顽痹康丸治疗肾虚湿热型强直性脊柱炎的临床研究

Clinical Study on Treatment of Ankylosing Spondylitis with Kidney Deficiency Dampness Heat Syndrome with Wanbikang Pill

目的:观察顽痹康丸治疗肾虚湿热型强直性脊柱炎的临床疗效。方法:选取2018年1月至2020年1月于我院风湿科住院的100例肾虚湿热型强直性脊柱炎合并骨质疏松患者,依据随机、对照的原则,将患者分为两组,每组50例。对照组患者给予柳氮磺吡啶肠溶片联合美洛昔康胶囊,治疗组在对照组的基础上口服顽痹康丸,疗程均为12周。比较两组患者治疗前后的血沉(ESR)、血清C反应蛋白(CRP)、股骨颈骨密度、血清骨钙素(BGP)、β异构C末端肽(β-CTX)水平的变化情况,并在治疗12周后依据ASAS20疗效评价标准评估临床疗效。记录两组患者不良反应发生情况。结果:治疗后,两组患者的ESR、CRP及β-CTX水平均低于治疗前,股骨颈骨密度值及BGP水平高于治疗前(P<0.05);且治疗组上述指标改善程度均优于对照组(P<0.05)。治疗12周后治疗组有效率为77.08%,高于对照组的有效率(52.17%)(P<0.05)。结论:顽痹康丸能够降低强直性脊柱炎患者的炎性指标ESR、CRP,改善股骨颈骨密度值,提高血清BGP水平,降低血清β-CTX水平,使之达到骨代谢的平衡,延缓疾病进展,减少骨量丢失,且不良反应较少。

Objective:To observe the clinical efficacy of wanbikang pill in the treatment of ankylosing spondylitis with kidney deficiency dampness heat syndrome.Methods:100 ankylosing spondylitis patients with kidney deficiency dampness heat syndrome hospitalized in the rheumatology department of our hospital from January 2018 to January 2020 were selected.According to the principle of randomization and control,the patients were divided into two groups,50 cases in each group.The control group was given sulfasalazine enteric-coated tablets combined with meloxicam capsule,and the treatment group was given wanbikang pill on the basis of the treatment of the control group.The treatment course of both groups was 12 weeks.The blood sedimentation rate(ESR),C-reactive protein(CRP),bone mineral density of femoral neck,serum osteocalcin(BGP)andβIsomeric C-terminal peptide(β-CTX)levels of the two groups of patients were compared before and after the treatment.The clinical efficacy was evaluated according to ASAS20 efficacy evaluation criteria after 12 weeks of treatment.The occurrence of adverse reactions in the two groups of patients was recorded.Results:After treatment,the ESR,CRP andβ-CTX levels of the two groups of patients were all lower than those before treatment,and bone mineral density of femoral neck and BGP levels were higher than those before treatment(P<0.05).The improvement degree of the above indexes in the treatment group was better than that in the control group(P<0.05).After 12 weeks of treatment,the effective rate in the treatment group was 77.08%,which was higher than 52.17%in the control group(P<0.05).Conclusion:Wanbikang pill can not only reduce the inflammatory indicators(ESR and CRP)of ankylosing spondylitis patients,but also improve the bone mineral density of femoral neck,increase the level of BGP and reduce theβ-CTX level,so as to achieve the balance of bone metabolism,delay disease progression,reduce bone loss,and have less adverse reactions.