补肾活血透邪法对强直性脊柱炎病情复发的影响

目的：探讨补肾活血透邪法对强直性脊柱炎（ankylosing spondylitis，AS）病情复发的影响。方法：将 60 例 AS 患者随机分为治疗组和对照组，每组各 30 例。治疗组按补肾活血透邪法，用补肾活血透邪方、双氯芬酸钠治疗；对照组用柳氮磺胺吡啶（sulfasalazine，SSZ）、双氯芬酸钠治疗；两组治疗 12 周后达到 ASAS20 改善的患者，停用双氯芬酸钠，治疗组继续使用补肾活血透邪方，对照组继续使用柳氮磺胺吡啶，每 2 周定期随访，直至病情复发或至 28 周，观察两组治疗后复发时间、Bath 强直性脊柱炎病情活动性指数（Bath AS disease activity index，BASDAI）、Bath 强直性脊柱炎功能指数（Bath AS functionalindex，BASFI）、脊柱痛、患者的总体评价积分，观察患者血沉（erythrosedim entation，ESR）、C-反应蛋白（C-reactive protein，CRP）、药物的不良反应。结果：12 周后共 51 例患者达到了 ASAS20 改善标准并进入随访研究，其中治疗组 27 例，对照组 24 例。至研究结束时，治疗组复发率为 51.8% ，复发时间中位数为 14 周；对照组复发率为 79.1% ，复发时间中位数为 10 周，两组比较，差异有统计学意义（P 〈 0.05）。治疗组在降低 ESR、CRP，改善 BASDAI、BASFI等各项观察指标优于对照组，差异有统计学意义（P 〈 0.05）。结论：AS 患者停用双氯芬酸钠后维持原药物治疗，多数患者病情会复发，早期联合使用补肾活血透邪方能够有效维持疗效，延缓复发，且无明显的不良反应。

Effect of the Therapy of Bushen Huoxue Touxie Method on Relapse of Ankylosing Spondylitis

Objective：To explore the effect of the therapy of bushen huoxue touxie on relapse of ankylosing spondylitis.Methods：Sixty patients with AS were randomly divided into two groups,30 patients in the treatment group were treated with BuShenHuoXueTouXieFang and diclofenac sodium.30 patients in the control group were treated with SSZ and diclofenac sodium.After 12 weeks,patients who attained an improvement ofASAS20,were followed up until relapse or 28 weeks after stopping using diclofenac sodium.The duration of relapse,Bath AS disease activity index（BAS-DAI）,Bath AS functional index（BASFI）,Visual Analogue Scale（VAS）of spinal pain,evaluation of patients,the erythrosedi mentation（ESR）,C-reactive protein（CRP）,as well as adverse effect of medicine were observed.Results：51 patients who attained an improvement ofASAS20 at week 12 were followed using a definition of relapse.The duration of relapse of treatment group was 14 weeks,however that in the control group was 10 weeks.The rates of relapse in the treatment group and control group were 51.8%,79.1%,respectively,The differents betweent the two groups were significantly（P〈0.05）.The treatment group also showed better results on down-regulation of ESR,CRP level and improvement of BASDAI,BASFI and other indexes after treatment（P〈0.05）.Conclusion：After discontinuing the diclofenac sodium keeping the initial medications almost patients completed disease relapsed within short times.Bushen huoxue touxiefang could prolong the duration of remission,but less adverse reaction in the treatment of AS.