顽痹清丸联合常规西药治疗湿热痹阻证强直性脊柱炎28例临床观察
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摘要
目的:观察顽痹清丸联合常规西药治疗湿热痹阻证强直性脊柱炎的临床疗效。方法:将56例湿热痹阻证强直性脊柱炎患者随机分为治疗组和对照组,每组28例。对照组口服美洛昔康胶囊和柳氮磺吡啶肠溶片治疗,治疗组在对照组的基础上加用顽痹清丸口服治疗。2组均以12周为1个疗程。观察2组治疗前后中医证候疗效、西医ASAS20疗效及红细胞沉降率(ESR)、C-反应蛋白(CRP)等实验室指标的变化情况,并比较2组不良反应发生情况。结果:中医证候疗效:治疗组临床痊愈3例,显效12例,有效10例,无效3例,总有效率为89.29%;对照组临床痊愈1例,显效13例,有效8例,无效6例,总有效率为78.57%。2组比较,差异有统计学意义(P <0.05)。西医ASAS20疗效:治疗组ASAS20达标率为89.29%,对照组达标率为75.00%,治疗组明显优于对照组(P <0.05)。治疗后,2组中医证候积分、ESR、CRP较治疗前均显著下降(P <0.05),且治疗组下降幅度优于对照组(P <0.05)。2组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论:顽痹清丸联合常规西药治疗湿热痹阻证强直性脊柱炎疗效显著,不增加不良反应的发生,可显著控制患者病情,改善其生活质量。
Objective:To observe the clinical effect of Wanbiqing Wan (顽痹清丸)combined with conventional Western medicine in treating ankylosing spondylitis of damp-heat-obstruction syndrome.Methods:Fifty-six cases of ankylosing spondylitis with damp-heat-obstruction syndrome were randomly divided into a treatment group and a control group,28 cases in each group.The control group was treated with meloxicam capsule and sulfasalazine enteric-coated tablets,while the treatment group was treated with Wanbiqing Wan based on the treatment of the control group.The two groups were treated 12 weeks as a course.The changes of TCM syndromes,ASAS20,ESR,CRP and other laboratory indicators were observed before and after treatment,and the adverse reactions were compared between the two groups.Results:For the curative effect of TCM syndromes:in the treatment group,3 cases were clinical cured,12 cases were markedly effective,10 cases were effective and3 cases were ineffective,the total effective rate being 89.29%;while in the control group,1 case was clinical cured,13 cases were markedly effective,8 cases were effective and 6 cases were ineffective,the total effective rate being 78.57%.There was a significant difference between the two groups(P < 0.05).For the curative effect of ASAS20:the standard rate of ASAS20 in the treatment group was 89.29%,and that in the control group standard rate was 75.00%,and the treatment group was significantly better than the control group(P < 0.05).After treatment,the scores of TCM syndromes,ESR and CRP in the two groups were significantly lower than those before treatment(P < 0.05),and the decrease of treatment group was better than the control group(P < 0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05).Conclusion:Wanbiqing Wan combined with conventional western medicine is effective in treating ankylosing spondylitis with Damp-heat-obstruction syndrome.It does not increase the incidence of adverse reactions,and can significantly control patients' condition and improve their quality of life.
Objective:To observe the clinical effect of Wanbiqing Wan (顽痹清丸)combined with conventional Western medicine in treating ankylosing spondylitis of damp-heat-obstruction syndrome.Methods:Fifty-six cases of ankylosing spondylitis with damp-heat-obstruction syndrome were randomly divided into a treatment group and a control group,28 cases in each group.The control group was treated with meloxicam capsule and sulfasalazine enteric-coated tablets,while the treatment group was treated with Wanbiqing Wan based on the treatment of the control group.The two groups were treated 12 weeks as a course.The changes of TCM syndromes,ASAS20,ESR,CRP and other laboratory indicators were observed before and after treatment,and the adverse reactions were compared between the two groups.Results:For the curative effect of TCM syndromes:in the treatment group,3 cases were clinical cured,12 cases were markedly effective,10 cases were effective and3 cases were ineffective,the total effective rate being 89.29%;while in the control group,1 case was clinical cured,13 cases were markedly effective,8 cases were effective and 6 cases were ineffective,the total effective rate being 78.57%.There was a significant difference between the two groups(P < 0.05).For the curative effect of ASAS20:the standard rate of ASAS20 in the treatment group was 89.29%,and that in the control group standard rate was 75.00%,and the treatment group was significantly better than the control group(P < 0.05).After treatment,the scores of TCM syndromes,ESR and CRP in the two groups were significantly lower than those before treatment(P < 0.05),and the decrease of treatment group was better than the control group(P < 0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05).Conclusion:Wanbiqing Wan combined with conventional western medicine is effective in treating ankylosing spondylitis with Damp-heat-obstruction syndrome.It does not increase the incidence of adverse reactions,and can significantly control patients' condition and improve their quality of life.
引文
[1]姬元庆,张九妹.中药复方对强直性脊柱炎防治的研究进展[J].中国骨质疏松杂志,2018,24(5):681-685.
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[9]吴超,娄玉玲,杨亚飞,等.强直性脊柱炎中医辨证分型研究进展[J].风湿病与关节炎,2015,4(6):69-72.
[10]杨少祥,郑福增,孟庆良,等.强直性脊柱炎的中西医治疗研究进展[J].风湿病与关节炎,2017,6(7):77-80.
[11]李鹤,周学龙,王明杰,等.强直性脊柱炎的中医药治疗概况[J].风湿病与关节炎,2015,4(3):74-77.
[12]刘念,沈嘉艳,许飞,等.强直性脊柱炎的中医诊疗进展[J].风湿病与关节炎,2018,7(12):73-76.
[13]王啸,李无阴.顽痹清丸治疗湿热痹阻证强直性脊柱炎33例临床研究[J].亚太传统医药,2019,15(2):146-149.
[14]李满意,娄玉钤.强直性脊柱炎的中医源流[J].风湿病与关节炎,2017,6(7):60-65.
[15]张永红,王笑青,张万义,等.顽痹清丸与白芍总苷胶囊治疗湿毒瘀热型类风湿关节炎的对比研究[J].中医正骨,2014,26(12):890-895.
[16]刘卫欣,卢兖伟,杜海涛,等.地黄及其活性成分药理作用研究进展[J].国际药学研究杂志,2009,36(4):277-280.
[17]黄丽婵,杨世奎,刘发元,等.川牛膝、怀牛膝治疗骨关节炎的药效物质基础探讨[J].风湿病与关节炎,2014,3(11):52-54.
[18]赵雪梅,王桂玲,费洪荣,等.紫草有效成分的提取及其抗炎作用研究[J].中药药理与临床研究,2008,24(4):36-38.
[19]郑勇凤,王佳婧,傅超美,等.黄芩的化学成分与药理作用研究进展[J].中成药,2016,38(1):141-147.
[2]冯方,孙永强.强直性脊柱炎的研究进展[J].风湿病与关节炎,2015,4(5):77-80.
[3]付长龙,郑春松,刘献祥.强直性脊柱炎药物治疗现状与思考[J].风湿病与关节炎,2014,3(10):72-76.
[4]中华医学会风湿病学分会.强直性脊柱炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(8):557-559.
[5]国家食品药品监督管理局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:116-119.
[6]ANDERSON JJ,BARON G,VAN DER HEIJDE D,et al.Ankylosing spondylitis assessment group preliminary definition of short-term improvement in ankylosing spondylitis[J].Arthritis Rheum,2001,44(8):1876-1886.
[7]LUKAS C,LANDEWéR,SIEPER J,et al.Development of an ASAS-endorsed disease activity score(ASDAS)in patients with ankylosing spondylitis[J].Ann Rheum Dis,2009,68(1):18-24.
[8]WARD MM,DEODHAR A,AKL EA,et al.American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis[J].Arthritis Rheumatol,2016,68(2):282-298.
[9]吴超,娄玉玲,杨亚飞,等.强直性脊柱炎中医辨证分型研究进展[J].风湿病与关节炎,2015,4(6):69-72.
[10]杨少祥,郑福增,孟庆良,等.强直性脊柱炎的中西医治疗研究进展[J].风湿病与关节炎,2017,6(7):77-80.
[11]李鹤,周学龙,王明杰,等.强直性脊柱炎的中医药治疗概况[J].风湿病与关节炎,2015,4(3):74-77.
[12]刘念,沈嘉艳,许飞,等.强直性脊柱炎的中医诊疗进展[J].风湿病与关节炎,2018,7(12):73-76.
[13]王啸,李无阴.顽痹清丸治疗湿热痹阻证强直性脊柱炎33例临床研究[J].亚太传统医药,2019,15(2):146-149.
[14]李满意,娄玉钤.强直性脊柱炎的中医源流[J].风湿病与关节炎,2017,6(7):60-65.
[15]张永红,王笑青,张万义,等.顽痹清丸与白芍总苷胶囊治疗湿毒瘀热型类风湿关节炎的对比研究[J].中医正骨,2014,26(12):890-895.
[16]刘卫欣,卢兖伟,杜海涛,等.地黄及其活性成分药理作用研究进展[J].国际药学研究杂志,2009,36(4):277-280.
[17]黄丽婵,杨世奎,刘发元,等.川牛膝、怀牛膝治疗骨关节炎的药效物质基础探讨[J].风湿病与关节炎,2014,3(11):52-54.
[18]赵雪梅,王桂玲,费洪荣,等.紫草有效成分的提取及其抗炎作用研究[J].中药药理与临床研究,2008,24(4):36-38.
[19]郑勇凤,王佳婧,傅超美,等.黄芩的化学成分与药理作用研究进展[J].中成药,2016,38(1):141-147.