温肾强脊方联合不同剂量阿托伐他汀治疗强直性脊柱炎合并颈动脉粥样硬化患者的临床观察

Clinical Observation of Wenshen Qiangji Decoction Combined with Different Doses of Atorvastatin in the Treatment of Ankylosing Spondylitis with Carotid Atherosclerosis

目的:评价温肾强脊方联合不同剂量阿托伐他汀(atorvastatin)治疗强直性脊柱炎(ankylosing spondylitis,AS)合并颈动脉粥样硬化患者的疗效,并观察本联合方案对血清瘦素(LEP)、肿瘤坏死因子-α(TNF-α)、血沉(ESR)、C反应蛋白(CRP)的影响。方法:选取我院60例AS合并颈动脉粥样硬化患者作为研究对象,随机分为治疗组及对照组,每组各30例。治疗组给予口服温肾强脊方联合阿托伐他汀40 mg·d-1,疗程90 d;对照组口服温肾强脊方联合阿托伐他汀20 mg·d-1,疗程90 d。观察患者LEP、TNF-α、ESR、CRP水平的变化。结果:治疗后两组患者LEP、TNF-α、ESR、CRP水平均低于治疗前(P <0. 05);与对照组相比,治疗组患者LEP、TNF-α、CRP水平均较低,差异均有统计学意义(P <0. 05)。结论:阿托伐他汀联合温肾强脊方可降低AS患者LEP、TNF-α、ESR、CRP水平,加倍剂量阿托伐他汀更有助于改善患者体内的炎症状态,对降低LEP、TNF-α、CRP水平作用更强。

Objective:To evaluate the clinical effects of wenshen qiangji decoction combined with different doses of atorvastatin in the treatment of ankylosing spondylitis(AS)with carotid atherosclerosis,and to observe the effects on LEP,TNF-α,ESR and CRP of this combination therapy.Methods:60 cases of patients with AS combined with carotid atherosclerosis were randomly divided into the treatment group(n=30)and the control group(n=30).Patients in the treatment group were treated with wenshen qiangji decoction combined with atorvastatin 40 mg·d^-1,and those in the control group were treated with wenshen qiangji decoction combined with atorvastatin 20 mg·d^-1.All of the patients were treated for 90 d.The changes of LEP,TNF-α,ESR and CRP levels were observed after the treatment.Results:After the treatment,levels of LEP,TNF-α,ESR,and CRP in the two groups were lower than those before the treatment(P<0.05).Compared with the control group,the treatment group had lower LEP,TNF-αand CRP levels,and the differences were statistically significant(P<0.05).Conclusion:Wenshen qiangji decoction combined with atorvastatin can reduce the levels of LEP,TNF-α,ESR and CRP in patients with AS.Doubled doses of atorvastatin can improve the inflammatory state in the patients and has a supplementary effect on reducing the levels of LEP,TNF-αand CRP.