补肾强脊加减汤结合穴位贴敷对强直性脊柱炎患者证候改善及炎症状况的影响
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摘要
目的 :探讨补肾强脊加减汤结合穴位贴敷对强直性脊柱炎患者证候改善及炎症状况的影响。方法 :回顾性分析2014年4月～2017年6月我院收治的280例强直性脊柱炎患者的临床资料。根据治疗方式的不同,将患者分为两组,每组140例。观察组采用补肾强脊加减汤结合穴位贴敷治疗,对照组采用常规西药治疗。比较两组治疗前后的强直性脊柱炎疾病活动指数(BASDAI)、强直性脊柱炎功能指数(BASFI)、中医证候积分、中医证候疗效、炎症因子,以及不良反应情况。结果 :观察组的总有效率明显高于对照组,差异有统计学意义。治疗后,两组的BASDAI、BASFI和中医证候积分均低于治疗前,且观察组的各指标均低于对照组,差异均有统计学意义。治疗后,两组的C反应蛋白(CRP)、血沉(ESR)、肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平均低于治疗前,且观察组的各指标低于对照组,差异均有统计学意义。两组的不良反应发生率相比,差异无统计学意义。结论 :补肾强脊加减汤结合穴位贴敷治疗强直性脊柱炎的疗效较好,可有效改善患者的证候和炎症状况,安全性较高,可在临床上推广。
Objective To investigate the effect of Bushenqiangjiao Decoction combined with acupoint application on syndrome improvement and inflammatory status in patients with ankylosing spondylitis. Methods The clinical data of 280 patients with ankylosing spondylitis admitted to our hospital from April 2014 to June 2017 were retrospectively analyzed. Patients were divided into two groups according to different treatment methods, with 140 cases in each group. The observation group were treated with Bushenqiangjiao Decoction combined with acupoint application, and the control group were treated with conventional western medicine. The ankylosing spondylitis disease activity index(BASDAI), ankylosing spondylitis functional index(BASFI), TCM syndrome scores, TCM syndrome efficacy, inflammatory factors, and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant. After treatment, the scores of BASDAI, BASFI and TCM syndromes in the two groups were lower than those before treatment, and the indexes in the observation group were lower than those in the control group,with statistical significance. After treatment, the levels of CRP, ESR, TNF-α and IL-6 in the two groups were lower than those before treatment, and the indexes in the observation group were lower than those in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Bushenqiangji Decoction combined with acupoint application is effective in treating ankylosing spondylitis, which can effectively improve the syndrome and inflammation of patients, and has high safety and can be promoted clinically.
Objective To investigate the effect of Bushenqiangjiao Decoction combined with acupoint application on syndrome improvement and inflammatory status in patients with ankylosing spondylitis. Methods The clinical data of 280 patients with ankylosing spondylitis admitted to our hospital from April 2014 to June 2017 were retrospectively analyzed. Patients were divided into two groups according to different treatment methods, with 140 cases in each group. The observation group were treated with Bushenqiangjiao Decoction combined with acupoint application, and the control group were treated with conventional western medicine. The ankylosing spondylitis disease activity index(BASDAI), ankylosing spondylitis functional index(BASFI), TCM syndrome scores, TCM syndrome efficacy, inflammatory factors, and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant. After treatment, the scores of BASDAI, BASFI and TCM syndromes in the two groups were lower than those before treatment, and the indexes in the observation group were lower than those in the control group,with statistical significance. After treatment, the levels of CRP, ESR, TNF-α and IL-6 in the two groups were lower than those before treatment, and the indexes in the observation group were lower than those in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Bushenqiangji Decoction combined with acupoint application is effective in treating ankylosing spondylitis, which can effectively improve the syndrome and inflammation of patients, and has high safety and can be promoted clinically.
引文
[1]庄建阳,刘雪梅,庄建艳.团体心理辅导结合引导式教育对强直性脊柱炎患者行为问题的影响[J].中国健康心理学杂志, 2018,26(01):61-65.
[2]贺子君,陈翠清,肖俊卿,等.中药穴位贴敷配合关节操在强直性脊柱炎患者骶骼关节功能恢复中的应用[J].临床护理杂志, 2017,16(06):38-40.
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[6]刘宏潇,高凡珠,冯兴华.从三首古方探讨强直性脊柱炎的辨证治疗[J].中医杂志, 2017, 58(18):1603-1606.
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[8]吴豫云,周倩仪,崔家康,等.独活寄生汤联合化学药治疗强直性脊柱炎疗效的Meta分析[J].中国药房, 2016, 27(21):2945-2947.
[9]王英杰,丘文静.浮针联合补肾强督治尪汤治疗早期强直性脊柱炎髋关节病变疗效观察[J].中国中医基础医学杂志, 2016, 22(02):229-230+269.
[10]马涌,欧勇,马原. VCR、VCD治疗强直性脊柱炎并发重度车轮状后凸畸形的临床研究[J].湖南师范大学学报(医学版), 2016, 13(03):11-13.
[11]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.
[12]林庆宾,张俐.艾灸联合五藤汤加减治疗活动期强直性脊柱炎[J].中华中医药杂志, 2015, 30(05):1701-1703.
[13]周献伟,李洋.克痹通络汤合独活寄生汤加减治疗强直性脊柱炎肝肾阴虚证患者54例临床观察[J].中医杂志, 2015, 56(08):686-689.
[14]孙鹏,李建,沙明波,等.独活寄生汤加减对强直性脊柱炎肾虚督寒证骨代谢和炎症因子的影响[J].中国实验方剂学杂志, 2017,23(24):202-207.
[15]李小敬.益肾强脊经验汤联合西药对强直性脊柱炎患者关节痛感、炎症因子的影响[J].陕西中医, 2016, 37(01):76-77.
[16]夏淑洁,王义军.胡荫奇运用桂枝加葛根汤辨治风湿病经验[J].时珍国医国药, 2017, 28(05):1233-1234.
[2]贺子君,陈翠清,肖俊卿,等.中药穴位贴敷配合关节操在强直性脊柱炎患者骶骼关节功能恢复中的应用[J].临床护理杂志, 2017,16(06):38-40.
[3]Calin A. Spondylarthropathies[M]. Orlando:Grune and Stratton Inc,1984:69.
[4]阎小萍.强直性脊柱炎[M].北京:中国医药科技出版社, 2004:53-80.
[5]谷家立,马莹.温阳通络法治疗寒湿痹阻型强直性脊柱炎的疗效[J].世界中医药, 2018, 13(09):2224-2228.
[6]刘宏潇,高凡珠,冯兴华.从三首古方探讨强直性脊柱炎的辨证治疗[J].中医杂志, 2017, 58(18):1603-1606.
[7]杨怡坤,房定亚.解痉舒督汤治疗60例强直性脊柱炎临床疗效观察[J].中国中西医结合杂志, 2017, 37(08):1011-1013.
[8]吴豫云,周倩仪,崔家康,等.独活寄生汤联合化学药治疗强直性脊柱炎疗效的Meta分析[J].中国药房, 2016, 27(21):2945-2947.
[9]王英杰,丘文静.浮针联合补肾强督治尪汤治疗早期强直性脊柱炎髋关节病变疗效观察[J].中国中医基础医学杂志, 2016, 22(02):229-230+269.
[10]马涌,欧勇,马原. VCR、VCD治疗强直性脊柱炎并发重度车轮状后凸畸形的临床研究[J].湖南师范大学学报(医学版), 2016, 13(03):11-13.
[11]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.
[12]林庆宾,张俐.艾灸联合五藤汤加减治疗活动期强直性脊柱炎[J].中华中医药杂志, 2015, 30(05):1701-1703.
[13]周献伟,李洋.克痹通络汤合独活寄生汤加减治疗强直性脊柱炎肝肾阴虚证患者54例临床观察[J].中医杂志, 2015, 56(08):686-689.
[14]孙鹏,李建,沙明波,等.独活寄生汤加减对强直性脊柱炎肾虚督寒证骨代谢和炎症因子的影响[J].中国实验方剂学杂志, 2017,23(24):202-207.
[15]李小敬.益肾强脊经验汤联合西药对强直性脊柱炎患者关节痛感、炎症因子的影响[J].陕西中医, 2016, 37(01):76-77.
[16]夏淑洁,王义军.胡荫奇运用桂枝加葛根汤辨治风湿病经验[J].时珍国医国药, 2017, 28(05):1233-1234.