运用强脊康复汤治疗强直性脊柱炎（肾督亏虚型）的临床观察

发布时间：2019-04-24 06:08

【摘要】：目的:通过采用强脊康复汤对治疗肾督亏虚型强直性脊柱炎的临床疗效,分析其对炎症指标(ESR、CRP),枕墙距、指地距的影响,初步探讨强脊康复汤对肾督亏虚型强直性脊柱炎的治疗作用及可能机制。方法:收集来自开封淮河医院中医科门诊50名患者均符合肾督亏虚型患者,按照随机数字分组表分为治疗组25例和对照组25例。对照组采用柳氮磺吡啶(疼痛评分(VAS评分)4分时,给予醋氯芬酸)治疗,治疗组在对照组的基础上加用强脊康复汤治疗,观察期均为3个月,通过中、西医的评价标准,评估强脊康复汤对强直性脊柱炎肾督亏虚型的临床疗效。结果:1.试验组28例,因无法坚持3个月的观察周期,脱落3例患者,因此试验组进行有效观察25例,对照组25例。2.实验组、对照组中医证候疗效总有效率92%、84%,差异有统计学意义(P0.05),实验组优于对照组。3.实验组、对照组达到ASAS20标准分别为17例、23例。差异有统计学意义(P0.05),即以ASAS20为疗效标准时,两组的治疗效果试验组显著优于对照组。4.实验组与对照组治疗后指地距、ESR、CRP数值较治疗前降低,差异有统计学意义(P0.05),枕墙距较治疗前无改善,差异无统计学意义(P0.05)。组间比较,指地距、ESR、CRP差异有统计学意义(P0.05)枕墙距差异无统计学意义(P0.05)。5.治疗前后患者、疼痛评分、BASDAI指数、BASFI指数比较,结果差异有统计学意义(P0.05),两组间的临床症状治疗后均较治疗前有所改善。组间比较,患者疼痛评分、BASDAI指数、BASFI指数差异有统计学意义(P0.05),临床症状的改善程度试验组较对照组明显。结论:强脊康复汤联合柳氮磺吡啶与单纯应用柳氮磺吡啶对强直性脊柱炎肾督亏虚型均有明显的疗效,在改善AS患者疾病活动度方面效果明显,但两种治疗方式相比强脊康复汤联合柳氮磺吡啶在改善中医证候疗效、降低炎症指标(ESR、CRP)方面优于单纯使用柳氮磺吡啶;提示强脊康复汤能够抗炎止痛、延缓病情进展,且强脊康复汤具有补肾通督、逐瘀蠲浊,强筋健骨之功效,在临床上对肾虚督亏的病人效果显著,安全性好,副作用小,对治疗强直性脊柱炎有很好的前景。
[Abstract]:Objective: to analyze the effect of Qiangji Kangkangtang on inflammatory index (ESR,CRP), occipital-wall distance and finger-to-ground distance in the treatment of ankylosing spondylitis of deficiency type of kidney. To explore the therapeutic effect and possible mechanism of Qiangji Kangkangtang on ankylosing spondylitis of deficiency type of kidney. Methods: 50 patients from Kaifeng Huaihe Hospital were collected and divided into treatment group (n = 25) and control group (n = 25) according to randomly divided into two groups: treatment group (n = 25) and control group (n = 25). The control group was treated with sulfasalazine (VAS score) 4 points, and the treatment group was treated with Qiangji Kangkangtang on the basis of the control group. The observation period was 3 months. The evaluation criteria of Chinese and western medicine were adopted in the treatment group, and the patients in the treatment group were treated with Qiangji Kangkangtang on the basis of the control group. To evaluate the clinical effect of Qiangji Kangkangtang on ankylosing spondylitis with deficiency of kidney and governor. Results: 1. There were 28 patients in the test group, who could not hold on to the 3-month observation period, and 3 patients fell off. Therefore, 25 patients in the test group were observed effectively and 25 patients in the control group were observed. The total effective rate of TCM syndrome in experimental group and control group was 92% and 84%, the difference was statistically significant (P0.05). The experimental group was better than the control group. The experimental group and the control group reached the ASAS20 standard in 17 cases and 23 cases respectively. The difference was statistically significant (P0.05), that is, when ASAS20 was used as the therapeutic standard, the therapeutic effect of the two groups was significantly better than that of the control group. After treatment between the experimental group and the control group, the number of finger-to-ground distance and ESR,CRP decreased significantly (P0.05), the occipital wall distance did not improve than before treatment, there was no significant difference (P0.05). Group comparison, finger distance, ESR,CRP difference was statistically significant (P0.05) occipital wall distance difference was not statistically significant (P0.05). 5. Before and after treatment, the pain score, BASDAI index and BASFI index were significantly different between the two groups (P0.05), and the clinical symptoms between the two groups were improved after treatment. There were significant differences in pain score, BASDAI index and BASFI index between groups (P0.05). The improvement degree of clinical symptoms in the experimental group was significantly higher than that in the control group. Conclusion: Qiangji Kangkangtang combined with sulfasalazine and sulfasalazine alone has obvious curative effect on ankylosing spondylitis with deficiency of kidney and governor, and it has obvious effect on improving the disease activity of patients with AS, and it is effective in improving the disease activity of patients with ankylosing spondylitis. However, compared with Qiangji Kangkangtang combined with sulfasalazine, the two treatment methods were better than using sulfasalazine alone in improving the curative effect of TCM syndrome and reducing the inflammatory index (ESR,CRP). It is suggested that Qiangji Kangkangtang can anti-inflammatory and relieve pain, delay the progress of the disease, and Qiangjishou decoction has the effect of tonifying the kidney, removing blood stasis, strengthening tendons and invigorating bones, and it has obvious effect on the patients with deficiency of kidney, good safety and little side effect. There is a good prospect for the treatment of ankylosing spondylitis.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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