温肾强督散寒汤联合西药治疗肾虚督寒型强直性脊柱炎的疗效评价及对炎症因子的影响

Evaluation of curative effect of Wenshen Qiangdu Sanhan Decoction combined with western medicine on the treatment of kidney deficiency type ankylosing spondylitis and its effect on inflammatory factors

目的:观察温肾强督散寒汤联合西药治疗肾虚督寒型强直性脊柱炎的临床疗效及对炎症因子的影响。方法:将160例患者按随机数表法分为对照组和治疗组,每组80例。对照组给予美洛昔康片口服,15mg/次,1次/d,疼痛缓解后改为7.5mg/次,1次/d;柳氮磺胺吡啶片口服,1g/次,2次/d。治疗组在对照组的基础上,给予温肾强督散寒汤口服,1剂/d。两组疗程均为12周。记录治疗前后综合指数评分(BAS-G)、脊柱疼痛视觉模拟评分(VAS)、巴氏强直性脊柱炎活动指数(BASDAI)、疾病功能指数(BASFI)、患者整体评分(PGA)、中医症候评分;检测治疗前后患者血沉(ESR)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,并进行安全性评价。结果:治疗组总有效率[87.01%(67/77)]显著高于对照组[61.33%(46/75)](P<0.05);治疗后与对照组比较,治疗组患者BAS-G、VAS、PGA评分、中医症候评分及ESR、CRP、TNF-α、IL-6水平显著降低(P<0.05),BASDAI、BASFI评分显著升高(P<0.05)。结论:在西药常规治疗的基础上,采用温肾强督散寒汤治疗肾虚督寒型强直性脊柱炎可有效缓解其临床症状,下调炎症因子,控制疾病活动度,提高临床疗效,且安全性较好,临床疗效优于单纯的西医治疗。

Objective: To observe the clinical effect of Wenshen Qiangdu Sanhan Decoction combined with western medicine in treating kidney deficiency type ankylosing spondylitis and its effect on inflammatory factors. Methods: A total of 160 patients were randomly divided into control group and treatment group, 80 cases in each group. The control group was given meloxicam tablets 15 mg/time, 1 time/d, pain relief to 7.5 mg/time, 1 time/d;Sulfadiazepine Tablets 1 g/time, 2 times/d. Treatment group on the basis of the control group, given Wenshen Qiangdu Sanhan Decoction oral, 1 dose/d. Both groups were treated for 12 weeks. Comprehensive index scores BAS-G, VAS, BASDAI, BASFI, PGA, TCM syndrome score;ESR, CRP, TNF-α, IL-6, and safety evaluation before and after treatment. Results: The total effective rate of the treatment group [87.01%(67/77)] was higher than that of the control group [61.33%(46/75)](P<0.05). After treatment, compared with the control group, the BAS-G, VAS,PGA score, TCM symptom score and the levels of ESR, CRP, TNF-α, IL-6 in the treatment group decreased significantly(P<0.05),BASDAI, BASFI score increased significantly(P<0.05). Conclusion: On the basis of routine western medicine, the treatment of patients with kidney deficiency type ankylosing spondylitis with Wenshen Qiangdu Sanhan Decoction can effectively relieve the clinical symptoms, down-regulate the inflammatory factors, control the disease activity, improve the clinical efficacy, and good safety, the clinical effect is better than that of western medicine.