壮腰健肾丸联合柳氮磺吡啶治疗强直性脊柱炎的临床研究

Clinical study on Zhuangyao Jianshen Pills combined with sulfasalazine in treatment of ankylosing spondylitis

目的探讨壮腰健肾丸联合柳氮磺吡啶治疗强直性脊柱炎的临床疗效。方法选取2014年3月—2015年12月延安市人民医院收治的强直性脊柱炎患者86例,随机分为对照组和治疗组,每组各43例。对照组口服柳氮磺吡啶肠溶片,第1周,2片/次,2次/d;第2周,3片/次,2次/d;第3周后,4片/次,2次/d。治疗组在对照组基础上口服壮腰健肾丸,1丸/次,3次/d。两组患者均治疗6个月。观察两组的临床疗效,比较两组的临床症状指标、血清学指标的变化情况。结果治疗后,对照组和治疗组的总有效率分别为76.74%、93.02%,两组比较差异有统计学意义(P<0.05)。治疗后,两组胸廓活动度和腰椎活动度明显升高,而枕墙距、巴氏强直性脊柱炎疾病活动指数(BASDAI)和巴氏强直性脊柱炎功能指数(BASFI)明显下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组C反应蛋白(CRP)、血沉(ESR)、白细胞介素-33(IL-33)及瘦素均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的降低程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论壮腰健肾丸联合柳氮磺吡啶治疗强直性脊柱炎具有较好的临床疗效,可明显改善患者临床症状,降低炎性反应,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Zhuangyao Jianshen Pills combined with sulfasalazine in treatment of ankylosing spondylitis. Methods Patients （86 cases） with ankylosing spondylitis in Yan’an People’s Hospital from March 2014 to December 2015 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Sulfasalazine Tablets, the dose was 2 tablets/time, twice daily at the first week, the dose was 3 tablets/time, twice daily at the second week, 4 tablets/time, twice daily after the third week. Patients in the treatment group were po administered with Zhuangyao Jianshen pills on the basis of the control group, 1 pill/time, three times daily. After treatment, the clinical efficacies were evaluated, and the changes of clinical symptom indexes and serological indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.74%and 93.02%, respectively, and there was difference between two groups （P 〈 0.05）. After treatment, thoracic activity and lumbar activity in two groups were significantly increased, but occiput to wall distance, BASDAI scores, and BASFI scores in two groups were significantly decreased, and the difference was statistically significant in the same group （P〈0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups （P〈0.05）. After treatment, CRP, ESR, IL-33, and leptin in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups （P〈0.05）. Conclusion Zhuangyao Jianshen Pills combined with sulfasalazine has clinical curative effect in treatment of ankylosing spondylitis, and can significantly improve clinical symptoms, decrease inflammatory reaction, which has a certain clinical application value.