益肾强督通络汤联合西药治疗强直性脊柱炎临床研究

Clinical Study on Treatment of Ankylosing Spondylitis with Yishen Qiangdu Tongluo Decoction Combined with Western Medicine

目的:观察益肾强督通络汤治疗强直性脊柱炎的临床疗效。方法:选择强直性脊柱炎患者102例,将愿意服用中药及局部外敷治疗的纳入52例患者纳入治疗组,不愿意服用中药及局部外敷治疗的50例患者纳入对照组,对照组患者采用西医规范治疗,治疗组患者在对照组治疗的基础上加用益肾强督通络汤内服和外敷治疗,两组均以12周为1个疗程。治疗结束后观察两组患者临床症状及体征的变化,比较两组患者临床疗效、专科检查评分(颌柄距、指地距、胸廓扩张度、枕墙距、Schober试验)、中医证候积分、病情活动指数(BASDAI评分、BASFI评分、BASMI评分)、炎性反应指标水平(ESR和CRP)及不良反应等指标。结果:治疗后治疗组和对照组总有效率分别为96.15%和82.00%,经比较差异具有统计学意义(P<0.05)。治疗后治疗组的颌柄距、指地距、枕墙距和中医证候积分均较明显低于对照组(P<0.05),胸廓扩张度、Schober试验指标均明显高于对照组(P<0.05)。治疗后治疗组的BASDAI评分、BASMI评分和BASFI评分均比对照组改善显著(P<0.05)。治疗组治疗后ESR和CRP水平均显著低于对照组(P<0.05)。结论:益肾强督通络汤联合西药治疗强直性脊柱炎疗效确切,能够显著改善强直性脊柱炎患者的临床症状和中医证候积分,且能明显降低患者的炎症反应。

Objective:To observe the clinical effect of Yishen Qiangdu Tongluo Decoction on ankylosing spondylitis.Methods:1o2 patients with ankylosing spondylitis were selected.Those who were willing to take traditional Chinese medicine and local external application were included in the treatment group,and those who were unwilling to take traditional Chinese medicine and local external application were included in the control group,including 52 patients in the treatment group and 50 patients in the control group.The patients in the control group were treated with western medicine,and the patients in the treatment group were treated with Yishen Qiangdu Tongluo Decoction for internal use and external collapse on the basis of the treatment in the control group.Both groups took 12 weeks as a course of treatment.After treatment,the changes of clinical symptoms and signs of the two groups were observed.These indexes of the two groups were compared,including clinical efficacy,special examination scores(jaw handle distance,finger ground distance,chest expansion,occipital wall distance,Schober test),TCM syndrome score,disease activity index(BASDAI score,BASFI score,BASMI score),inflammatory response index level(ESR and CRP)and adverse reactions.Results:After treatment,the total effective rates of the treatment group and the control group were 96.15%and 82.00%respectively,with significant difference(P<0.05).After treatment,the jaw handle distance,finger ground distance,occipital wall distance and TCM syndrome score in the treatment group were significantly lower than those in the control group(P<0.05),and the chest expansion and Schober test indexes were significantly higher than those in the control group(P<0.05).After treatment,the scores of BASDAI,BASMI and BASFI in the treatment group were significantly improved than those in the control group(P<0.05).The levels of ESR and CRP in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion:Yishen Qiangdu Tongluo Decoction combined with western medicine is effective in the treatment of ankylosing spondylitis,which can significantly improve the clinical symptoms and TCM symptom scores of Patients with ankylosing spondylitis,and significantly reduce the inflammatory reaction of Patients.