益肾温督膏方治疗肾虚督寒型强直性脊柱炎30例疗效观察

Clinical Observation of Treating 30 Cases of Ankylosing Spondylitis due to Kidney Deficiency and Cold Attacking the Governor Vessel with Yishen Wendu Gaofang

目的:观察益肾温督膏方治疗肾虚督寒型强直性脊柱炎的临床疗效。方法:将60例强直性脊柱炎患者分为治疗组和对照组,每组30例。对照组给予柳氮磺吡啶每次0.75 g,每日2次,口服治疗;治疗组在对照组基础上加用益肾温督膏方治疗,观察两组治疗前后血常规、肝肾功能、C-反应蛋白、红细胞沉降率、中医证候积分、关节疼痛程度(Likert四级积分法)、枕墙距、扩胸距、指地距、Sch?ber试验、Bath AS疾病活动指数(BASDAI)、Bath AS功能指数(BASFI)的变化情况。结果:治疗后,治疗组达到ASAS 20疗效评价和中医证候疗效的有效率均为96.67%,优于对照组的66.67%和56.67%,ASAS 20组间比较,差异有统计学意义(P<0.05);两组患者的BASDAI、Likert积分、BASFI、中医证候积分、扩胸距均有改善(P<0.05),且治疗组改善较为明显(P<0.05)。两组枕墙距、指地距均有改善(P<0.05),组间比较差异无统计学意义(P>0.05);两组Sch?ber均无改善(P>0.05)。两组C-反应蛋白、红细胞沉降率均无明显变化(P>0.05)。结论:益肾温督膏方治疗肾虚督寒型强直性脊柱炎患者中医证候、关节疼痛、晨僵、疲倦等有一定疗效,且安全性良好。

Objective：To observe the clinical effect of Yishen Wendu Gaofang （ointment formula to tonify the kidney and warm the Governor Vessel） in the treatment of ankylosing spondylitis due to kidney deficiency and cold attacking the Governor Vessel.Methods：60 cases of ankylosing spondylitis were equally divided into the treatment group and the control group.The control group were given Sulfasalazine orally,0.75 g each time and twice a day,while the treatment group were given Yishen Wendu Gaofang based on the treatment of the control group,observing the blood routine,liver and kidney functions,C-reactive protein,erythrocyte sedimentation rate,TCM syndrome integral,joint pain （Likert four-stage integral method）,the occiput to wall distance,chest distance,finger to floor distance,Sch？ber test,Bath ankylosing spondylitis disease activity index （BASDAI） rating scale,Bath AS functional index （BASFI） rating scale of the two groups before and after treatment.Results：The total effective rates of the treatment group reaching ASAS20 efficacy evaluation and TCM syndrome efficacy were both 96.67%,better than 66.67% and 56.67% of the control group,and the difference being statistically signiifcant （P〈0.05） comparing ASAS20 of the two groups;The BASDAI,Likert integral,BASFI,TCM syndrome integral,and chest distance of the two groups all improved after treatment （P〈0.05）,but the treatment group improved more obviously （P〈0.05）;The occiput to wall distance and the ifnger to lfoor distance of the two groups also improved after treatment （P〈0.05）,difference between groups being not statistically signiifcant （P〉0.05）;Schober of the two groups showed no improvement after treatment （P 〉 0.05）;the C-reactive protein and erythrocyte sedimentation rate of the two groups had no signiifcant change before and after treatment （P〉0.05）.Conclusion：Yishen Wendu Gaofang had certain curative effects and safety in treating ankylosing spondylitis due to kidney deficiency and cold attacking the Governor Vessel on the aspects of TCM syndromes,joint pain,morning stiffness and fatigue.