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李欣玲,吴金玉,蒋君艳,樊泽锋,镇立,梁迪,陈永贵.健脾除痹汤联合沙利度胺治疗强直性脊柱炎的临床研究[J].湖南中医药大学学报,2018,38(6):706-710[点击复制] |
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健脾除痹汤联合沙利度胺治疗强直性脊柱炎的临床研究 |
李欣玲,吴金玉,蒋君艳,樊泽锋,镇立,梁迪,陈永贵 |
(广西中医药大学, 广西 南宁 530000;广西中医药大学第一附属医院风湿病科, 广西 南宁 530000) |
摘要: |
目的 探讨健脾除痹汤联合沙利度胺治疗脾虚湿阻型强直性脊柱炎(ankylosing spondylitis,AS)的临床疗效及安全性。方法 将46例AS患者随机分为治疗组(23例)和对照组(23例),对照组给予沙利度胺+双氯酚酸口服,治疗组在对照组的基础上联合健脾除痹汤治疗,疗程12周。比较两组患者总体评价(BAS-G)、AS活动指数(BASDAI)、AS功能指数(BASFI)、脊柱痛VAS评分、晨僵程度、晨僵时间、中医证候积分、体征和实验室指标等变化。疗效评估采用ASAS评分和总有效率比较。结果 (1)治疗组ASAS20缓解率(69.6%)优于对照组(34.8%),差异具有统计学意义(P<0.05)。(2)治疗组和对照组总有效率分别为82.6%和52.2%,差异有统计学意义(P<0.05)。(3)治疗组对BAS-G、BASDAI、BASFI、脊柱痛VAS评分、晨僵程度、Schober试验及ESR的改善优于对照组(P<0.05,P<0.01)。(4)治疗组不良反应发生率(17.4%)低于对照组(56.5%)(P<0.05)。结论 健脾除痹汤联合沙利度胺治疗AS疗效优于单用西药组,且安全性好。 |
关键词: 强直性脊柱炎 健脾除痹汤 脾虚湿阻 沙利度胺 临床研究 |
DOI:10.3969/j.issn.1674-070X.2018.06.021 |
投稿时间:2018-03-05 |
基金项目:2017年研究生教育创新计划资助项目(YJSP201734)。 |
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Clinical Study of Jianpi Chubi Decoction Combined with Thalidomide in Treatment of Ankylosing Spondylitis |
LI Xinling,WU Jinyu,JIANG Junyan,FAN Zefeng,ZHEN Li,LIANG Di,CHEN Yonggui |
(Guangxi University of Chinese Medicine, Nanning, Guangxi 530000, China;Department of Rheumatology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi 530000, China) |
Abstract: |
Objective To investigate the efficiency and safety of Jianpi Chubi decoction combined with thalidomide in treating ankylosing spondylitis (AS). Methods Forty-six patients with AS in the hospital were selected and randomly divided into the control group (n=23) and the treatment group (n=23). Oral administration of thalidomide and diclofenac were given to the all patients, meanwhile, Jianpi Chubi decoction was given to the patients in the treatment group. After twelve weeks of treatment, Bath AS global index (BAS-G), Bath AS disease activity index (BASDAI), Bath AS function index (BASFI),the VAS sore of spine pain, morning stiffness duration, morning stiffness severity, Chinese medicine symptom score, the signs and laboratory indexes were compared between the two groups. ASAS criterion and the Chinese medicine efficiency standard were for the evaluation of the clinical effect. Results (1) The remission rate of ASAS20 in the treatment group (69.6%) was higher than that in the control group (34.8%), the difference has statistical significance (P<0.05). The total effective rate was 82.6% in the treatment group, and 52.2% in the control group; the difference was statistically significant (P<0.05). (2) The total effective rate in the treatment group and control group was 82.6% and 52.2%, respectively (P<0.05). (3) Improvement of BAS-G, BASDAI, BASFI, the VAS sore of spine pain, morning stiffness duration, morning stiffness severity, Schober experiment and ESR in the treatment group was better than control group (P<0.05, P<0.01). (4) The rate of adverse reaction in the treatment group (17.4%) was lower than that in the control group (56.5%). Conclusion Jianpi Chubi decoction combined with thalidomide in treating AS is safe and shows better effect than that of Western medicine alone. |
Key words: ankylosing spondylitis Jianpi Chubi decoction deficiency of spleen leading to accumulation of dampness thalidomide clinical study |
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