强柱方辅助治疗强直性脊柱炎的临床疗效观察

Therapeutic Effect of Adjunctive Treatment with Qiangzhu Recipe for Ankylosing Spondylitis

【目的】评价强柱方辅助治疗强直性脊柱炎(AS)的临床疗效。【方法】收集符合纳入标准的AS患者48例,按就诊顺序采用随机数字表法将患者随机分为观察组和对照组各24例。观察组给予强柱方辅助柳氮磺砒啶、塞来昔布治疗,对照组仅给予柳氮磺砒啶、塞来昔布治疗。2组均以4周为1个疗程,共治疗3个疗程。观察并记录治疗前后2组患者的主要临床指标,包括巴氏AS功能指数(BASFI),巴氏AS疾病活动性指数(BASDAI),疼痛视觉模拟(VAS)评分,总体VAS评分,脊柱活动度(指地距、枕墙距、胸廓活动度、Schober试验、脊柱侧弯)和实验室炎性指标[血沉(ESR)、C反应蛋白(CRP)]等的变化情况及不良反应的发生情况。【结果】(1)治疗4、8、12周后,观察组ASAS20比例分别为16.67%、33.34%、70.83%,对照组分别为8.33%、29.17%、58.33%;观察组ASAS40比例分别为4.17%、20.83%、37.50%,对照组分别为0.00%、12.50%、25.00%。观察组的ASAS20、ASAS40疗效有优于对照组趋势,但差异均无统计学意义(P>0.05)。(2)治疗后,2组均能显著缓解症状,提高脊柱活动度,降低ESR、CRP等炎性指标,与治疗前比较差异均有统计学意义(P<0.05或P<0.01);在改善BASDAI方面观察组显著优于对照组(P<0.01);其余指标观察组亦有优于对照组的趋势,但差异均无统计学意义(P>0.05)。【结论】强柱方辅助治疗AS疗效确切。

Objective To observe the therapeutic effect of adjunctive treatment with Qiangzhu Recipe for ankylosing spondylitis（AS）. Methods Forty-eight AS patients were evenly randomized into observation group and control group according to the admission order. The observation group was given Qiangzhu Recipe together with sulfasalazine and celecoxib orally, and the control group received oral use of sulfasalazine and celecoxib. Four weeks constituted one treatment course, and the treatment covered 3 courses. The main clinical outcomes of the patients included Bath AS functional index（BASFI）, Bath AS disease activity index（BASDAI）, pain visual analog scale（VAS） scores, global VAS scores, spinal mobility indexes（finger-to-floor distance, occiput-wall distance, thoracic mobility, Schober test, scoliolosis test）, and laboratory inflammatory indicators of erythrocyte sedimentation rate（ESR） and C-reactive protein. Moreover, the incidence of adverse reaction was also recorded. Results（1） After treatment for 4, 8, and 12 weeks, the percentage of the patients arriving at the degree of ASAS20 was 16.67%, 33.34%, and 70.83% respectively in the observation group, and was8.33%, 29.17%, and 58.33% in the control group; the percentage of the patients arriving at the degree of ASAS40 was 4.17%, 20.83%, and 37.50% respectively in the observation group, and was 0.00%, 12.50%and 25.00% in the control group. The differences of the percentage of the patients arriving at the degree of ASAS20 and ASAS40 were insignificant between the two groups（P〉0.05）.（2） After treatment, symptoms were much relieved, spinal mobility was improved, and inflammatory indicators of ESR and CRP were alleviated in the two groups（P〈0.05 or P〈0.01 compared with those before treatment）. The observation group had better effect on BASDAI than the control group（P〈0.01）, but only showed a trend on improving the other clinical outcomes（P〉0.05 compared with the control group）. Conclusion Adjunctive treatment with Qiangzhu Recipe exerts certain synergistic action on sulfasalazine and celecoxib in treating ankylosing spondylitis.