四味青白颗粒对活动性中轴型脊柱关节炎的临床疗效

Clinical Efficacy of Siwei Qingbai Granule in the Treatment of Active Axial Spondyloarthritis

目的探讨四味青白颗粒对活动性中轴型脊柱关节炎(axial spondyloarthritis,ax-SpA)患者的临床疗效及其相关机制。方法观察2018年1月—2019年6月收治的60例活动性ax-SpA患者的临床资料,分为观察组和对照组各30例。对照组给予沙利度胺、美洛昔康治疗,观察组在对照组用药基础上给予四味青白颗粒治疗,观察两组患者治疗前、治疗4、8、12周后Bath强直性脊柱炎疾病活动性指数(BASDAI)、Bath强直性脊柱炎疾病功能指数(BASFI)、血沉(ESR)、血清肿瘤坏死因子-α(TNF-α)、细胞白介素-6(IL-6)、C反应蛋白(CRP)及治疗后ASAS20、ASAS40改善效果及临床不良反应。结果治疗前,两组BASDAI、BASFI、ESR、TNF-α、IL-6、CRP差异均无统计学意义(P均>0.05);治疗后,两组BASDAI、BASFI、ESR、TNF-α、IL-6、CRP均下降(P均<0.05);两组治疗4周后BASDAI、BASFI、ESR差异均无统计学意义(P均>0.05);观察组治疗8、12周后BASDAI、BASFI、ESR均低于对照组(P均<0.05),观察组治疗12周后TNF-α、IL-6、CRP均低于对照组(P均<0.05);观察组治疗4、8周时ASAS20改善率(70.00%、76.67%)均优于对照组(43.33%、50.00%)(P均<0.05);ASAS40改善率(60.00%、70.00%)均优于对照组(33.33%、43.33%)(P均<0.05);两组不良反应总发生率差异无统计学意义(P>0.05)。结论四味青白颗粒可有效改善活动性ax-SpA患者功能及症状,降低血清ESR、TNF-α、IL-6、CRP水平,短期疗效较为满意。

Objective To investigate the clinical efficacy and mechanism of Siwei Qingbai granule in the treatment of patients with active axial spondylarthritis(ax-SpA).Methods The clinical data of 60 patients with active ax SpA from January 2018 to June 2019 were observed and divided into observation group and control group with 30 cases in each group.The control group was treated with thalidomide and meloxicam.The observation group was given Siwei Qingbai granule on the basis of the control group.Bath ankylosing spondylitis disease activity index(BASDAI),Bath ankylosing spondylitis disease function index(BASFI),erythrocyte sedimentation rate(ESR),serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)were observed before and after treatment for 4,8 and 12 weeks.And ASAS20,ASAS40 improvement effect and clinical adverse reactions after treatment.Results Before treatment,there was no significant difference in BASDAI,BASFI,ESR,TNF-α,IL-6 and CRP between the two groups(P all>0.05);BASDAI,BASFI,ESR,TNF-α,IL-6 and CRP decreased after treatment in the two groups(P all<0.05);there was no significant difference in BASDAI,BASFI and ESR after 4 weeks between the two groups(P all>0.05);BASDAI,BASFI and ESR in the observation group were lower than after 8 and 12 weeks those in the control group(P all<0.05);TNF-α,IL-6 and CRP in the observation group were lower after 12 weeks than those in the control group(P all<0.05);the improvement rate of ASAS20 in the observation group(70.00%,76.67%) was better than that in the control group(46.67%, 60.00%)(P all<0.05);the improvement rate of ASAS40 (50.00%,66.67%) was better than that in the control group (33.33%,43.33%)(P all<0.05),the total incidence of adverse reactions in the two groups was no significant difference(P>0.05). Conclusion Siwei Qingbai granule can significantly improve the function and symptoms of patients with active ax-SpA, reduce the levels of ESR,TNF-α,IL-6 and CRP, with satisfactory clinical effect and high safety, and has important value in the clinical treatment of ax-SpA.