补肾强督治尪汤联合西药治疗强直性脊柱炎(肾虚督寒)随机平行对照研究

A Randomized Contrastive Study on the Treatment of Ankylosing Spondylitis(Kidney Deficiency) with Bushen Qiangzhi Decoction and Western Medicine

[目的]观察补肾强督治尪汤联合西药治疗强直性脊柱炎(肾虚督寒)疗效。[方法]使用随机平行对照方法,将100例住院及门诊患者按病志号抽签简单随机分两组。对照组50例塞来昔布,0.2g/次,2次/d;柳氮磺吡啶,1g/次,2次/d。治疗组50例补肾强督治尪汤(熟地15~20g,淫羊藿9~12g,金狗脊30~45g,制附片9~12g,鹿角胶烊化10g,川断12~20g,骨碎补15~20g,羌活10g,独活10g,桂枝12~20g,赤芍12~20g,白芍12~20g,知母12~15g,地鳖虫6~9g,防风10~12g,麻黄3~9g,干姜6~9g,淮山药12~18g,炙山甲6~9g,制草乌3g,杜仲15g,白僵蚕9g),1剂/d,水煎400m L,早晚饭后30min口服;西药治疗同对照组。连续治疗4周为1疗程。观测临床症状、中医症候积分(晨僵、关节压痛、关节肿胀、骶髂脊背疼痛、腰脊活动受限)、症状及体征改善评价指标[脊柱VAS疼痛评分、巴氏强直性脊柱炎活动指数(BASDAI)、巴氏强直性脊柱炎功能指数(BASFI)、健康综合评分(BAS-G)、患者总体评价(PGA)]、ESR、hs-CRP、Ig G、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组痊愈7例,显效24例,有效16例,无效3例,总有效率94.00%;对照组痊愈4例,显效18例,有效14例,无效14例,总有效率72.00%;治疗组疗效优于对照组(P<0.05)。ESR、hs-CRP、Ig G、中医症候积分、脊柱VAS疼痛评分、BASDAI、BASFI、BAS-G、PGA改善治疗组优于对照组(P<0.05,P<0.01)。[结论]补肾强督治尪汤联合西药治疗强直性脊柱炎(肾虚督寒),疗效满意,无严重不良反应,值得推广。

[Objective] To observe the therapeutic effect of Bushen Qiangzhi Zhizhu decoction combined with western medicine on the treatment of ankylosing spondylitis （Kidney Deficiency）. [Methods] 100 random inpatients and outpatients were randomly divided into two groups according to the random number method. Control group 50 cases eelecoxib, 0.2 g/times, 2 times/d; sulfasalazine, 1 g/times, 2 times/＆ Treatment group of 50 cases of Bushen Qiangzhi governance soup （Rehmannia 15-20g, Epimedium 9-12g, golden dog ridge 30-45g, made with tablets 9-12g, antler gelation of lOg, cut off 12-20g, bone 10-12g, 12-20g of red peony, 12-20g of white peony root, 12-15g of Anopheles, 6-9g of Eupolyphaga sinensis, 10-12g of windbreak, 10-12g of terrestris, 9g, dried ginger 6~9g, yam and medicine 12-18g, bushanang 6-9g, system grass 3g, Eucommia 15g, white silkworm 9g）, i/d, decoction 400mL, morning and evening 30rain orally; Western medicine treatment with the control group. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms, TCM syndrome （morning stiffness, joint tenderness, joint swelling, sacroiliac pain, lumbar soine activity）, symptoms and signs to improve the evaluation of indicators [spinal VAS pain score, ankylosing ankylosing spondylitis activity index BASDAI, BASF, BAS-G, PGA, ESR, hs-CRP, IgG and adverse effects. Continuous treatment of 3 courses to determine the efficacy. [Results] The treatment group recovered 7 cases, markedly effective in 24 cases, effective in 16 cases, ineffective in 3 cases, the total effective rate was 94.00%; the control group recovered 4 cases, markedly effective in 18 cases, effective in 14 cases, 14 cases, the total effective rate was 72.00%; The treatment group was better than the control group （P〈0.05）. ESR, hs-CRP, IgG, TCM syndrome score, spine VAS pain score, BASDAI, BASFI, BAS-G, PGA improved treatment group were better than the control group （P〈0.05, P〈0.01）. [Conclusion] Bushen Qiangguizhi Decoction combined with western medicine for the treatment of ankylosing spondylitis （renal failure）, the effect is satisfactory, no serious adverse reactions, it is worth promoting.