中西医结合治疗强直性脊柱炎20例临床观察

Clinical Observation of 20 Patients with Ankylosing Spondylitis Treated with a Combined Therapy

目的评价中药汤剂联合柳氮磺吡啶、甲氨蝶呤治疗强直性脊柱炎的疗效。方法将40例军人强直性脊柱炎随机分为两组,观察组(20例)用中药汤剂加柳氮磺吡啶、甲氨蝶呤治疗,对照组(20例)用甲氨蝶呤加柳氮磺吡啶治疗。观察治疗前后两组临床指标,包括腰背痛指数、晨僵时间、外周关节痛指数、胸廓活动度、Schober试验、Bath强直性脊柱炎活动性指数(BASDAI)、Bath强直性脊柱炎功能性指数(BASFI)、红细胞沉降率、C反应蛋白、骶髂关节X线分级等。结果两组治疗后临床指标均比本组治疗前显著改善(P<0.05);治疗后两组比较,除腰背痛指数、晨僵时间、外周关节痛指数差异有统计学意义(P<0.05)外,其余指标差异均无统计学意义。观察组主要不良反应发生率均低于对照组(P<0.05)。结论中药汤剂联合柳氮磺吡啶、甲氨蝶呤治疗强直性脊柱炎有较好的临床效果,且不良反应少而轻。

Objective To assess the efficacy and safety of decoction of herbal medicines combined with Sulfasalazine and Methotrexat in patients with ankylosing spondylitis. Methods Seventy patients from the military were randomly divided into 2 groups ： the treatment group （ n = 20） treated with decoction of herbal medicine and Sulfasalazine, the control group （n = 20 ） treated with Methotrexat and Sulfasalazine. Changes of clinical efficacy indexes including lunlber pain index, morning stiffness time, peripheral joint pain index, thoracic expression, Bath Ankylosing Spondylitis Disease Activity Index （BASDAI）, Bath Ankylosing Spondylitis Functional Index （BASH） , the level of Erythrocyte Sedimentation Rates （ESR） and C-reactive Protein （CRP） , X-ray of sacroiliac joint were observed. Results The clinical efficacy indexes improved significantly after treatment in the 2 groups （P 〈 0.05 ）. Lumber pain index, morning stiffness time, peripheral joint pain index were better in the treatment group than in the control group （ P 〈 0.05 ） , anti no significant difference was found in the other indexes between the two groups. The occurrence rate of adverse reaction was lower in the treatment group than in the control group （ P 〈 0.05 ）. The incidence rate of adverse events was lower in the control group than in the observation group （P 〈 0.05）. Conclusion Decoction of herbal medicine treatment eombined with Sulfasalazine, Methotrexate has better effect on AS with a milder reaction.