益肾蠲痹法对放弃MTX、SSZ治疗的强直性脊柱炎疗效观察

观察益肾蠲痹法治疗放弃甲氨蝶呤（MTX）、柳氮磺吡啶（SSZ）治疗的强直性脊柱炎（AS）患者的疗效。方法本研究为回顾性研究,应用＂益肾蠲痹法＂方法,对66例放弃MTX、SSZ治疗的AS患者连续治疗3年后,观察治疗前后临床症状、患者躯体功能、红细胞沉降率（ESR）、C反应蛋白（CRP）、HLA-B27和骶髂关节X线片的变化。结果 66例AS患者治疗后的Bath AS活动指数、功能指数、测量指数（BASDAI、BASMI、BASFI）积分显著下降（P〈0.05）,ESR、CRP明显下降（P〈0.05）;骶髂关节X线片有4例由Ⅰ级好转为0级,其余62例骶髂关节面模糊均有明显好转;24例患者HLA-B27转阴,阴转率达36.3%。结论益肾蠲痹法对于放弃MTX、SSZ治疗的难治性AS,具有疗效高、毒副作用小、症状及实验室指标改善明显等理想疗效,是一种易于推广使用、具有良好产业化前景的治疗方法。

Efficacy Observation of Yishen Jianbi Method(Reinforcing Kidney Expelling Impediment Method)on Ankylosing Spondylitis with MTX and SSZ Discontinuity

Objective To observe the efficacy of yishen jianbi method（reinforcing kidney expelling impediment method）on ankylosing spondylitis（AS）with methotrexate（MTX）and salfasalazine（SSZ）discontinuity.Methods Retrospective study and yishen jianbi method were adopted.After continuous 3-year treatment for 66 cases of AS that was discontinued the treatment with MTX and SSZ,the changes were observed before and after treatment in terms of clinical symptoms,physical function,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,HLA-B27 and X-ray of sacroiliac joint.Results After treatment,Bath AS activity index,function index and measurement index（BASDAI,BASMI and BASFI）were all reduced significantly for 66 cases of AS（P0.05）,ESR and CRP decreased remarkably（P0.05）.Of 66 cases,it was found in X-ray of sacroiliac joint that 4 cases were improved from I grade to 0 grade and the rest 62 cases were improved obviously in blurred sacroiliac joint surface.24 cases presented negative conversion of HLA-B27,and the conversion rate was 36.3%.Conclusion Yishen jianbi method presents a high efficacy,less side effects and obvious improvements in symptoms and laboratory indexes for intractable AS with MTX and SSZ discontinuity.This therapeutic method is apt to be promoted in practice and will bring a good industrialization prospect.