右归汤加减治疗肾虚督寒型强直性脊柱炎临床观察

发布时间：2019-05-11 09:47

【摘要】：目的:观察右归汤加减治疗肾虚督寒型强直性脊柱炎的疗效及安全性,并探讨其作用机制。方法:将165例肾虚督寒型强直性脊柱炎患者随机分为中药组(52例)、西药组(53例)和中西药组(60例)。中药组给予右归汤加减,西药组给予双氯芬酸钠缓释片,中西药组同时给予右归汤加减和双氯芬酸钠缓释片,疗程均为56 d。观察各组治疗前后活动度衡量指数(BASMI),疾病功能指数(BASFI),放射学指数(BASRI)和中医辨证肾虚督寒型强直性脊柱炎中医证候评分;检测治疗前后血沉(ESR),C-反应蛋白(CRP)和甲状旁腺激素(PHI)的变化;比较各组有效率及不良反应发生率。结果:治疗后中西药组总有效率87.7%,优于中药组的76.5%和西药组的73.5%(P0.05);中药组和西药组比较无统计学差异;中西药组和中药组中医证候评分较西药组改善更为明显(P0.05);中西药组其他临床症状评分均较中药组和西药组改善明显(P0.05),中药组和西药组比较无统计学差异;不良反应的发生率中药组(1.9%)小于中西药组(17.5%),中西药组(17.5%)小于西药组(30.6%)(P0.05)。结论:右归汤加减治疗肾虚督寒型强直性脊柱炎的疗效与西药双氯芬酸钠缓释片无明显差异,具有有效性,且不良反应发生率较双氯芬酸钠缓释片低;右归汤加减结合双氯芬酸钠缓释片治疗肾虚督寒型强直性脊柱炎疗效优于双氯芬酸钠缓释片。
[Abstract]:Objective: to observe the efficacy and safety of Yougui decoction in the treatment of ankylosing spondylitis with kidney deficiency and cold type, and to explore its mechanism. Methods: 165 patients with ankylosing spondylitis with kidney deficiency and cold were randomly divided into traditional Chinese medicine group (52 cases), western medicine group (53 cases) and Chinese and western medicine group (60 cases). The traditional Chinese medicine group was given Yougui decoction, the western medicine group was given diclofenac sodium sustained-release tablets, and the Chinese and western medicine group was given Yougui decoction and diclofenac sodium sustained-release tablets at the same time. The course of treatment was 56 days. Before and after treatment, the activity index (BASMI), disease function index (BASFI), radiology index (BASRI) and TCM syndrome score of syndrome differentiation of kidney deficiency and cold type ankylosing spondylitis were observed. The changes of erythrocyte sedimentation rate (erythrocyte sedimentation rate) (ESR), C-reactive protein (CRP) and parathyroid hormone (PHI) were measured before and after treatment, and the effective rate and the incidence of adverse reactions in each group were compared. Results: after treatment, the total effective rate of Chinese and western medicine group was 87.7%, which was better than that of traditional Chinese medicine group (76.5%) and western medicine group (73.5%), but there was no significant difference between traditional Chinese medicine group and western medicine group. The scores of TCM syndromes in the Chinese and western medicine group and the traditional Chinese medicine group were significantly better than those in the western medicine group (P 0.05), and the scores of other clinical symptoms in the Chinese and western medicine group were significantly better than those in the traditional Chinese medicine group and the western medicine group (P 0.05), but there was no significant difference between the traditional Chinese medicine group and the western medicine group. The incidence of adverse reactions in the traditional Chinese medicine group (1.9%) was lower than that in the Chinese and western medicine group (17.5%), and that in the Chinese and western medicine group (17.5%) was lower than that in the western medicine group (30.6%) (P 0.05). Conclusion: the therapeutic effect of Yougui decoction on ankylosing spondylitis of kidney deficiency and cold type is not significantly different from that of diclofenac sodium sustained-release tablets, and the incidence of adverse reactions is lower than that of diclofenac sodium sustained-release tablets. Yougui decoction combined with diclofenac sodium sustained-release tablets is superior to diclofenac sodium sustained-release tablets in the treatment of ankylosing spondylitis with kidney deficiency and cold.
【作者单位】：河南省中医院;郑州市第九人民医院;郑州市中医院;
【基金】：河南省重点科技攻关计划项目(092102310181)
【分类号】：R259

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