中药外贴干预强直性脊柱炎患者负性情绪及生活质量的研究

Study of Chinese medicine paster on negative emotion and quality of life in patients with ankylosing spondylitis

目的研究中药外贴双侧华佗夹脊穴治疗强直性脊柱炎(AS)患者的临床疗效及治疗后负性情绪和生活质量的变化。方法将128例男性AS患者随机分为2组,对照组62例给予柳氮磺胺吡啶加白芍总甙胶囊口服并双侧华佗夹脊穴激光点灼,治疗组66例在对照组的基础上加用中药外贴双侧华佗夹脊穴。采用半定量症状分级法对AS患者焦虑自评量表(SAS)、抑郁自评量表(SDS)、强直性脊柱炎患者生存质量测定表(QOL-AS)相关临床症状积分进行统计,分析AS患者负性情绪及生活质量的变化和临床疗效。结果 AS患者焦虑抑郁指数(SAS+SDS积分)较健康人明显升高(P<0.05),且HLA-B27阳性患者焦虑抑郁指数较阴性患者显著下降(P<0.05);AS患者生活质量有不同程度的下降(P<0.05或0.01),且HLA-B27阳性患者较阴性患者下降显著(P<0.05);经2个疗程治疗后2组患者上述各指标改善明显(P<0.05或0.01),2组比较有显著性差异(P<0.05或0.01)。结论 AS患者处于轻中度精神抑郁状态,生活质量有一定程度的下降,以HLA-B27阳性患者更甚。中药外贴法可改善AS患者的负性情绪,提高生活质量。

Objective It is to observe the clinical effect of traditional Chinese medicine posted outside on bilateral Huatuo spine points in patients with ankylosing spondylitis（AS）,and to observe the changes of negative emotion and quality of life after therapy.Methods 128 male patients With AS were randomly divided into treatment group（66 cases） and control group（62 cases）.All patients were treated with Sulfasalazine and total glucosides of paeony capsules by oral administration,and Huatuo spine points point-stimulating therapy with laser;on this basis,the patients in the treatment group were treated with traditional Chinese medicine posted outside on bilateral Huatuo spine points.The integral of Self-Rating Anxiety Scale（SAS）,self-rating depression scale（SDS）,the quality of life of AS patients（QOL-AS） were counted by semi-quantitative method,and the clinical effect and the changes of emotional and quality of life were analyzed.Results The anxiety and depression index（SAS ＋ SDS score） of AS patients was higher than that of healthy people（P〈0.05 or 0.01）,and the anxiety and depression index of positive HLA-B27 patients were significantly higher than negative HLA-B27（P〈0.05）;The life quality of AS patients were descended differently,there was significant difference with healthy people（P〈0.05 or 0.01）,and positive HLA-B27 patients were significantly higher than that of negative patients（P〈0.05）;All the indexes were significantly changed after 2 courses of treatment（P〈0.05 or 0.01）,and there were significant differences between both groups（P〈0.05 or 0.01）.Conclusion AS patients are in mild or moderate depression,their quality of life decreases to some extent,especially in the HLA-B27 positive patients.The herb paste method can improve the negative emotion and quality of life of AS patients.