中药汤剂联合美洛昔康、来氟米特治疗强直性脊柱炎临床观察

Clinical Observation of Treating Ankylosing Spondylitis with TCM Decoction Combined with Meloxicam and Leflunomide

目的:观察中药汤剂联合美洛昔康、来氟米特治疗强直性脊柱炎的临床疗效及不良反应。方法:将112例强直性脊柱炎患者随机分为治疗组64例和对照组48例。对照组给予美洛昔康、来氟米特治疗,治疗组在对照组治疗基础上加用中药汤剂。疗程6个月,观察两组患者的临床疗效及红细胞沉降率、C-反应蛋白等指标。结果:治疗组临床缓解36例,显效16例,有效8例,无效4例,总有效率为93.75%;对照组临床缓解15例,显效8例,有效12例,无效13例,总有效率为72.92%。两组比较,差异有统计学意义(P<0.05)。治疗后,两组患者枕墙距、指地距、髋关节屈伸角度均优于治疗前,差异有统计学意义(P<0.05);两组患者红细胞沉降率、C-反应蛋白、Bath AS功能指数、Bath AS病情活动指数较治疗前均有显著改善(P<0.05),且治疗组优于对照组(P<0.05);治疗组不良反应发生率较对照组低,差异有统计学意义(P<0.05)。结论:中药汤剂联合美洛昔康、来氟米特治疗强直性脊柱炎疗效肯定,不良反应相对较少,值得临床推广。

Objective：To observe the clinical efficacy and adverse reaction of traditional Chinese medicine （ TCM ） decoction combined with meloxicam and leflunomide in the treatment of ankylosing spondylitis.Methods： 112 cases of ankylosing spondylitis were randomly divided into a treatment group （ 64 cases ） and a control group （ 48 cases ） .The control group was given meloxicam and leflunomide,while the treatment group,based on the treatment for the control group,was treated with TCM decoction.After 6 months of treatment,the clinical efficacy, erythrocyte sedimentation rate and C-reactive protein of two groups were observed. Results：In the treatment group,36 cases were relieved,16 cases were markedly effective,8 cases were total effective,and 4 cases were invalid,the total efficiency being 93.75%;while in the control group,15 cases were clinically relieved,8 cases were markedly effective,12 cases were effective,and 13 cases were invalid, the total effective rate being 72.92%.The difference between the two groups was statistically significant （ P 〈 0.05 ） .After treatment,the occipital wall distance,finger to floor distance and hip flexion angle of the two groups were better than those before treatment,the difference being statistically significant （P 〈 0.05 ） .The erythrocyte sedimentation rate,C-reactive protein,Bath AS function index,and Bath AS disease activity index of the two groups were significantly improved than those before treatment （ P 〈 0.05 ） ,the treatment group being better than the control group （ P 〈 0.05 ） .The incidence of adverse reaction of the treatment group was lower than that of the control group,the difference being statistically significant （P 〈 0.05 ） .Conelusion：TCM decoction combined with meloxicam and leflunomide is effective in treatment of ankylosing spondylitis with relatively less adverse reactions and being worthy of clinical promotion.