补肾强督祛寒汤治疗强直性脊柱炎的临床观察

Clinical Observation of Bushen Qiangdu Quhan Decoction in the Treatment of Ankylosing Spondylitis

目的观察补肾强督祛寒汤治疗强直性脊柱炎的临床疗效与安全性。方法入选2015年1月—2017年12月在北京同仁堂中医医院门诊接受治疗的170例强直性脊柱炎患者,随机将患者分成治疗组和对照组,每组85例,治疗组给予中药汤剂补肾强督祛寒汤治疗,30 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,3次/天,30 d为1个疗程,持续治疗3个疗程。比较2组治疗前后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)和脊柱痛,观察2组治疗前后体征变化情况,并检测患者血沉(ESR)、C反应蛋白(CR P)水平。结果与治疗前比较,2组治疗后BASFI、BASDAI、脊柱痛均显著下降,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,2组枕墙距、指地距均短于治疗前(P<0.05),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2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)。2组治疗后ESR、CRP水平比较,差异无统计学意义(P>0.05)。结论补肾强督祛寒汤治疗强直性脊柱炎的临床疗效确切,其能明显改善患者的临床症状、体征,且安全可靠,值得临床推广应用。

Objective To observe the clinical efficacy and safety of Bushen Qiangdu Quhan decoction in the treatment of ankylosing spondylitis.Methods 170 cases of severe direct spondylitis in the outpatient of Beijing Tongren Tang traditional Chinese Medicine Hospital of Beijing January 2015 to December 2017 were randomly divided into the treatment group and the control group randomly.Each group was treated with 85 cases.The treatment group was treated with Bushen Qiangdu Quhan decoction.The treatment group was treated with 30d for 1 courses and continued treatment for 3 courses.The control group was given sulfasalazine enteric-coated tablets,1g/time,3 times/day,30 days for 1 courses,continuous treatment for 3 courses.The function index of ankylosing spondylitis(BASFI),Bath ankylosing spondylitis disease activity index(BASDAI)and spinal pain were compared between the two groups before and after treatment.The changes of physical signs before and after treatment in two groups were observed,and the level of ESR and CRP(C reaction protein)was detected.Results compared with before treatment,BASFI,BASDAI and spinal pain in the two groups were significantly decreased after treatment,and the difference was statistically significant(P<0.05),and the scores of the above indexes in the treatment group were significantly lower than those of the control group(P<0.05).After treatment,the two groups of occipital wall distance and finger distance were shorter than those before treatment(P<0.05 or P<0.01),and the thoracic activity,spinal activity and Schober test were significantly higher than those before treatment(P<0.05),but there was no significant difference between the groups(P>0.05).After treatment,ESR and CRP in the two groups decreased significantly compared with those before treatment,and the difference was statistically significant(P<0.01).There was no significant difference in the levels of ESR and CRP between the two groups after treatment(P>0.05).Conclusion The clinical effect of Bushen Qiangdu Quhan decoction in the treatment of ankylosing spondylitis is accurate.It can obviously improve the clinical symptoms of the patients,and it is safe and reliable.It is worthy of clinical application.