中医定向透药法联合托法替布在强直性脊柱炎的应用研究

Research on application of directional penetration of traditional Chinese medicine combined with Tofacib in ankylosing spondylitis

目的探究中医定向透药法联合托法替布在强直性脊柱炎的应用价值。方法取2018年2月至2021年8月新余钢铁集团有限公司中心医院收治的70例强直性脊柱炎患者作为研究对象,按照随机数字表法分为研究组(n=35)和对照组(n=35)。对照组采用常规抗风湿药物,研究组采用中医定向透药法联合托法替布治疗。比较两组临床疗效、视觉模拟评分法(VAS)评分、巴氏强直性脊柱炎计量学指数(BASMI)、巴氏强直性脊柱炎功能指数(BASFI)、巴氏强直性脊柱炎活动指数(BASDAI)、匹茨堡睡眠质量指数(PSQI)评分、生活质量综合评估问卷(GQOL-74)评分、红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、γ干扰素(IFN-γ)、骨碱性磷酸酶(BALP)、骨钙素(BGP)、骨密度及不良反应总发生率。结果研究组的总有效率高于对照组,差异有统计学意义(P<0.05)。研究组治疗3个月后VAS、BASMI、BASFI、BASDAI、PSQI评分低于对照组,GQOL-74评分高于对照组,差异有统计学意义(P<0.05)。研究组治疗3个月后ESR、hs-CRP、TNF-α、IL-1β、BGP水平低于对照组,IFN-γ、BALP、骨密度水平高于对照组,差异有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论中医定向透药法联合托法替布治疗强直性脊柱炎患者,可提高疗效,增强脊柱功能,有利于生活质量提高,促进炎症水平降低,且安全性较高,临床应当关注。

Objective To investigate the application value of traditional Chinese medicine directional penetration combined with Tofacitb in ankylosing spondylitis.Methods From February 2018 to August 2021,70 patients with ankylosing spondylitis admitted to the Central Hospital of Xinyu Iron and Steel Group Co.,Ltd.were selected as research objects,and divided into study group(n=35)and control group(n=35)according to the random number table method.The control group was treated with conventional antirheumatic drugs,while the study group was treated with traditional Chinese medicine directional penetration combined with Tofacitinib.The clinical efficacy,scores of visual analogue scale(VAS),Bath ankylosing spondylitis metroloty index(BASMI),Bath ankylosing spondylitis functional index(BASFI),Bath ankylosing spondylitis disease activity index(BASDAI),Pittsburgh sleep quality index scale(PSQI),generic quality of life inventory-74(GQOL-74),erythrocyte sedimentation rate(ESR),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α,interleukin-1β(IL-1β),interferon-gamma(IFN-γ),bone alkaline phosphatase(BALP),bone gamma-carboxyglutamic-acid-containing proteins(BGP),bone mineral density and total incidence of adverse reactions were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).After 3 months of treatment,the scores of VAS,BASMI,BASFI,BASDAI and PSQI in the study group were lower than those in the control group,and the scores of GQOL-74 were higher than those in the control group,group,and the differences were statistically significant(P<0.05).After 3 months of treatment,the levels of ESR,hs-CRP,TNF-α,IL-1βand BGP in the study group were lower than those in the control group,while the levels of IFN-γ,BALP and bone mineral density were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Directional penetration of traditional Chinese medicine combined with Tofacitb in the treatment of patients with ankylosing spondylitis can improve the curative effect,enhance the spinal function,improve the quality of life and reduce the level of inflammation,which is safe and should be paid attention to clinically.