附子汤加减联合西药治疗强直性脊柱炎寒湿痹阻证临床研究
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R593.23

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第四批全国中医(临床、基础) 优秀人才研修项目(国中医药人教发[2017]-24号)


Clinical Study on Modified Fuzi Tang Combined with Western Medicine for Ankylosing Spondylitis with Cold-Dampness Obstruction Syndrome
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    摘要:

    目的:观察附子汤加减联合西药治疗强直性脊柱炎(AS) 寒湿痹阻证的临床疗效。方法:将80 例患者随机分为对 照组和观察组各40 例。2 组均服用美洛昔康片与沙利度胺片,观察组加予附子汤加减内服。2 组疗程均为6 个月。于治疗前、治疗3 个月和6 个月评价脊柱疼痛视觉模拟评分法(VAS) 评分、巴氏AS 功能指数(BASFI) 评分、巴氏AS 疾病活动性指数(BASDAI) 评分、医生整体评估(PGA) 评分、肾虚督亏证积分,并检测C-反应蛋白(CRP) 和血沉(ESR) 水平,比较2 组的国际脊柱关节炎评估工作组(ASAS) 20、ASAS50、BASDAI50 达标率。结果:治疗后,观察组ASAS20 达标率为97.5%,高于对照组的77.5% (P<0.05);观察组ASAS50 达标率为82.5%,高于对照组的57.5% (P<0.05);观察组BASDAI50 达标率为70.0%,高于对照组的47.5% (P<0.05)。治疗3 个月,2 组脊柱痛VAS 评分、寒湿痹阻证积分、PGA 评分、BASFI 评分、BASDAI 评分及CRP、ESR 水平均较治疗前下降(P<0.01);治疗6 个月,2 组5 项分值及CRP、ESR 水平均较治疗3 个月时下降(P<0.01)。观察组治疗3 个月和治疗6 个月的脊柱痛VAS 评分、寒湿痹阻证积分、PGA 评分、BASFI 评分、BASDAI 评分及CRP、ESR 水平均低于同期对照组(P<0.01)。结论:在美洛昔康片与沙利度胺片的基础上予附子汤加减方治疗寒湿痹阻型AS患者,可更好地控制脊柱疼痛等症状,抑制疾病的活动,提高临床效果。

    Abstract:

    Abstract:Objective:To observe the clinical effect of modified Fuzi tang combined with western medicine for ankylosing spondylitis(AS) with cold-dampness obstruction syndrome. Methods:A total of 80 cases of patients were randomly divided into the control group and the observation group, 40 cases in each group. Both groups were given meloxicam tablets and thalidomide tablets,and the observation group was additionally treated with oral administration of modified Fuzi tang. Both groups were treated for six months. Before treatment as well as after three-month and six-month treatments,the scores of Visual Analogue Scale(VAS) for evaluating spinal pain,the scores of Bath Ankylosing Spondylitis Functional Index(BASFI),the scores of Bath Ankylosing Spondylitis Disease(BASDAI),Physician's Global Assessment(PGA),and the syndrome scores of kidney-governor vessel deficiency were evaluated;the levels of C-reactive protein(CRP) and erythrocyte sedimentation rate (ESR) were detected, and the standard- reaching rates of Assessment of SpondyIoArthritis International Society(ASAS)20, ASAS50 and BASDAI50 were compared between the two groups. Results:After treatment,the standard-reaching rate of ASAS20 was 97.5% in the observation group, higher than that of 77.5% in the control group(P<0.01); the standardreaching rate of ASAS50 was 82.5% in the observation group,higher than that of 57.5% in the control group(P<0.05);the standard-reaching rate of BASDAI50 was 70.0% in the observation group,higher than that of 47.5% in the control group(P< 0.05). After three- month treatment, the VAS scores of spinal pain, the syndrome scores of kidney- governor vessel deficiency,the scores of PGA,BASFI and BASDAI,and the levels of CRP and ESR in the two groups were decreased when compared with those before treatment(P<0.01);after six- month treatment,the above five scores and the levels of CRP and ESR in the two groups were decreased when compared with those after three-month treatment(P<0.01). After threemonth and six- month treatments, the VAS scores of spinal pain, the syndrome scores of kidney- governor vessel deficiency,the scores of PGA,BASFI and BASDAI,and the levels of CRP and ESR in the observation group were all lower than those in the control group at the same period(P<0.01). Conclusion: Based thalidomide tablets and onmeloxicam tablets, the therapy of modified Fuzi tang in treating AS patients of cold- dampness obstruction type can better control symptoms like spinal pain,inhibit the activities of the disease,and improve clinical effect.

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俞琪芳,丁红生,吴潍.附子汤加减联合西药治疗强直性脊柱炎寒湿痹阻证临床研究[J].新中医,2020,52(19):27-30

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  • 在线发布日期: 2020-10-12
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