强直性脊柱炎骨量丢失的中西医结合诊治进展

The progress of treatment of bone loss in ankylosing spondylitis with combined use of traditional Chinese and western medicine

强直性脊柱炎是一种慢性进行性骨关节病,主要影响中轴骨骼并导致显着的疼痛和残疾。多见于青少年,主要侵犯骶髂关节、髋关节和脊柱,并且可伴有关节外表现。早期表现为肌腱、韧带附着点的炎症,进而出现关节骨质破坏,软骨内、韧带纤维化及异位骨化,造成脊柱关节强直改变,最终导致残废。在我国强直性脊柱炎的发病率约为0.3%,是临床最常见的风湿病之一,发病高峰年龄为15~30岁,男性的患病率比女性高2~3倍,且男性平均发病年龄要早于女性平均发病年龄。骨质疏松作为强直性脊柱炎最常见的一种并发症,以全身性骨病,以骨各种成分等比例减少而导致骨脆性增加、易发生骨折为特征,其发生率为50%~92%,并且有35%的强直性脊柱炎患者可发生因骨质疏松而导致椎体压缩性骨折。目前,强直性脊柱炎的治疗主要以西医为主,存在明显的局限性,中医中药可以充分弥补其不足,中西医结合多途径多靶点阻断骨量丢失,可望能为强直性脊柱炎的治疗拓展新思路,提供新方法。

Ankylosing spondylitis（ AS） is a progressively chronic joint disease,which involves axial skeleton and leads to pain and disability. It is commonly seen in adolescent,mainly involving the sacroiliac joint,hip and spine,and with extra-articular manifestation. It is characterized by inflammation of the tendon and ligament attachment points at the early stage,then the destruction of the joint bone,fibrosis of cartilage and ligaments,and heterotypic ossification. It causes spinal joint stiffness,and eventually leads to disability. In our country,the incidence of AS is about 0. 3%,which is one of the most common clinical rheumatological diseases. The peak age incidence is from 31 to 60 years,and the prevalence in men is 2-3 times higher than in women. The average onset age in men is earlier than in women. Osteoporosis is one of the most common complications of AS,which is described as systemic skeleta1 disease and a reduction of bone composition,leading to the increase of the bone fragility and the fracture risk. Its incidence is 50-92%,and 35% percent of patients can happen vertebral compression fractures caused by osteoporosis. At present,There is an obvious limitation that the treatments of AS mainly occupied by western medicine. Traditional Chinese medicine can fully compensate the shortage. The combination of Chinese and western medicine to block bone loss is expected to be the newidea for the treatment of AS,and provides a newmethod.