补肾强督治偻汤联合督灸治疗强直性脊柱炎的临床观察

目的:观察补肾强督治偻汤联合督灸治疗强直性脊柱炎(肾虚督寒证)的疗效及安全性。方法:将40例门诊患者随机按数字表法分为两组,治疗组18例采用中药加上督灸治疗,对照组20例单用中药汤剂治疗。两组疗程均为12周。进行治疗前后中医证候积分的评价;观察治疗前后巴氏强直性脊柱炎活动指数(BASDAI),巴氏强直性脊柱炎功能指数(BASFI),患者总体评价(PGA),脊柱痛VAS,指地距,枕墙距,胸廓活动度,腰椎活动度(Schober试验)等变化情况;检测治疗前后血沉(ESR)和超敏C-反应蛋白(CRP)水平;进行肝、肾、血常规等安全性指标检查。结果:治疗组中医证候总有效率为94.4%,对照组为70%,治疗组优于对照组(P0.05);治疗组ASAS20,ASAS50,BASDAI50例数多于对照组(P0.05);治疗后治疗组指地距,PGA,脊柱痛、脊柱炎症,BASDAI等的改善优于对照组(P0.05);治疗后治疗组中医症状积分低于对照组(P0.05);治疗后两组ESR和CRP水平均比治疗前下降(P0.05,P0.01),但组间比较差异无统计学意义;两组治疗期间均发现肝、肾功能及血常规明显异常,未见严重不良反应发生。结论:补肾强督治偻汤联合督灸内外合用明显优于单用中药内服,且安全性较好,具有广阔的应用前景。

Clinical Observation of Bushen Qiangdu Zhilou Decoction Combined Du-moxibustion in Treating Ankylosing Spondylitis

Objective: To observe the efficacy and safety of Bushen Qiangdu Zhilou decoction combined du-moxibustion in treating ankylosing spondylitis of kidney deficiency and cold syndrome. Method: Fourty patients were selected from the Rheumatism clinic and randomly divided into the combination group (traditional Chinese medicine combined du-moxibustion treatment) and the control group (Chinese medicine treatment). All patients received 12 weeks of treatment. Before and after treatment, the integral score of Chinese medical syndrome, the Bath ankylosing spondylitis activity index (BASDAI), the Bath ankylosing spondylitis functional index (BASFI), patients' overall evaluation (PGA), spinal pain VAS, refers to the distance, pillow wall distance, thoracic mobility, lumbar motion changes (Schober test), blood sedimentation (ESR) and c-reactive protein (CRP) level were measured. At the same time, the adverse reactions like liver function test, kidney function test, blood routine examination were recorded during the treatment. Result: The total effectiveness of symptomatic efficacy in the combination group was 94.4%, which was superior to that of 70% in the control group (P<0.05). The cases of ASAS20, ASAS50 and BASDAI50 in the combination group were more than those in the control group (P<0.05).The improvements of the refers to the distance spinal pain, spinal inflammation, the BASDAI, score of Chinese medical symptom were better in the treatment group as compared with the control group (P<0.05). Levels of ESR and CRP decreased in the two groups after treatment (P<0.05, P<0.01), but there was no statistically significant difference between the two groups. Unusual liver and kidney function, and blood routine tests were found during the treatment. However, no serious adverse reactions were found. Conclusion: Bushen Qiangdu Zhilou decoction combined du-moxibustion could enhance the clinical curative effect and safety greatly in treating ankylosing spondylitis, and it has wide application prospect.