补骨祛痛方辨证治疗强直性脊柱炎的临床疗效及对炎性因子的影响
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摘要
目的:观察补骨祛痛方治强直性脊柱炎的临床疗效及其对炎性因子的作用。方法:选取87例强直性脊柱炎患者随机分为2组,对照组43例,观察组44例,对照组患者口服来氟米特片,柳氮磺吡啶肠溶片,甲氨蝶呤片;观察组在对照组基础上加服补骨祛痛方,2组均连续治疗3个月。比较2组患者治疗前后血清中的C反应蛋白(CRP)、血沉(ESR)、肿瘤坏死因子-α(TNF-α)及白介素-6(IL-6)水平;比较治疗前后2组BASDAI、BASFI评分及活动功能评分;采用中医证候积分评价2组临床疗效。结果:2组患者给药后与给药前比较,ESR、CRP、TNF-α及IL-6水平显著降低(P<0.05);并且观察组比对照组的ESR、CRP、TNF-α及IL-6水平降低的幅度更明显(P<0.05)。治疗后2组患者BASDAI和BASFI评分显著下降,并且观察的BASDAI和BASFI评分显著低于对照组(P<0.05);治疗后2组的枕墙距、指地距、扩胸度、脊柱痛评分均显著降低(P<0.05),Schober试验指标明显上升(P<0.05),并且治疗后观察组的枕墙距、指地距、扩胸度、脊柱痛评分显著较对照组低(P<0.05),Schober试验指标显著较对照组高(P<0.05)。对照组的总有效率为79.1%,观察组的总有效率为90.1%,2组的临床疗效具有显著性差异(P<0.05)。结论补骨祛痛方治疗强直性脊柱炎疗效确切,其机制可能与调节体内炎性因子相关。
Objective: To explore the therapeutic effect of using Bugu Qutong Recipe in the treatment of ankylosing spondylitis and its effect on inflammatory factors. Methods: 87 cases of ankylosing spondylitis were randomly divided into 2 groups,43 cases in controlled group,44 cases in observation group,the controlled group was treated with Leflunomide Tablets,Sulfasalazine Enteric-coated Tablets,Methotrexate Tablets; The observation group was treated with Bugu Qutong Decoction on the basisi of the controlled group,the 2 groups were treated for 3 months. Comparison of 2 groups of patients before and after treatment of serum C reactive protein( CRP),erythrocyte sedimentation rate( ESR),tumor necrosis factor alpha( TNF-alpha) and interleukin-6( IL-6) level; Scores of 2 groups of BASDAI,BASFI score and function before and after treatment; The TCM syndrome score to evaluate the clinical efficacy of the 2 groups. Results: After treatment,the levels of ESR,CRP,TNF-alpha and IL-6 in the 2 groups were significantly lower than those in the controlled group( P<0. 05),and the ESR,CRP,TNF-alpha and IL-6 levels in the observation group decreased more significantly than those in the controlled group( P< 0. 05). After the treatment of 2 patients with BASDAI and BASFI scores were significantly decreased,and the observation of BASDAI and BASFI were significantly lower than the controlled group( P<0. 05); The 2 groups after treatment,pillow wall distance,mean distance,chest expansion,spinal pain scores were significantly lower( P<0. 05),Schober test index significantly increased( P< 0. 05),and after treatment in the observation group,pillow wall distance,mean distance,chest expansion,spinal pain scores were significantly lower than the controlled group( P<0. 05),Schober test index was significantly higher than the controlled group( P<0. 05). The total effective rate of the controlled group was 79. 1%,the total effective rate of the observation group was 90. 1%,and the clinical effect of the2 groups had significant difference( P<0. 05). Conclusion: Using Bugu Qutong Recipe in the treatment of ankylosing spondylitis is effective,and its mechanism may be related to the regulation of inflammatory factors in the body.
Objective: To explore the therapeutic effect of using Bugu Qutong Recipe in the treatment of ankylosing spondylitis and its effect on inflammatory factors. Methods: 87 cases of ankylosing spondylitis were randomly divided into 2 groups,43 cases in controlled group,44 cases in observation group,the controlled group was treated with Leflunomide Tablets,Sulfasalazine Enteric-coated Tablets,Methotrexate Tablets; The observation group was treated with Bugu Qutong Decoction on the basisi of the controlled group,the 2 groups were treated for 3 months. Comparison of 2 groups of patients before and after treatment of serum C reactive protein( CRP),erythrocyte sedimentation rate( ESR),tumor necrosis factor alpha( TNF-alpha) and interleukin-6( IL-6) level; Scores of 2 groups of BASDAI,BASFI score and function before and after treatment; The TCM syndrome score to evaluate the clinical efficacy of the 2 groups. Results: After treatment,the levels of ESR,CRP,TNF-alpha and IL-6 in the 2 groups were significantly lower than those in the controlled group( P<0. 05),and the ESR,CRP,TNF-alpha and IL-6 levels in the observation group decreased more significantly than those in the controlled group( P< 0. 05). After the treatment of 2 patients with BASDAI and BASFI scores were significantly decreased,and the observation of BASDAI and BASFI were significantly lower than the controlled group( P<0. 05); The 2 groups after treatment,pillow wall distance,mean distance,chest expansion,spinal pain scores were significantly lower( P<0. 05),Schober test index significantly increased( P< 0. 05),and after treatment in the observation group,pillow wall distance,mean distance,chest expansion,spinal pain scores were significantly lower than the controlled group( P<0. 05),Schober test index was significantly higher than the controlled group( P<0. 05). The total effective rate of the controlled group was 79. 1%,the total effective rate of the observation group was 90. 1%,and the clinical effect of the2 groups had significant difference( P<0. 05). Conclusion: Using Bugu Qutong Recipe in the treatment of ankylosing spondylitis is effective,and its mechanism may be related to the regulation of inflammatory factors in the body.
引文
[1]裘影影,汤郁,芮金兵,等.锝(-(99)Tc)亚甲基二磷酸盐治疗难治性强直性脊柱炎临床疗效观察[J].重庆医学,2016,45(29):4059~4061
[2]孟祖志,杨莹,王传荣.全髋关节置换术治疗强直性脊柱炎14例效果观察[J].临床军医杂志,2016,44(2):182~183
[3]徐萍,陶洪,袁良俊.阳和汤方加减治疗肾督亏虚寒湿痹阻型强直性脊柱炎临床研究[J].四川中医,2016,34(6):98~100
[4]周静,杨栋,王晋平,等.活血祛瘀中药溻渍联合西药治疗强直性脊柱炎活动期患者45例临床观察[J].中医杂志,2016,57(3):233~236
[5]黄旦,刘健,宋倩,等.强直性脊柱炎中医内外合治研究进展[J].中华中医药学刊,2016,34(11):2650~2652
[6]彭文旭.中医内外合治法治疗强直性脊柱炎的临床疗效分析[J].广州中医药大学学报,2016,33(4):473~477
[7]李有武,赵冬娣,袁涛.中西医综合疗法治疗肾虚寒湿型强直性脊柱炎22例临床研究[J].江苏中医药,2016,48(3):55~57
[8]刘强,熊小云.丹鹿通督片联合柳氮磺吡啶治疗强直性脊柱炎的临床研究[J].现代药物与临床,2017,32(3):472~476
[9]蔡波,成百朵,强建红.壮腰健肾丸联合柳氮磺吡啶治疗强直性脊柱炎的临床研究[J].现代药物与临床,2016,31(9):1399~1402
[10]戴小良,郑聪,宋利梅,等.南蛇藤合剂治疗强直性脊柱炎的时效性研究[J].湖南中医药大学学报,2017,37(9):992~997
[11]陈倩倩.五藤汤加减对活动期强直性脊柱炎患者血栓形成因子的影响及作用机制初探[J].四川中医,2017,35(8):93~96
[12]许兴辉.补肾强督方治疗强直性脊柱炎的临床效果[J].中国医药导报,2017,14(1):102~105
[13]姜益常,李远峰,宋寒冰,等.补肾强督祛湿法治疗肾虚督寒型强直性脊柱炎的临床疗效评价[J].中医药学报,2017,45(4):83~86
[14]蔡余力,张兴彩,胡亚黎,等.补肾通阳法对强直性脊柱炎患者CRP、BGP及CTX-I影响的研究[J].吉林中医药,2017,37(10):1005~1007
[15]许红娣.督灸结合甘草附子汤对强直性脊柱炎活动期炎症指标的影响[J].针灸临床杂志,2017,33(10):16~19
[16]高巧霞.督灸联合补肾祛寒化湿中药治疗强直性脊柱炎肾虚督寒证疗效及对ESR、炎性细胞因子的影响[J].现代中西医结合杂志,2017,26(10):1103~1106
[2]孟祖志,杨莹,王传荣.全髋关节置换术治疗强直性脊柱炎14例效果观察[J].临床军医杂志,2016,44(2):182~183
[3]徐萍,陶洪,袁良俊.阳和汤方加减治疗肾督亏虚寒湿痹阻型强直性脊柱炎临床研究[J].四川中医,2016,34(6):98~100
[4]周静,杨栋,王晋平,等.活血祛瘀中药溻渍联合西药治疗强直性脊柱炎活动期患者45例临床观察[J].中医杂志,2016,57(3):233~236
[5]黄旦,刘健,宋倩,等.强直性脊柱炎中医内外合治研究进展[J].中华中医药学刊,2016,34(11):2650~2652
[6]彭文旭.中医内外合治法治疗强直性脊柱炎的临床疗效分析[J].广州中医药大学学报,2016,33(4):473~477
[7]李有武,赵冬娣,袁涛.中西医综合疗法治疗肾虚寒湿型强直性脊柱炎22例临床研究[J].江苏中医药,2016,48(3):55~57
[8]刘强,熊小云.丹鹿通督片联合柳氮磺吡啶治疗强直性脊柱炎的临床研究[J].现代药物与临床,2017,32(3):472~476
[9]蔡波,成百朵,强建红.壮腰健肾丸联合柳氮磺吡啶治疗强直性脊柱炎的临床研究[J].现代药物与临床,2016,31(9):1399~1402
[10]戴小良,郑聪,宋利梅,等.南蛇藤合剂治疗强直性脊柱炎的时效性研究[J].湖南中医药大学学报,2017,37(9):992~997
[11]陈倩倩.五藤汤加减对活动期强直性脊柱炎患者血栓形成因子的影响及作用机制初探[J].四川中医,2017,35(8):93~96
[12]许兴辉.补肾强督方治疗强直性脊柱炎的临床效果[J].中国医药导报,2017,14(1):102~105
[13]姜益常,李远峰,宋寒冰,等.补肾强督祛湿法治疗肾虚督寒型强直性脊柱炎的临床疗效评价[J].中医药学报,2017,45(4):83~86
[14]蔡余力,张兴彩,胡亚黎,等.补肾通阳法对强直性脊柱炎患者CRP、BGP及CTX-I影响的研究[J].吉林中医药,2017,37(10):1005~1007
[15]许红娣.督灸结合甘草附子汤对强直性脊柱炎活动期炎症指标的影响[J].针灸临床杂志,2017,33(10):16~19
[16]高巧霞.督灸联合补肾祛寒化湿中药治疗强直性脊柱炎肾虚督寒证疗效及对ESR、炎性细胞因子的影响[J].现代中西医结合杂志,2017,26(10):1103~1106