益肾壮督汤联合西药治疗强直性脊柱炎随机平行对照研究

Random Parallel Control Study of Yishenzhuangdu Decoction Combined with Western Medicine in the Treatment of Ankylosing Spondylitis

[目的]观察益肾壮督汤联合西药治疗强直性脊柱炎疗效。[方法]使用随机平行对照方法,将60例门诊及住院患者按随机数字表法随机分为两组,对照组30例柳氮磺胺吡啶片,1g/次,2次/d,治疗组30例益肾壮督汤(杜仲、骨碎补、狗脊、续断、熟地各15g,独活12g,乌梢蛇10g,制川乌8g,桂枝10g,白芍12g,知母15g,炙麻黄、防风各10g,炙甘草6g),1剂/d,水煎200mL,早晚口服,西药治疗同对照组,连续治疗2个月为1疗程。观测临床症状、脊柱功能、Bath疾病活动指数(BASDAI)、Bath功能指数(BASFI)、晨僵时间、血沉(ESR)、C-反应蛋白(CRP)不良反应。连续治疗3疗程,判定疗效。[结果]治疗组临床缓解7例,显效14例,有效7例,无效2例,总有效率93.30%。对照组临床缓解6例,显效5例,有效14例,无效5例,总有效率83.30%。治疗组疗效优于对照组(P<0.05)。脊柱功能及症状、实验室指标两组均有改善(P<0.01),Schober实验、指地距、BASDAI、BASFI、晨僵时间、ESR、CRP治疗组改善均优于对照组(P<0.05),胸廓扩张度、枕墙距两组间无明显差异(P>0.05)。[结论]益肾壮督汤联合西药治疗强直性脊柱炎疗效满意。

[Objective]To observe the curative effect of Yishenzhuangdu Decoction combined with sulfasalazine tablet on ankylosing spondylitis.[Method]Random parallel control method is used,60 patients were divided into two groups by the table of random number. Patients in the experimental group（n=30）received treatment of Yishenzhuangdu Decoction combination of sulfasalazine tablet;Patients in the control group（n=30）were treated with sulfasalazine tablet.2 months constituted 1 treatment course,and the treatment lasted 3 courses. Therapeutic effect was evaluated with activity of thoracic cage,Schober sign,finger to floor distance,occiput to wall distance,BASDAI,BASFI,morning anchylosis time,ESR and CRP.[Results]The total effective rate of the treated group was 93.30%,7cases were clinical remission,14 cases were markedly effective,7 cases were effective,2 cases were ineffective. The total effective rate of the control group was83.30%,6cases were clinical remission,5 cases were markedly effective,14 cases were effective,5 cases were ineffective.There was statistical significance between 2groups（P0.05）.Spinal function and symptom were inproved in both groups（P0.01）.The index of experimental group were significantly better than those of control group including Schober sign,finger to floor distance,BASDAI,BASFI,morning anchylosis time,ESR and CRP（P0.05）.There were no significant difference in thoracic expansion and occiput to wall distance（P0.05）[.Conclusion]Yishenzhuangdu Decoction has a good curative effect on AS and is safe and reliable.