pain, serum anti-keratin antibody(AKA), anti-perinuclear factor antibody(APF)and anti-cyclic citrullinated peptide antibody(CCP).
    MethodsA total of 160 people with joint pain symptoms from five typical hot spring areas in Guizhou province were selected as the subjects. They were treated with hot spring bathing intervention for 4 weeks, once a day, 5 times a week, 40 to 50 minutes each time. According to the evaluation index of physiotherapy natural mineral water in the Code for Geological Exploration and Evaluation of Natural Warm Mineral Water Resources(GB/T 13727-2016)and geological types, the five typical hot springs were divided into three different types, namely water temperature type hot springs(water temperature > 36 ℃), metasilicate type hot springs(metasilicate > 50 mg/L)and warm mineral spring type hot springs(total dissolved solids > 1 000 mg/L). WHO pain grading standard was used to score the degree of joint pain before and after hot spring bathing intervention. Serum APF, AKA and CCP antibodies were detected by ELISA kit before and after hot spring bathing.
    ResultsThe joint pain score of the subjects was 2.60±0.60, and the joint pain score of the total population decreased after intervention(0.61±0.57, P < 0.05). Before intervention, the joint pain scores of water temperature type, metasilicic acid type and warm mineral spring type were 2.78±0.96, 1.98±1.15 and 3.31±0.57, respectively. After intervention, the scores of joint pain of the three kinds of hot spring bathing patients all decreased(P < 0.05), and were 0.50±0.65, 0.48±0.74 and 0.85±0.90, respectively. Before intervention, AKA(ng/L)and CCP(μg/mL)antibody levels of the observed subjects were 34.89±16.06 and 107.58±10.40, respectively, which significantly decreased after intervention(both P < 0.05), namely 26.06±10.68 and 102.93±6.01, respectively. AKA(ng/L)was 35.04±20.01 before intervention, but decreased significantly after intervention(26.61±7.54, P < 0.05). AKA(ng/L)and CCP(μg/mL)were 31.09±17.26 and 106.51±10.13 before intervention, respectively. After intervention, the above two antibody indexes significantly decreased(all P < 0.05)to 24.53±13.98 and 98.57±5.68, respectively. Before intervention, the AKA(ng/L), APF(ng/mL)and CCP(μg/mL)antibody levels were 38.40±8.66, 349.46±118.43 and 104.96±9.66, respectively. After intervention, the above three antibody indexes significantly decreased(all P < 0.05). The values were 34.00±7.55, 269.38±127.55 and 101.65±3.04, respectively.
    ConclusionThe typical hot spring bathing intervention in Guizhou province can relieve the symptoms of joint pain, and the three types of hot springs can reduce the levels of AKA, APF and CCP antibodies to different degrees, and the warm mineral spring type of hot spring is better than the other types of hot spring.

     

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