湿热型强直性脊柱炎中医内外合治的临床数据挖掘研究

发布时间：2018-08-06 09:13

【摘要】：目的探讨中医论治湿热型强直性脊柱炎的特色及中医内外合治治疗强直性脊柱炎的疗效及初步以实验室指标验证中医内外合治的优越性。方法基于临床数据挖掘技术,对232例湿热型强直性脊柱炎住院患者进行回顾性研究,以住院期间是否使用外治法为条件,对232例湿热型强直性脊柱炎患者进行分组,并收集与分析各组中药情况。采用SPSS 17.0统计软件,计量资料以均数±标准差(xs恕纒)表示,以t检验对各指标进行统计学分析中医单纯内治、内外合治与血常规、脂代谢、炎症指标、免疫指标、氧化应激指标的情况。结果 232例湿热型强直性脊柱炎患者单纯内治组80例(34%),内外合治组152例(66%),(1)外治法中消瘀接骨散、中药熏蒸、麝香镇痛膏、芙蓉膏、芙蓉膏联合消瘀接骨散居前五位。(2)健脾祛湿药以陈皮、薏苡仁、茯苓、山药、泽泻为主;清热解毒药以蒲公英、蛇舌草、黄柏、黄芩、地丁、知母为主;祛风除湿药以威灵仙、狗脊、宧莶草、伸筋草、羌独活为主;活血化瘀药以丹参、桃仁、红花、鸡血藤、牛膝为主。(3)单纯内治组患者的免疫指标IgA、炎症指标(ESR、hs-CRP、α1-AGP)、超氧化物岐化酶(SOD)、血小板(PLT)均有所降低(P0.05或P0.01);内外合治组患者的免疫指标(C3、C4、IgA)、炎症指标(ESR、hs-CRP、α1-AGP、ASO)、超氧化物岐化酶(SOD)、血小板(PLT)均有所降低(P0.05或P0.01);内外合治组较单纯内治组超氧化物歧化酶(SOD)、血沉(ESR)改善更为显著(P0.05)。结论根据各用药的比例分析,治疗湿热型强直性脊柱炎以从脾论治为主,兼顾肝肾,配伍祛风除湿、活通络、清热解毒等药物的配方原则,形成了以院内制剂外敷为主配合膏药外贴及中药外用的内外合治的治疗体系,内外合治作为我院风湿科的特色疗法,具有一定的疗效,在改善患者免疫炎症及SOD指标上较单纯内治法治疗疗效更加显著。
[Abstract]:Objective to discuss the characteristics of TCM treatment of damp heat ankylosing spondylitis and the therapeutic effect of internal and external treatment on ankylosing spondylitis with internal and external treatment in traditional Chinese medicine and to verify the superiority of internal and external treatment of TCM with laboratory indexes. Methods based on clinical data mining, 232 patients with damp and hot ankylosing spondylitis were retrospectively studied in hospital period. 232 cases of damp and hot ankylosing spondylitis were divided into groups, 232 cases of damp and hot ankylosing spondylitis were collected and analyzed. The statistical software of SPSS 17 was used, the measurement data were expressed with mean standard deviation (XS forgiveness), and the statistical scores of each index were analyzed by t test, the internal and external treatment and blood routine, lipid metabolism were analyzed. Results of 232 cases of damp heat type ankylosing spondylitis in 80 cases (34%), 152 cases in internal and external treatment group (34%), 152 cases in internal and external treatment group (66%), (1) elimination of blood stasis and receiving bone powder in external treatment, Chinese medicine fumigation, musk analgesic ointment, Hibiscus paste, and hibiscus cream in the top five. (2) invigorating spleen and dispelling dampness medicine with Tangchen peel and job job Tuckahoe, tuckahoe, yam, Alisma orientalis mainly; the antipyretic drugs are mainly dandelion, hytitis, Radix Scutellariae, Radix Scutellariae, radix and Anemarrhenae; the drugs for removing wind and dehumidification are mainly with the dehumidium, the spine of the dog, the extensor grass, and the Qiang alone. (3) the immune index of the patients in the group of simple internal treatment group (3) the inflammatory index (ESR, Hs-CRP, alpha 1-AGP), superoxide dismutase (SOD) and platelets (PLT) decreased (P0.05 or P0.01); immune indexes (C3, C4, IgA) in patients with internal and external treatment (ESR, hs-CRP, alpha 1-AGP), superoxide dismutase, and blood plates were reduced. (SOD), the improvement of erythrocyte sedimentation rate (ESR) is more significant (P0.05). Conclusion according to the analysis of the proportion of various drugs, the treatment of damp and hot ankylosing spondylitis mainly from the spleen theory, both liver and kidney, combination of dispelling wind and dehumidification, activating collaterals, clearing heat and detoxifying drugs, forming the internal and external treatment with external application of hospital preparation and external use of traditional Chinese medicine. The treatment system, internal and external treatment as the characteristic therapy in our department of rheumatism, has a certain effect. It is more effective in improving the patient's immune inflammation and the SOD index than the simple internal therapy.
【作者单位】：安徽中医药大学;安徽中医药大学第一附属医院;
【基金】：国家中医药重点学科中医痹病学建设项目(No.国中医药发[2009]30号) 国家临床重点专科中医风湿病科建设项目(No.财社[2013]239号) 国家自然基金青年项目(No.81403388) 安徽省重点实验室建设项目(No.1306c083035) 安徽省科技攻关项目(No.1604a0802085) 安徽省自然科学基金项目(No.1508085QH159)
【分类号】：R259

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