牛贝活血祛痰方治疗强直性脊柱炎痰瘀痹阻证临床观察
发布时间：2018-07-28 09:21
【摘要】：研究目的:分析比较强直性脊柱炎痰瘀痹阻证治疗前后各项观察指标的改善情况,对牛贝活血祛痰方治疗强直性脊柱炎痰瘀痹阻证的有效性和安全性进行临床评价,为临床推广提供可信依据。研究内容及方法:本研究共收集病例66例,采用随机对照法随机分为试验组和对照组,试验过程中试验组脱落1例,对照组脱落2例,最终试验组32例,对照组31例。对照组服用柳氮磺吡啶肠溶片和洛索洛芬钠片治疗,试验组在对照组基础上加服牛贝活血祛痰方。两组均要求患者进行常规肢体功能锻炼,减少负重和劳累,观察时间两个月,记录各项观察指标,用统计软件SPSS24.0综合分析,评定临床疗效。研究结果:1基线比较两组患者入组时年龄、性别、病程、主要症状积分、BASDAI、脊柱疼痛VAS评分、PGA及实验室指标(ESR、CRP)比较,均无统计学差异(p0.05),两组具有可比性。2疗效比较中医证候疗效中,试验组总有效率为84.39%,对照组为58.07%,差异有统计学意义(P0.05)。3中医证候积分组内疗效比较,试验组治疗前后比较有统计学意义(p0.05)。对照组在腰骶疼痛、脊背疼痛、腰脊活动受限、夜间疼痛、晨僵、外周关节肿胀方面治疗前后疗效比较有统计学意义(p0.05);在肌肤紫暗、肢体困重、腰膝酸软方面治疗前后疗效比较无统计学意义(p0.05)。组间疗效比较,两组在腰骶疼痛、脊背疼痛、腰脊活动受限、夜间疼痛、四肢关节肿胀、肌肤紫暗、腰膝酸软方面组间疗效比较有统计学意义(p0.05);在晨僵、肢体困重方面,组间疗效比较无统计学意义(p0.05)。4 BASDAI、脊柱VAS评分、PGA评分试验组、对照组的BASDAI、脊柱VAS评分、PGA评分组内和组间疗效比较均有统计学意义(p0.05)。5实验室指标试验组、对照组的ESR、CRP组内和组间疗效比较均有统计学意义(p0.05)。6安全性分析试验组有1例患者在治疗过程中出现恶心、呕吐等胃肠不适,对照组有1例患者出现轻度腹泻、1例患者肝功能出现异常。经过对症处理后均得到好转,按时完成试验。两组其余患者在试验过程中并未发现血常规、便常规、肝肾功等异常现象。研究结论:柳氮磺砒啶肠溶片、洛索洛芬钠片联合牛贝活血祛痰方与单用柳氮磺砒啶肠溶片、洛索洛芬钠片治疗痰瘀痹阻型强直性脊柱炎在改善患者症状、体征、脊柱功能及炎症指标方面均有效果,使病情得以延缓;但联合牛贝活血祛痰方比单用柳氮磺砒啶肠溶片、洛索洛芬钠片总体疗效更好,总有效率更高,改善中医症候方面效果更确实。可见,牛贝活血祛痰方联合柳氮磺吡啶肠溶片、洛索洛芬钠片治疗强直性脊柱炎痰瘀痹阻证能获得满意临床疗效和安全性。
[Abstract]:Objective: to analyze and compare the improvement of observation indexes before and after treatment of ankylosing spondylitis phlegm stasis obstruction syndrome, and to evaluate the efficacy and safety of Niubai Huoxue Quphan recipe in treating ankylosing spondylitis with phlegm stasis obstruction syndrome. To provide reliable basis for clinical popularization. Contents and methods: a total of 66 cases were randomly divided into two groups: the experimental group (1 case), the control group (2 cases), the final test group (32 cases) and the control group (31 cases). The control group was treated with sulfasalopyridine enteric-coated tablets and losuprofen sodium tablets, while the experimental group was treated with Niubai Huoxue Ququan recipe on the basis of the control group. The patients in both groups were required to perform routine limb function exercises to reduce the burden and tiredness, observe for two months, record the observation indexes, and evaluate the clinical efficacy by comprehensive analysis of statistical software SPSS24.0. Results the age, sex, course of disease, main symptom score, VAS score of spinal pain and laboratory index (ESR-CRP) were compared between the two groups at baseline of 1: 1. There was no statistical difference between the two groups (p0.05). In the two groups, the total effective rate was 84.39 in the experimental group and 58.07 in the control group, and the difference was statistically significant (P0.05) in the TCM syndromes integral group, and the total effective rate was 84.39 in the experimental group and 58.07 in the control group, and the difference was statistically significant (P0.05). There was significant difference before and after treatment in the experimental group (p 0.05). In the control group, there were significant differences before and after treatment in lumbosacral pain, back pain, limited lumbar spinal activity, nocturnal pain, morning stiffness and swelling of peripheral joints (p0.05). There was no significant difference in the curative effect before and after treatment (p0.05). There was significant difference between the two groups in lumbosacral pain, back pain, limited lumbar spinal movement, nocturnal pain, swelling of extremities, dark skin and sore waist and knee (p0.05); There was no significant difference in curative effect between groups (p0.05) 4.BASDAI, spinal VAS score and PGA score in test group, control group, spinal VAS score and VAS score in group A and between groups were statistically significant (p0.05). The efficacy of ESR-CRP in the control group was statistically significant (p0.05) the safety analysis showed that one patient in the trial group had gastrointestinal discomfort such as nausea and vomiting during the course of treatment. In the control group, 1 patient had mild diarrhea and 1 patient had abnormal liver function. After the symptomatic treatment were improved, the test was completed on time. The other patients in the two groups did not find blood routine, liver and kidney function and other abnormal phenomena. Conclusion: salbutamuridine enteric-coated tablets, iosoprofen sodium tablets combined with Niubei Huoxue Quphan decoction and single salicylobuprofen enteric-coated tablets can improve the symptoms and signs of ankylosing spondylitis of phlegm-stasis type. The spinal function and inflammation index were all effective, so that the disease could be delayed, but the combination of Niubai Huoxue Quphan recipe was better and the total effective rate was higher than that of salbutamuridine enteric-coated tablet alone, and the total effective rate was higher than that of single salicyloprofen sodium tablet. The improvement of TCM symptoms is more effective. It can be seen that Niubai Huoxue Quphan recipe combined with sulfampyridine enteric-coated tablets and losuprofen sodium tablets can obtain satisfactory clinical efficacy and safety in treating ankylosing spondylitis with phlegm stasis obstruction syndrome.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259
本文编号：2149639
[Abstract]:Objective: to analyze and compare the improvement of observation indexes before and after treatment of ankylosing spondylitis phlegm stasis obstruction syndrome, and to evaluate the efficacy and safety of Niubai Huoxue Quphan recipe in treating ankylosing spondylitis with phlegm stasis obstruction syndrome. To provide reliable basis for clinical popularization. Contents and methods: a total of 66 cases were randomly divided into two groups: the experimental group (1 case), the control group (2 cases), the final test group (32 cases) and the control group (31 cases). The control group was treated with sulfasalopyridine enteric-coated tablets and losuprofen sodium tablets, while the experimental group was treated with Niubai Huoxue Ququan recipe on the basis of the control group. The patients in both groups were required to perform routine limb function exercises to reduce the burden and tiredness, observe for two months, record the observation indexes, and evaluate the clinical efficacy by comprehensive analysis of statistical software SPSS24.0. Results the age, sex, course of disease, main symptom score, VAS score of spinal pain and laboratory index (ESR-CRP) were compared between the two groups at baseline of 1: 1. There was no statistical difference between the two groups (p0.05). In the two groups, the total effective rate was 84.39 in the experimental group and 58.07 in the control group, and the difference was statistically significant (P0.05) in the TCM syndromes integral group, and the total effective rate was 84.39 in the experimental group and 58.07 in the control group, and the difference was statistically significant (P0.05). There was significant difference before and after treatment in the experimental group (p 0.05). In the control group, there were significant differences before and after treatment in lumbosacral pain, back pain, limited lumbar spinal activity, nocturnal pain, morning stiffness and swelling of peripheral joints (p0.05). There was no significant difference in the curative effect before and after treatment (p0.05). There was significant difference between the two groups in lumbosacral pain, back pain, limited lumbar spinal movement, nocturnal pain, swelling of extremities, dark skin and sore waist and knee (p0.05); There was no significant difference in curative effect between groups (p0.05) 4.BASDAI, spinal VAS score and PGA score in test group, control group, spinal VAS score and VAS score in group A and between groups were statistically significant (p0.05). The efficacy of ESR-CRP in the control group was statistically significant (p0.05) the safety analysis showed that one patient in the trial group had gastrointestinal discomfort such as nausea and vomiting during the course of treatment. In the control group, 1 patient had mild diarrhea and 1 patient had abnormal liver function. After the symptomatic treatment were improved, the test was completed on time. The other patients in the two groups did not find blood routine, liver and kidney function and other abnormal phenomena. Conclusion: salbutamuridine enteric-coated tablets, iosoprofen sodium tablets combined with Niubei Huoxue Quphan decoction and single salicylobuprofen enteric-coated tablets can improve the symptoms and signs of ankylosing spondylitis of phlegm-stasis type. The spinal function and inflammation index were all effective, so that the disease could be delayed, but the combination of Niubai Huoxue Quphan recipe was better and the total effective rate was higher than that of salbutamuridine enteric-coated tablet alone, and the total effective rate was higher than that of single salicyloprofen sodium tablet. The improvement of TCM symptoms is more effective. It can be seen that Niubai Huoxue Quphan recipe combined with sulfampyridine enteric-coated tablets and losuprofen sodium tablets can obtain satisfactory clinical efficacy and safety in treating ankylosing spondylitis with phlegm stasis obstruction syndrome.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259
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