中药治疗强直性脊柱炎的疗效评价

Evaluation of curative effect of traditional Chinese medicine in treatment of AS

目的探讨中药治疗活动期强直性脊柱炎的疗效。方法采用分层区组随机、平行对照试验,将承德医学院附属医院2008年9月~2009年12月收治的90例活动期强直性脊柱炎（ankylosing spondylitis,AS）患者随机分入中药组和西药组,中药组采取辨证论治,西药组予柳氮磺吡啶肠溶片口服,疗程20周,采用脊柱痛评分、夜间痛评分、患者总体评价（patient global assessment,PGA）、Bath强直性脊柱炎功能指数（Bath ankylosing spondylitis functional index,BASFI）、Bath强直性脊柱炎病情活动指数（Bath ankylosing spondylitis disease activity index,BASDAI）、Bath强直性脊柱炎测量学指数（Bath ankylosing spondylitis metrology index,BASMI）、中医证候疗效评价标准,实验室指标C反应蛋白（CRP）、血沉（ESR）、Ig A等指标综合评价中医辨证治疗AS的临床疗效。结果治疗20周后,中药组患者的脊柱痛评分、夜间痛评分和PGA,BASDAI、BASFI、BASMI、中医证候积分明显低于西药组（P〈0.01）;与西药组同期比较治疗效果,中药组疗效明显增高（P〈0.05,P〈0.01）。2组CRP、ESR、Ig A和不良反应差异无统计学意义。结论以补肾活血、清热利湿活血法为处方的中药治疗AS有一定效果。

Objective To evaluate the curative effect and safety of traditional Chinese medicine in treatment of ankylosing spondylitis（ AS）.Methods Using stratified randomized,parallel controlled clinical trial,90 patients with active AS patients were randomly divided into traditional Chinese medicine group and Western medicine group,Chinese medicine group with syndrome differentiation of TCM,Western medicine group with sulfasalazine enteric coated tablets for 20 weeks. Spinal pain score,night pain score,patient overall evaluation（ PGA）,BASFI,BASDAI,the index of measuring the Bath ankylosing spondylitis（ BASMI）,evaluation standard of TCM therapeutic efficacy on syndromes and laboratory indicators of C reaction protein（ CRP）,erythrocyte sedimentation rate（ ESR）,the Ig A index of comprehensive were used to evaluate the clinical efficacy of traditional Chinese medicine syndrome differentiation and treatment of AS. Results After 20 weeks of treatment,patients with AS of Chinese medicine group can significantly reduce the patients with spinal pain,night pain score and score of PGA,BASDAI,BASFI,BASMI,TCM syndrome integral,better than that of Western medicine group（ P〈0. 01）. Compared with the Western medicine group in the same period,the effect of treatment,curative effect of traditional Chinese medicine increased significantly（ P〈0. 05,P〈0. 01）. The differences of CRP,ESR,Ig A and adverse reaction between two groups were not statistically significant. Conclusion Chinese medicine which could invigorate the kidney and promte blood circulation,clear heat and remove dampness and activated blood circulation,has clinical efficacy in treatment of AS.