益肾强督利节汤联合西药治疗强直性脊柱炎临床研究

Clinical Observation on Treating Ankylosing Spondylitis with Yishen Qiangdu Lijie Decoction Combined with Western Medicine

目的:观察益肾强督利节汤联合西药治疗强直性脊柱炎的临床疗效。方法:选择2020年1月-2022年6月明确诊断为强直性脊柱炎的患者90例,按是否愿意配合中医治疗分为治疗组(愿意配合益肾强督利节汤治疗)和对照组(不愿意配合益肾强督利节汤治疗),两组分别纳入45例。对照组45例患者运用常规西医规范治疗,治疗组45例患者在对照组治疗基础上加用益肾强督利节汤治疗。两组均以4周为1个疗程,不间断治疗3个疗程,结束治疗后根据量表所记录指标变化进行疗效评价。结果:治疗组和对照组总有效率分别为97.78%和80.00%,两组治疗总有效率比较差异有统计学意义(P<0.05);治疗后治疗组腰脊活动受限、腰骶脊背疼痛、夜间疼痛、关节肿痛、中医证候总积分较对照组均明显降低(P<0.05);两组患者治疗后ESR、CRP水平较治疗前均明显降低(P<0.05),且治疗组ESR、CRP水平较对照组均明显降低(P<0.05);两组患者治疗后BASDAI、BASFI较治疗前均明显改善,且治疗后治疗组较对照组均改善明显(P<0.05)。结论:益肾强督利节汤联合西药治疗强直性脊柱炎疗效显著,且能降低中医积分和炎症反应。

Objective:To observe the clinical efficacy of yishen qiangdu lijie decoction combined with western medicine in the treatment of ankylosing spondylitis.Methods:90 patients with ankylosing spondylitis diagnosed definitely from January 2020 to June 2022 were selected and divided into treatment group(willing to cooperate with yishen qiangdu lijie decoction for treatment)and control group(unwilling to cooperate with yishen qiangdu lijie decoction for treatment)according to whether they are willing to cooperate with TCM treatment,45 cases in each group.The control group was treated with conventional western medicine,and the treatment group was treated with yishen qiangdu lijie decoction on the basis of the control group.Both groups took 4 weeks as a course of treatment,three courses of uninterrupted treatment.After the treatment,the curative effect was evaluated according to the index changes recorded in the scale.Results:The total effective rate was 97.78%in the treatment group and 80.00%in the control group.The total effective rates of the two groups were compared(P<0.05).After treatment,the scores of limited lumbar spine activity,lumbosacral back pain,nocturnal pain,joint swelling and pain,and total score of TCM symptoms in the treatment group were significantly lower than those in the control group(P<0.05).The levels of ESR and CRP in the two groups were significantly lower than before treatment(P<0.05),and the levels of ESR and CRP in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,BASDAI and BASFI in the two groups were significantly improved compared with those before treatment,and the treatment group was significantly improved compared with the control group(P<0.05).Conclusion:Yishen qiangdu lijie decoction combined with western medicine has a significant effect on ankylosing spondylitis,and can reduce TCM score and inflammatory response.