补肾强督方联合柳氮磺吡啶治疗强直性脊柱炎30例临床观察

Clinical Observation on Bushen Qiangdu Recipe(BQR,补肾强督方) Combined with Sulfasalazine in the Treatment of 30 Ankylosing Spondylitis Patients

目的观察补肾强督方联合柳氮磺吡啶治疗强直性脊柱炎(AS)的临床疗效及安全性。方法 60例AS患者随机分为治疗组和对照组各30例。对照组给予柳氮磺吡啶口服,每次1 g,每日2次。治疗组在对照组基础上给予补肾强督方,每日1剂。两组均治疗3个月。观察两组治疗前后强直性脊柱炎评估指标(ASAS20)、Bath强直性脊柱炎病情活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、Bath强直性脊柱炎测量指数(BASMI)、患者总体评价VAS评分、脊柱痛、全身痛及夜间痛评分,并检测血沉(ESR)、C反应蛋白(CRP)水平。结果 57例患者完成了研究,其中治疗组29例,对照组28例。治疗组和对照组治疗后达到ASAS20的比例分别为82.75%(24例/29例)和71.43%(20例/28例)。治疗组治疗后BASDAI、BSAFI、BASMI、总体评价VAS评分、脊柱痛、全身痛及夜间痛评分均较治疗前明显降低(P<0.05或P<0.01)。治疗后治疗组BASDAI、总体评价VAS评分、脊柱痛、全身痛及夜间痛评分均明显低于对照组(P<0.05)。两组患者治疗后ESR和CRP水平均较治疗前明显下降(P<0.05或P<0.01)。治疗后治疗组ESR、CRP水平明显低于对照组(P<0.05)。治疗组不良反应发生率为10.0%,明显低于对照组的23.3%(P<0.05)。结论补肾强督方联合柳氮磺吡啶能显著改善AS临床症状、降低ESR和CRP水平,且比单用柳氮磺吡啶具有更好的疗效和安全性。

Objective To study the efficacy and satety oi ttushen Qiangdu Rectpe [ t3t2ti, 补肾强督方） commneu with sulfasalazine in the treatment of ankylosing spondylitis （AS）. Methods Totally of 60 AS patients were ran-domly and equally assigned to the treatment group and control group. The treatment group received BQR twice a day and sulfasalazine 2 g daily for 3 months. The control group received only sulfasalazine 2 g daily for 3 months. The Assessment in Ankylosing Spondylitis 20 （ASAS 20）, Bath Ankylosing Spondylitis Disease Activity Index （BASDAI）, Bath Ankylosing Spondylitis Functional Index （BASFI）, Bath Ankylosing Spondylitis Metrology Index （BASMI）, pa-tient＇s general assessment, spinal pain, general pain and night pain were used for scoring (1-10） patients with AS. A higher score indicated a more severe illness stage. Physical examination, blood and urine tests, erythrocyte sedi-mentation rate （ESR） and C-reactive protein （CRP） measurement were performed at each visit. Results A total of 57 patients completed the study. There were 29 patients in treatment group and 28 patients in control group. There was less side effect in the treatment group than that in the control group. After treated by combined medicine and sul-fasalazine, the proportion of ASAS20 responders at 3 month was 82.75% （24/29） and 71.43% （20/28） respective-ly. Both combined medicine and sulfasalazine treatment induced significant decrease in the proportion of expressing ESR and CRP at 3-month of treatment compared with baseline values (P 〈 0. 05). The effective rate in the treatment group was significantly higher than that in the control group. Conclusion Combined treatment of BQR and sul-fasalazine could improve the symptoms and inflammation level of AS and it showed better effect and safety than sul-fasalazine alone.