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1.
目的:探讨益肾壮督汤联合柳氮磺胺吡啶治疗强直性脊柱炎(AS)的疗效及对炎性因子及腰椎功能的影响。方法:选取2017年6月至2019年10月山东省烟台市中医院收治的AS患者88例作为研究对象,按照随机数字表法分为对照组和观察组,每组44例。对照组给予柳氮磺胺吡啶片治疗,观察组在此基础上增加补肾强督汤治疗,2组均连续服用2个月。比较2组临床疗效;观察2组治疗前后晨僵时间、疼痛程度、Bath功能指数(BASFI)、Bath疾病活动指数(BASDAI)、Dougados指数、指地距及枕墙距改善情况;检测并比较2组血清炎性因子。结果:治疗后观察组总有效率为95.45%,高于对照组的81.82%,差异有统计学意义(P0.05)。治疗后2组患者晨僵时间、指地距和枕墙距均缩短,BASFI、BASDAI、VAS评分、Dougados指数及血清IL-4、IL-12及TNF-α、CRP水平均降低,且观察组低于对照组,差异有统计学意义(P0.05)。结论:补肾强督汤联合柳氮磺胺吡啶可有效降低AS患者疼痛程度及血清炎性因子水平,改善临床症状及腰椎功能、关节功能,提高总体治疗效果。 相似文献
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目的 观察腰痛宁胶囊联合艾瑞昔布片治疗强直性脊柱炎寒湿瘀阻证的临床疗效。方法 120例患者随机分为治疗组和对照组各60例;对照组口服艾瑞昔布片,治疗组口服艾瑞昔布片、腰痛宁胶囊。比较两组患者治疗前后巴氏AS功能指数(BASFI)、巴氏AS病情活动指数(BASDAI)、评分,血沉(ESR)、C反应蛋白(CRP)水平,中医证候评分,评定综合疗效。结果 两组治疗前BASDAI、BASFI评分,ESR、CRP水平,中医证候评分比较差别不大,治疗后组内比较,两组各项评分及ESR、CRP水平均降低(P<0.05),治疗后组间比较,治疗组各项评分及ESR、CRP水平低于对照组(P<0.05);治疗组总有效率86.67%优于对照组的65.00%(P<0.01)。结论 腰痛宁胶囊能有效改善强直性脊柱炎临床证候,降低炎症指标及疾病活动度,改善患者功能活动指数,疗效确切。 相似文献
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Hana Sahli Asma Bachali Raoudha Tekaya Ines Mahmoud Yassine Sedki Olfa Saidane Leila Abdelmoula 《Foot and Ankle Surgery》2019,25(2):226-230
Background
The purpose of this study was to evaluate the foot involvement in a group of patients with spondyloarthritis in regard to symptoms, type and frequency of deformities, location and radiological changes.Methods
We conducted a cross sectional study including 60 patients with spondyloarthritis over a period of six months. Anamnesis, clinical examination, podoscopic examination, biological tests and X-rays of feet were done for each patient.Results
Foot involvement was found in 31 patients (52%). It was symptomatic in 35% of cases and inaugural in 42% of cases. The most frequent site was the hindfoot (22 patients/31). Radiological findings were: erosion (17%), reconstruction (33%), erosion and reconstruction (50%). Forefoot involvement was found in 18/31 patients. Forefoot deformities were found in 9 patients. Two patients had sausage toe and feet skin abnormalities were observed in 12 patients. At podoscopic examination, 23 patients had abnormal footprints. Foot involvement was more frequent in peripheral spondyloarthritis (p = 0.008). Patients with foot involvement had an advanced age of disease onset (p = 0.05), a shorter disease duration (p = 0.038) and more comorbidities (p = 0.039). Foot involvement was correlated with C Reactive protein (p = 0.043).Conclusion
In our study, foot involvement and foot symptoms were seen frequently in spondyloarthritis and it is associated with late onset of the disease and with higher inflammation in blood tests. 相似文献5.
Background
Despite significant pain relief following total hip arthroplasty (THA) in patients with ankylosing spondylitis, a small subset of patients presenting with extra-articular extension contracture of hips remains unsatisfied.Methods
We retrospectively evaluated the patients with ankylosing spondylitis who underwent simultaneous bilateral THA and had extensor tightness of both hips preoperatively. They were managed with modified Z-plasty of iliotibial band. Patients with windswept deformity, commonly seen in bilateral hip arthritis caused by ankylosing spondylitis, were excluded.Results
Between July 2011 and June 2015, out of 148 patients with bilateral hip involvement, 10 patients (20 hips) had extension contracture of both hips that was addressed during surgery. All patients were followed up for a minimum of 2 years. They could sit comfortably on a chair of height 18 inches with hips and knees flexed to at least 90°. The mean postoperative sum range of motion was 144.6° with an average hip flexion of 95° (range, 90°-105°). None of them had recurrence of extension contracture. There was significant improvement in range of motion and hence ambulation and function. No radiolucent lines exceeding 2 mm were seen in any of the zones around either of the components as evaluated in latest X-rays.Conclusion
Extension contracture of hip although rare is a noticeable problem and needs to be addressed during THA. Modified Z-plasty technique of iliotibial band is a reliable method in managing these patients. 相似文献6.
强直性脊柱炎(ankylosing spondylitis,AS)是一种自身免疫功能异常引起的以慢性炎症性关节炎为主要表现的疾病,可发展为脊柱关节炎,慢性炎症和病理性骨形成是它的两个主要病理特点。进行性的脊柱关节僵硬引起的脊柱活动障碍是患者最常见的主诉,因此对脊柱关节的异常骨增生的病理机制得到广泛的关注。但随着对AS研究的深入,发现在脊柱局部过度骨化的同时伴有系统性的骨丢失,表明AS发病过程不仅仅是单一的成骨或破骨异常,而是处于兼有两者的骨代谢失衡环境中。目前研究发现AS疾病中Wnt、BMP信号通路和炎症反应在AS疾病中既促进成骨,又能影响破骨细胞形成;而破骨细胞在发挥骨吸收作用的同时,它的产物又参与了新生骨形成。但大多数研究均是着重于描述单独的成骨或破骨机制,未能明确地阐明它们是如何在引起脊柱周围骨质增生的同时导致全身骨量丢失的具体作用机制。AS病理过程中炎症因子是否在不同的部位发挥不同的作用,如何在控制新生骨形成的同时减少骨质疏松发生的风险,这些问题仍需要得到进一步的探索研究。 相似文献
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Fawad Aslam Frederick Spencer Chivers Krupa B. Doshi April Chang‐Miller 《International journal of rheumatic diseases》2019,22(12):2213-2217
A 36‐year‐old man was treated for several years with multiple agents for ankylosing spondylitis based on positive human leukocyte antigen‐B27 and sacroiliitis. He was also diagnosed with osteoporosis and hypophosphatemia. Over these years, from being an avid runner, he became dependent on a walker for ambulation. The lack of treatment response and the low phosphorus were clues that eventually led to a diagnosis of tumor‐induced osteomalacia. This case discusses the importance of not solely relying on genetic markers and sacroiliitis for diagnosing ankylosing spondylitis as other conditions can cause similar presentations. 相似文献
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