寒湿痹颗粒联合塞来昔布治疗强直性脊柱炎的临床研究

Clinical study on Hanshibi granules combined with celecoxib in the treatment of ankylosing spondylitis

目的探讨寒湿痹颗粒联合塞来昔布治疗强直性脊柱炎的效果。方法选取2020年1月至2023年8月西安交通大学附属红会医院收治的128例强直性脊柱炎患者,按照随机数字表法将患者分为对照组和观察组,每组各64例。对照组给予塞来昔布胶囊治疗,观察组在对照组基础上给予寒湿痹颗粒治疗。2组患者均连续治疗6周。比较2组患者的治疗效果、视觉模拟量表(VAS)评分和Bath强直性脊柱炎功能指数(BASFI)评分、血清炎症指标、不良反应发生情况。结果对照组好转54例,无效10例;观察组好转61例,无效3例;观察组的总有效率高于对照组[95.3%(61/64)比84.4%(54/64)](χ^(2)=4.195,P=0.041)。治疗后,2组患者VAS和BASFI评分均低于治疗前,且观察组均低于对照组(均P<0.05)。治疗后,2组患者C反应蛋白、白细胞介素17、肿瘤坏死因子α水平均低于治疗前,且观察组均低于对照组(均P<0.05)。2组患者不良反应发生情况比较差异无统计学意义(χ^(2)=0.175,P=0.676)。结论在塞来昔布的基础上联用寒湿痹颗粒治疗强直性脊柱炎可获得较为满意的效果,能快速改善腰背痛、晨僵、关节痛等临床症状,降低VAS、BASFI评分和体内炎症反应,不良反应发生率较低,且症状轻微。

Objective To investigate the effect of Hanshibi granules combined with celecoxib in the treatment of ankylosing spondylitis.Methods A total of 128 patients with ankylosing spondylitis admitted to Honghui Hospital Affiliated to Xi′an Jiaotong University from January 2020 to August 2023 were selected.According to the random number table method,the patients were divided into control group and observation group,with 64 cases in each group.The control group was treated with celecoxib capsule,and the observation group was treated with Hanshibi granules on the basis of the control group.Both groups were treated for 6 weeks.The therapeutic effect,visual analogue scale(VAS)score,Bath ankylosing spondylitis functional index(BASFI)score,serum inflammatory indexes and adverse reactions were compared between the two groups.Results In the control group,54 cases were improved and 10 cases were ineffective.In the observation group,61 cases were improved and 3 cases were ineffective.The total effective rate of the observation group was higher than that of the control group[95.3%(61/64)vs 84.4%(54/64)](χ^(2)=4.195,P=0.041).After treatment,the VAS and BASFI scores of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(all P<0.05).After treatment,the levels of C-reactive protein,interleukin-17 and tumor necrosis factor-αin the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.175,P=0.676).Conclusion The combination of celecoxib and Hanshibi granules in the treatment of ankylosing spondylitis can achieve satisfactory results.It can rapidly improve the clinical symptoms such as low back pain,morning stiffness,aralgia and so on,reduce VAS,BASFI scores and inflammatory response in the body,with a low incidence of adverse reactions and mild symptoms.