加味治尪方联合塞来昔布对强直性脊柱炎湿热痹阻证患者血液流变学及BASDAI评分的影响观察

Effect of Celecoxib Combined with Modified Zhiwang Recipe on Hemorheology and BASDAI Score for Patients with Ankylosing Spondylitis of Dampness-heat Stagnation Syndrome

目的:探究塞来昔布联合加味治尪方对强直性脊柱炎(AS)湿热痹阻证患者血液流变学及Bath强直性脊柱炎疾病活动性指数(BASDAI)评分的影响观察。方法:选取2017年4月~2019年4月我院收治的80例AS湿热痹阻证患者,按随机数字表法将所有患者以1∶1的比例分为对照组与观察组,每组各40例。对照组患者给予常规西药塞来昔布口服治疗,观察组患者在其基础上联合加味治尪方治疗。两组均连续治疗3个月,比较两组中医证候疗效,并记录其治疗前后的疾病指数[BASDAI、Bath强直性脊柱炎功能指数(BASFI)]、体征指标(胸廓活动度、枕墙距、晨僵时间、指地距、Schober试验)、血液流变学指标[全血低切粘度(LBV)、全血高切粘度(HBV)、血浆粘度(PV)、红细胞压积(HCT)]、炎性因子[白细胞介素-1(IL-1)、肿瘤坏死因子(TNF-α)、超敏C-反应蛋白(hs-CRP)]水平变化。结果:观察组中医证候疗效总有效率为92.50%,对照组为75.00%,差异有统计学意义(P<0.05),且疗效各级别占比比较有统计学意义(P<0.05);治疗3个月后,两组患者BASDAI、BASFI评分、胸廓活动度、枕墙距、晨僵时间、指地距、LBV、HBV、PV、HCT水平均较治疗前显著下降(P<0.05),且观察组明显低于对照组(P<0.05);而Schober试验均较治疗前显著上升(P<0.05),且观察组明显高于对照组(P<0.05)。结论:塞来昔布联合加味治尪方治疗湿热痹阻证AS疗效显著,其作用机制可能与调节体内血液流变学指标有关。

Objective:To explore the effect of Celecoxib combined with Modified Zhiwang Recipe on hemorheology and Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)score for patients with ankylosing spondylitis(AS)of dampness-heat stagnation syndrome.Methods:A total of 80 patients with AS of dampness-heat stagnationsyndrome admitted to our hospital from April 2017 to April 2019 were selected.According to the random number table method,all patients were evenly divided into a controlled group and an observation group,with 40 cases in each group.Patients in the controlled group were treated with conventional western medicine Celecoxib orally,and patients in the observation group were combined with Modified Zhiwang Recipe on this basis,and the two groups were treated continuously for 3 months.The efficacy of TCM syndromes was compared between the two groups,and the disease index[BASDAI,Bath Ankylosing Spondylitis Function Index(BASFI)],signs indicators(thoracic mobility,pillow-wall distance,morning stiffness time,finger-floor distance,Schober test),hemorheology indicators[whole blood low shear viscosity(LBV),whole blood high shear viscosity(HBV),plasma viscosity(PV),hematocrit(HCT)]and inflammatory factors[interleukin-1(IL-1),tumor necrosis factor(TNF-α),high-sensitivity C-reactive protein(hs-CRP)]were recorded before and after treatment.Results:The total effective rate of TCM syndromes was 92.50%in the observation group,and was 75.00%in the controlled group(P<0.05),and there were statistically significant differences in the proportions of efficacy grades(P<0.05).After 3 months of treatment,the BASDAI score,BASFI score,thoracic mobility,pillow-wall distance,morning stiffness time,finger-floor distance,LBV,HBV,PV,and HCT in the two groups were significantly lower than those before treatment(P<0.05),and the above indexes in the observation group were significantly lower than those in the controlled group(P<0.05).And the Schober test was significantly higher than that before treatment(P<0.05),and the index in the observation group was significantly higher than that in the controlled group(P<0.05).Conclusion:Celecoxib combined with Modified Zhiwang Recipe has a significant efficacy in the treatment of AS of dampness-heat stagnation syndrome.And it role mechanism may be related to the regulation of hemorheology indicators in the body.