中药熏蒸联合常规西药治疗强直性脊柱炎30例临床观察

Clinical Observation on 30 Cases of Ankylosing Spondylitis Treated by TCM Fumigation Combined with Conventional Western Medicine

目的:观察中药熏蒸联合常规西药治疗强直性脊柱炎的临床疗效。方法:将60例强直性脊柱炎患者随机分为治疗组和对照组,每组30例。对照组给予口服洛索洛芬钠片,每次60 mg,每日3次;柳氮磺吡啶肠溶片每次1 g,每日2次。治疗组在对照组治疗基础上给予中药熏蒸治疗。观察2组患者中医证候疗效,治疗第2,6,10周ASAS20、ASAS40、Bath强直性脊柱炎疾病活动指数(BASDAI)、Bath强直性脊柱炎测量指数(BASMI)指标变化。结果:治疗组临床缓解2例,显效12例,有效16例,无效0例,总有效率为100%;对照组临床缓解0例,显效7例,有效18例,无效5例,总有效率为83.33%。2组比较,差异有统计学意义(P < 0.05)。治疗第2周,2组患者ASAS20、ASAS40、BASDAI、BASMI均较治疗前好转,BASMI改善方面组间比较,差异有统计学意义(P < 0.01);余项比较,差异无统计学意义(P > 0.05)。治疗第6,10周,2组患者上述指标均较前好转;组间比较,差异有统计学意义(P < 0.01或P < 0.05)。治疗后,治疗组腰骶疼痛、脊背疼痛、腰脊活动受限、晨僵、畏寒喜暖方面较治疗前明显改善(P < 0.01);对照组除畏寒喜暖指标外,其他指标也较治疗前明显改善(P < 0.01)。上述所有指标组间比较,差异均有统计学意义(P < 0.01)。结论:中药熏蒸联合常规西药治疗强直性脊柱炎,在一定程度上可改善患者临床症状,值得临床进一步运用。

Objective:To observe the clinical effect of TCM fumigation combined with conventional western medicine on ankylosing spondylitis.Methods:Sixty cases of ankylosing spondylitis were randomly divided into a treatment group and a control group,30 cases in each group.The control group was given loxoprofen sodium tablets,60 mg each time and three times a day;and sulfasalazine,1 g each time and twice a day.The treatment group was treated with TCM fumigation based on the treatment for the control group.The clinical effect of the two groups was observed.At the 2nd,6th and 10th weeks,the changes of ASAS20,ASAS40,BASDAI,and BASMI were observed.Results:In the treatment group,2 cases were relieved,12 cases were markedly effective,16 cases were effective,there were no cases ineffective,and the total effective rate was 100%;in the control group,there were no cases of clinical remission,7 cases were markedly effective,18 cases were effective,5 cases were ineffective,and the total effective rate was 83.33%.The difference between the two groups was statistically significant(P < 0.05).At the 2nd weeks of treatment,ASAS20,ASAS40,BASDAI and BASMI in the two groups were all improved compared with those before treatment.There was statistical significance in the improvement of BASMI between the two groups(P < 0.01),and there was no statistical significance in the rest(P > 0.05).At the 6th and 10th weeks of treatment,the above indicators in the two groups were all improved compared with those before treatment;and there was statistical significance in the difference between the two groups(P < 0.01 or P < 0.05).After the treatment,lumbosacral back pain,back pain,lumbar spinal activity limitation,morning stiffness,and warmth chills in the treatment group were significantly improved compared with those before the treatment(P < 0.01).In the control group,except for warmth chills indexes,others were also significantly improved compared with those before the treatment(P < 0.01).There was significant difference between the above indexes(P < 0.01).Conclusion:TCM fumigation combined with conventional western medicine can improve the clinical symptoms of patients with ankylosing spondylitis to a certain extent,which is worth further clinical application.