美洛昔康片联合七味通痹口服液治疗强直性脊柱炎肝肾亏虚证40例临床研究

Meloxicam Tablet Combined with Qiweitongbi Oral Liquid for Treating Ankylosing Spondylitis with Liver and Kidney Deficiency Syndrome in 40 Cases

目的观察美洛昔康片联合七味通痹口服液治疗强直性脊柱炎(AS)肝肾亏虚证的临床疗效。方法将80例AS患者随机分为治疗组和对照组,各40例。治疗组患者口服美洛昔康片和七味通痹口服液,对照组患者口服柳氮磺胺嘧啶和双氯芬酸钠肠溶片。观察治疗后两组患者的关节疼痛、肿胀及整体功能分级、Keitel试验、双侧4字试验、Schober试验、肌腱附着点炎症情况;实验室指标包括血沉(ESR),C反应蛋白(CRP)、X射线常规骶髂关节正位片或CT扫描及HLA-B27。结果治疗组的总有效率为85.00%,明显高于对照组的60.00%(P<0.05);治疗组髋疼痛、膝疼痛、膝肿胀、踝疼痛、踝肿胀评分均较对照组改善显著(P<0.05或P<0.01);治疗组前屈、侧屈、晨僵和Keitel试验评分均较对照组变化显著(P<0.05或P<0.01);治疗组体征及关节外症状各项指标与对照组比较,差异均有统计学意义(P<0.05或P<0.01);ESR,CRP,HLA-B27阳性及X线改变比较,治疗组各项指标变化均较对照组显著(P<0.05或P<0.01);治疗组不良反应明显少于对照组(P<0.05)。结论美洛昔康片结合七味通痹口服液治疗AS肝肾亏虚证疗效肯定且不良反应小。

Objective To observe the effect of meloxicam combined with Qiweitongbi Oral Liquid in treating ankylosing spondylitis（AS） with liver and kidney deficiency syndrome,and to investigate its symptoms,ESR,CRP,influence of frontal film and CT scanning of sacroiliac joint as well as the adverse reactions. Methods Totally 80 patients with AS were randomly divided into the treatment group and the control group,40 cases in each group. The treatment group was treated with oral Meloxicam Tablet and Qiweitongbi Oral Liq-uid,while the control group was treated with oral salazosulfadimidine and Diclofenac Sodium Enteric-Coated Tablets. The joint pain, joint swelling and overall function classifications,Keitel test,bilateral 4-word test,Schober test,inflammation of tendon attachment point after treatment were observed in the two groups;the laboratory indicators included ESR,CRP,X-ray routine frontal film or CT scanning of sacroiliac joint and HLA-B27. Results The total effective rate in the treatment group was 85. 00%,which was significantly higher than 60. 00% in control group（ P 〈 0. 05）;the hip pain,knee pain,knee swelling,ankle pain and ankle swelling score in the treatment group were significantly improved compared with the control group（ P 〈 0. 05 or P 〈 0. 01）;the anteflexion,lateroflexion,morning stiff-ness and the Keitel test score in the treatment group had significant changes compared with the control group（ P 〈 0. 05 or P 〈0. 01）. The body signs and extra-articular symptoms had statistical differences between the treatment group and the control group（ P 〈0. 05 or P 〈 0. 01）;the changes of ESR,CRP,HLA-B27 positive and X-ray in the treatment group were more significant compared with the control group（ P 〈 0. 05 or P 〈 0. 01）;the adverse reactions in the tneatment group were less than those in the control group （ P 〈 0. 05）. Conclusion Meloxicam combined with Qiweitongbi Oral Liquid has definite effect and small adverse reactions in treating AS.