温肾通督法治疗强直性脊柱炎（肾虚督寒型）的临床疗效观察

发布时间：2019-05-29 18:57

【摘要】：目的:本课题将以中医理论作为指导,观察温肾通督法治疗肾虚督寒型强直性脊柱炎患者全身痛VAS评分、BASFI评分、枕墙距、指地距、炎症指标及中医症候积分治疗前后的对比;评价温肾通督法的有效性及安全性;为该方法治疗AS提供理论依据。方法:全部病例来自河南中医药大学第二附属医院风湿骨病科2015年4月至2016年01月门诊或病房的病人。采用随机数字表法将研究对象分为治疗组和对照组,治疗组给予口服温肾通督汤配合督灸治疗,对照组给予柳氮磺吡啶肠溶片+双氯芬酸钠缓释片治疗。4周为1个疗程,共观察12周。结果:12周治疗疗程结束后,治疗组总有效率为93.3%,优于对照组的90%。温肾通督法可以明显缓解AS患者的症状,降低全身痛VAS、BASFI评分、枕墙距、指地距、血沉、C反应蛋白、中医症候积分等各项指标,尤其对患者指地距、枕墙距、中医症候积分有显著性差异,治疗组优于对照组。在治疗过程中,没有药物的过敏现象,但是对照组有2例受试者出现了恶心、呕吐、腹泻、纳差等胃肠道不适的症状,给予对症支持治疗,症状消失,不影响实验的进一步深入。在治疗结束后复查血、尿常规、肝、肾功能,治疗组未见异常;对照组有3例呈现出肝功能升高,予其对症处理。结论:温肾通督法治疗AS肾虚督寒型在缓解患者的症状、减低炎症指标、改善中医症候积分等方面有确切的疗效,可能与药物的镇痛、抗炎、调节免疫等作用相关,安全性有保障,值得进行更深一步研究。
[Abstract]:Objective: under the guidance of traditional Chinese medicine (TCM) theory, the VAS score, BASFI score, occipital wall distance, finger distance, inflammatory index and TCM syndrome score in the treatment of ankylosing spondylitis with kidney deficiency and cold type were observed. To evaluate the effectiveness and safety of Wenshen Tongdu method, and to provide theoretical basis for the treatment of AS. Methods: all the cases were from outpatient department or ward from April 2015 to January 2016 in the Department of Rheumatology, the second affiliated Hospital of Henan University of traditional Chinese Medicine. The subjects were randomly divided into treatment group and control group. The treatment group was treated with Wenshen Tongdu decoction combined with moxibustion, and the control group was treated with diclofenac sodium sustained-release tablets. 4 weeks as a course of treatment. A total of 12 weeks were observed. Results: after 12 weeks of treatment, the total effective rate of the treatment group was 93.3%, which was better than that of the control group (90%). Wenshen Tongdu method can obviously relieve the symptoms of AS patients, reduce the VAS,BASFI score of systemic pain, occipital wall distance, finger-to-ground distance, erythrocyte sedimentation rate, C-reactive protein, TCM syndrome score and other indicators, especially for patients with finger-to-ground distance, occipital wall distance. There was significant difference in TCM syndrome score, and the treatment group was superior to the control group. In the course of treatment, there was no allergic phenomenon of drugs, but in the control group, 2 subjects had symptoms of gastrointestinal discomfort, such as nausea, vomiting, diarrhea, anorexia, etc., and gave symptomatic support treatment, and the symptoms disappeared. It does not affect the further deepening of the experiment. After treatment, the blood, urine routine, liver and kidney function were not abnormal in the treatment group, and 3 cases in the control group showed elevated liver function, which were treated with symptomatic treatment. Conclusion: the treatment of AS syndrome with kidney deficiency and cold by warming kidney Tongdu method has definite curative effect on relieving symptoms, reducing inflammatory indexes and improving syndrome score of traditional Chinese medicine, which may be related to analgesic, anti-inflammatory and immunomodulatory effects of drugs. Safety is guaranteed and it is worth further study.
【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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