温阳通络法治疗寒湿痹阻型强直性脊柱炎的疗效
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摘要
目的:观察温阳通络法治疗寒湿痹阻型强直性脊柱炎(AS)的临床疗效。方法:选取2016年1月至2017年3月南京理工大学医院收治的寒湿痹阻型AS患者60例,随机分为观察组和对照组,每组30例。对照组给予西医常规治疗,观察组在对照组治疗基础上给予温阳通络法治疗。2组均以4周为1个疗程,治疗3个疗程后,比较2组治疗前后主要临床指标(胸廓活动度、枕墙距、指地距、Schober试验)、AS功能活动评分[巴氏强直性脊柱炎活动指数(BASDAI)、巴氏强直性脊柱炎功能指数(BASFI)]、实验室检查指标[红细胞沉降率(ESR)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]的改善情况,并比较2组临床疗效。结果:与治疗前比较,2组治疗后胸廓活动度和Schober试验测量值均显著升高(P<0.05),枕墙距和指地距均显著降低(P<0.05),且观察组治疗后上述指标改善程度更为显著,组间比较差异有统计学意义(P<0.05);2组治疗后BASDAI评分和BASFI评分均显著降低(P<0.05),且观察组治疗后上述评分降低程度更为显著,组间比较差异有统计学意义(P<0.05);2组治疗后ESR、CRP、IL-6、TNF-α水平均显著降低(P<0.05),且观察组治疗后上述指标降低更为显著,组间比较差异有统计学意义(P<0.05);治疗后,观察组总有效率为90.0%,显著高于对照组的66.7%,差异有统计学意义(P<0.05)。结论:温阳通络法联合西医常规治疗寒湿痹阻型AS能够抑制患者机体炎性反应,快速缓解患者的临床症状和体征,有助于改善患者脊柱功能。
Objective: To observe the therapeutic effects of Wenyang Tongluo Therapy on cold-dampness obstruction type ankylosing spondylitis( AS). Methods: A total of 60 patients with cold-dampness obstruction type AS treated in Nanjing University of Science and Technology Hospital from January 2016 to March 2017 were selected and randomly divided into observation group and control group,with 30 cases in each group. The control group was treated with conventional method while the observation group was treated with Wenyang Tongluo Therapy on the basis of the same treatment for 3 courses( 4 weeks as a course). The clinical effects and the improvement of main clinical indexes( thoracic activity,occipital wall spacing,finger-ground distance,Schober test),AS functional activity score [Barthol' s ankylosing spondylitis activity index( BASDAI),Pap spirometry ankylosing function index( BASFI) ],laboratory test indicators [ESR,C-reactive protein( CRP),tumor necrosis factor-on index,and interleukin-6( IL-6) ]were compared before and after treatment. Results: After treatment,the thoracic activity and Schober test score were significantly increased( P < 0. 05),and the occipital wall spacing and finger-ground distance were significantly decreased( P < 0. 05). The improvement of the above indicators was more significant in the observation group,and there was a statistically significant difference between the groups( P < 0. 05). Both BASDAI and BASFI scores decreased significantly after treatment in both groups( P <0. 05),and the above scores decreased more significantly after treatment in the observation group,with statistically significant difference between the two groups( P < 0. 05). After treatment,the levels of ESR,CRP,IL-6 and TNF-were significantly reduced in both groups( P < 0. 05),and the decrease of the above indicators was more significant in the observation group,with statistically significant difference between the two groups( P < 0. 05). After treatment,the total effective rate of the observation group was90. 0%,which was significantly higher than 66. 7% of the control group,and the difference was statistically significant( P <0. 05). Conclusion: The combination of Wenyang Tongluo Therapy and conventional treatment in treating cold-dampness obstruction type AS can inhibit the body inflammatory response of patients,quickly relieve the patient' s clinical symptoms and signs,and help to improve the spinal function of patients.
Objective: To observe the therapeutic effects of Wenyang Tongluo Therapy on cold-dampness obstruction type ankylosing spondylitis( AS). Methods: A total of 60 patients with cold-dampness obstruction type AS treated in Nanjing University of Science and Technology Hospital from January 2016 to March 2017 were selected and randomly divided into observation group and control group,with 30 cases in each group. The control group was treated with conventional method while the observation group was treated with Wenyang Tongluo Therapy on the basis of the same treatment for 3 courses( 4 weeks as a course). The clinical effects and the improvement of main clinical indexes( thoracic activity,occipital wall spacing,finger-ground distance,Schober test),AS functional activity score [Barthol' s ankylosing spondylitis activity index( BASDAI),Pap spirometry ankylosing function index( BASFI) ],laboratory test indicators [ESR,C-reactive protein( CRP),tumor necrosis factor-on index,and interleukin-6( IL-6) ]were compared before and after treatment. Results: After treatment,the thoracic activity and Schober test score were significantly increased( P < 0. 05),and the occipital wall spacing and finger-ground distance were significantly decreased( P < 0. 05). The improvement of the above indicators was more significant in the observation group,and there was a statistically significant difference between the groups( P < 0. 05). Both BASDAI and BASFI scores decreased significantly after treatment in both groups( P <0. 05),and the above scores decreased more significantly after treatment in the observation group,with statistically significant difference between the two groups( P < 0. 05). After treatment,the levels of ESR,CRP,IL-6 and TNF-were significantly reduced in both groups( P < 0. 05),and the decrease of the above indicators was more significant in the observation group,with statistically significant difference between the two groups( P < 0. 05). After treatment,the total effective rate of the observation group was90. 0%,which was significantly higher than 66. 7% of the control group,and the difference was statistically significant( P <0. 05). Conclusion: The combination of Wenyang Tongluo Therapy and conventional treatment in treating cold-dampness obstruction type AS can inhibit the body inflammatory response of patients,quickly relieve the patient' s clinical symptoms and signs,and help to improve the spinal function of patients.
引文
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[11]张利.白芍的药理作用及现代研究进展[J].中医临床研究,2014,6(29):25-26.
[12]赵文静,王历,王芝兰,等.淫羊藿的药理作用及临床应用研究进展[J].中医药信息,2016,33(2):105-108.
[13]冯晗,周宏灏,欧阳冬生.杜仲的化学成分及药理作用研究进展[J].中国临床药理学与治疗学,2015,20(6):713-720.
[14]王兵,王亚新,赵红燕,等.甘草的主要成分及其药理作用的研究进展[J].吉林医药学院学报,2013,34(3):215-218.
[2]章玲艳,林洁华,周颖燕,等.补肾强督治偻汤联合督灸治疗强直性脊柱炎的临床观察[J].中国实验方剂学杂志,2015,21(10):190-194.
[3]张英泽,阎小萍.补肾强督方治疗强直性脊柱炎肾虚督寒血瘀证的临床研究[J].北京中医药大学学报,2007,30(12):857-859.
[4]蒋明,林孝义,朱立平.中华风湿病学[M].北京:华夏出版社,2004:1018-1019.
[5]国家药品监督管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:119-123.
[6]Ishiguro N,Yamamoto K,Katayama K,et al.Concomitant iguratimod therapy in patients with active rheumatoid arthritis despite stable doses of methotrexate:a randomized,double-blind,placebo-controlled trial[J].Mod Rheumatol,2013,23(3):430-439.
[7]Almasi S,Aslani S,Poormoghim H,et al.Gene Expression Profiling of Toll-Like Receptor 4 and 5 in Peripheral Blood Mononuclear Cells in Rheumatic Disorders:Ankylosing Spondylitis and Rheumatoid Arthritis[J].Iran J Allergy Asthma Immunol,2016,15(1):87-92.
[8]张海龙,张俊英,晋学英,等.针刺华佗夹脊穴和督脉穴对强直性脊柱炎患者相关实验指标及炎性因子检测研究[J].医学综述,2015,21(9):1678-1680.
[9]朱妍,徐畅.熟地黄活性成分药理作用研究进展[J].亚太传统医药,2011,7(11):173-175.
[10]张利青,张占刚,付岩,等.桂皮醛药理作用的研究进展[J].中国中药杂志,2015,40(23):4568-4572.
[11]张利.白芍的药理作用及现代研究进展[J].中医临床研究,2014,6(29):25-26.
[12]赵文静,王历,王芝兰,等.淫羊藿的药理作用及临床应用研究进展[J].中医药信息,2016,33(2):105-108.
[13]冯晗,周宏灏,欧阳冬生.杜仲的化学成分及药理作用研究进展[J].中国临床药理学与治疗学,2015,20(6):713-720.
[14]王兵,王亚新,赵红燕,等.甘草的主要成分及其药理作用的研究进展[J].吉林医药学院学报,2013,34(3):215-218.
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