养血益气、补肾通络法治疗强直性脊柱炎的疗效观察

目的研究养血益气、补肾通络法对强直性脊柱炎的疗效与安全性。方法所选80例强直性脊柱炎(AS)患者,按照随机数字表分为益气养血补肾、祛邪通络法研究组40例和柳氮磺吡啶对照组40例,总疗程皆为8周,观察治疗前后患者症状、体征、实验室检查、生活质量、心理状态的变化等。结果 (1)研究组国际强直性脊柱炎工作小组提出的AS疗效评价标准评估改善20%(ASAS 20)、Bath强直性脊柱炎疾病活动指数改善50%(BASDAI 50)分别为80.0%,70.0%,对照组分别为75.0%,62.5%,研究组疗效高于对照组,差异无统计学意义(P0.05)。(2)研究组中医证侯疗效总有效率90.0%,对照组为82.5%,差异无统计学意义(P0.05),但研究组有效率(70.0%)显著高于对照组(45.0%),差异有统计学意义(P0.05)。(3)治疗后研究组各项中医症状积分均明显降低,研究组在降低患者少气懒言、心悸、胸闷、气短积分显著优于对照组(P0.05)。(4)治疗后两组患者的视觉模拟评分(VAS)、BASDAI、Bath强直性脊柱炎躯体功能指数(BASFI)、健康综合评分(BAS-G)各项积分均显著下降,研究组在改善BASFI、BAS-G积分上显著优于对照组(P0.05)。(5)两组治疗前后生活质量及焦虑、抑郁情绪变化比较,两组治疗后生活质量总积分及各维度积分均显著升高(P0.01),焦虑自评量表(SAS)、抑郁自评量表(SDS)显著降低(P0.01);与对照组比较,研究组治疗后生活质量总积分及各维度积分显著升高(P0.01),SAS、SDS显著降低(P0.01)。(6)治疗后研究组红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、免疫球蛋白(Ig G)均降低;对照组ESR、hs-CRP显著降低(P0.05或P0.01);与对照组相比,研究组能显著降低Ig G水平(P0.05或P0.01)。研究组未发现有不良反应。结论养血益肾、祛邪通络法治疗强直性脊柱炎,明显改善强直性脊柱炎的症状、体征、中医证候、功能活动、生活质量、实验室检查、免疫学等综合指标,疗效与柳氮磺胺吡啶相当甚至优于后者。

Efficacy of Yi Qi,Bushentongluo therapy on Ankylosing Spondyliti

Objective To study the effect of traditional Chinese medicine of YangXue YiShen and QuXie TongLuo regulating immune in patients with AS and evaluate its curative effect and safety.Methods 80 patients with AS were which randomly assigned for traditional Chinese medicine of YangXue YiShen and QuXie TongLuo as the re-search group (n =40)and Sulfasalazine as the control group (n =40).The total course of treatment was 8 weeks.After the end of treatment,the symptoms,signs,laboratory examination,quality of life and psychological status of patients with ankylosing spondylitis were observed.Results (1)The comparison of clinical curative effect in tow groups.The ASAS 20 and BASDAI 50 of the research group that the group of kidney nourishing and blood and Quxie Tongluo were respec-tively 80.0% and 70.0%,and the control group were respectively 75.0%,and 62.5%.Compared with the control
group,the curative effect of the research group was higher,but there was no statistically significant difference between the two groups(P >0.05).(2)The comparison of TCM syndrome curative effect in two groups between before and after treatment.The research group total effective rate 90.0%,the control group the total effective rate was 82.5%.There was no significant differenceabout the total effective rate in two groups(P >0.05).But compared with the control group (45.0%),the effective rate of the research group(70.0%)was significantly increased,and had statistical significance (P <0.05).(3)The changes of traditional Chinese medicine symptom integral of before and after treatment in the two groups.Team in patients with lower gas less lazy words,heart palpitations,chest tightness,shortness of breath integral significantly better than that of control group (P <0.05).(4)The change of the main symptoms and signs before and af-ter treatment in two groups.After treatment with a significant reduction in the integration of the two group.Compared with the control group after treatment,the team on the improvement of BAS FI,BAS -G integral significantly better than that of control group (P <0.05).(5)The change of the quality of life,and anxiety,depression,mood of before and after treat-ment in two groups.Compared with the control group after treatment,the team and the quality of life after treatment the total integral dimension score significantly increased (P <0.01 ),SAS,SDS,significantly reduced (P <0.01 ).(6) Changes of laboratory indexes before and after treatment in both groups.Compared with before treatment,C3 of the re-search group was significantly higher after treatment;ESR,hs-CRP,IgG decreased;ESR,hs-CRP of control group sig-nificantly reduced (P <0.05 or P <0.01);Compared with control group,the level of IgG significantly reduced in the research group (P <0.05 or P <0.01).Conclusion The Yangxue Yishen,Quxie Tongluo obviously improved compre-hensive indexes of the signs and symptoms,syndromes,functional activity,quality of life,laboratory examination,immu-nology etc of AS patients.Curative effect is comparable to western medicine SASP or better than the latter,effect is satis-fying.