补肾强督方治疗强直性脊柱炎的临床效果

Clinical effect of Bushen Qiangdu Prescription in the treatment of ankylosing spondylitis

目的观察肾强督方治疗强直性脊柱炎的临床效果。方法入选2012年1月~2015年12月宝鸡市中医医院收治的90例强直性脊柱炎患者,采用随机数字表法将患者随机分成治疗组和对照组,每组45例。治疗组给予中药汤剂补肾强督方治疗,60 d为1个疗程,持续治疗3个疗程。对照组给予柳氮磺吡啶肠溶片,1 g/次,2次/d,3个月为1个疗程,持续治疗2个疗程。比较两组治疗前后Bath强直性脊柱炎功能指数(BASFI)、Bath强直性脊柱炎疾病活动指数(BASDAI)、脊柱痛和中医证候积分,观察两组治疗前后体征变化情况,并检测患者血沉(ESR)和C反应蛋白(CRP)水平。结果与治疗前比较,两组治疗后BASFI、BASDAI、脊柱痛和中医证候积分指标均显著下降,差异有统计学意义(P<0.05),且治疗组治疗后上述指标评分均明显低于对照组治疗后(P<0.05)。治疗后,两组枕墙距、指地距均短于治疗前(P<0.05或P<0.01),胸廓活动度、脊柱活动度、Schober试验均明显大于治疗前(P<0.05),但组间差异无统计学意义(P>0.05)。治疗后两组患者ESR、CRP均较治疗前显著下降,差异有高度统计学意义(P<0.01)。两组治疗后ESR、CRP水平比较,差异无统计学意义(P>0.05)。结论补肾强督方治疗强直性脊柱炎效果显著,其能明显改善患者的临床症状,缓解腰背脊柱僵痛,减轻炎性反应,值得临床推广应用。

Objective To observe the clinical effect of Bushen Qiangdu Prescription in the treatment of ankylosing spondylitis. Methods Ninety cases of patients with ankylosing spondylitis admitted to Baoji Hospital of Traditional Chinese Medicine from January 2012 to December 2015 were enrolled, and they were randomly divided into treatment group and control group by random number table method, each group had 45 cases. The treatment group was given Bushen Qiangdu Prescription, 60 days were as a course, treating for 3 courses continuously. The control group was given Sulfasalazine Enteric Coatel Tablets, once 1 g, twice a day, 3 months were as a course, treating for 2 courses continuously. The scores of Bath ankylosing spondylitis functional index（BASFI）, Bath ankylosing spondylitis disease activity index（BASDAI）, spondylalgia and TCM syndrome of the two groups before and after treatment were compared, the conditions of syndrome of the two groups before and after treatment were compared, and the levels of erythrocyte sedimentation rate（ESR） and C-reactive protein were detected（CRP）. Results Compared with before treatment, the scores of BASFI, BASDAI, spondylalgia and TCM syndrome of the two groups after treatment were significantly decreased,there were statistically significant differences（P〈0.05）, and the scores above in the treatment group after treatment were significantly lower than those of control group after treatment（P〈0.05）. After treatment, the occiput to wall distance, finger to floor distance in the two groups were all shorter than those before treatment（P〈0.05 or P〈0.01）, the thoracic range of movement, spine range of movement, Schober test were all bigger than those before treatment（P〈0.05）, while there were no statistically significant differences between the two groups（P〉0.05）. After treatment, the levels of ESR, CRP in the two groups were all lower than those before treatment, the differences were highly statistically significant（P〈0.01）. While there were no statistically significant differences of the levels of ESR, CRP after treatment between the two groups（P〉0.05）. Conclusion Bushen Qiangdu Prescription in the treatment of ankylosing spondylitis has significant effects, which can obviously improve the clinical symptoms of patients, relieve the stiffness and pain of lumbar spinal cord and spine, reduce inflammatory response, it is worthy of promotion and application in clinic.