白芍总苷与甲氨蝶呤和柳氮磺胺吡啶联合应用治疗强直性脊柱炎的疗效及优越性观察(英文)  

Effect and superiority of the application of total glucosides of white peony,combined with methotrexate and sulfasalazine in the treatment of ankylosing spondylitis

作　　者：邓兆智[1] 叶雪英[2] 钟秋生[3] 吴月芹[4] 王维华[2] 王宝爱[2] 

机构地区：[1]广东省中医院风湿科,广东省广州市510120 [2]广州中医药大学中医系,广东省广州市510405 [3]广东省东莞市石龙人民医院ICU,广东省东莞市511721 [4]天津市第一中心医院中医西结合科,天津市300192

出　　处：《中国临床康复》2005年第27期236-238,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:白芍总苷为白芍中提取的有效成分,具有较好的抗炎和镇痛作用。目的:观察白芍总苷联合甲氨蝶呤和柳氮磺胺吡啶治疗强直性脊柱炎的协同疗效作用及其毒副作用。设计:随机对照观察。单位:广州省中医院风湿科。对象:选择2003-06/2004-04广东省中医院风湿科门诊收治强直性脊柱炎患者80例。随机分为2组,每组各40例。签书面知情同意书。方法:治疗组:口服白芍总苷胶囊2粒,3次/d;甲氨蝶呤10mg/次,1次/周;柳氮磺胺吡啶0.5g/次,3次/d。对照组:口服甲氨蝶呤和柳氮磺胺吡啶,剂量和方法同治疗组。两组均用尼美舒利,0.1g/次,2次/d。疗程均为3个月。于治疗前及治疗4,8,12周进行脊柱功能评价和实验室检查。主要观察指标:主要结局:Bath强直性脊柱炎活动指数、Bath强直性脊柱炎功能指数,晨僵时间,全身和脊柱疼痛Likert4级积分以及患者和医生的总体评价积分。次要结局:①血沉、C反应蛋白、Schober实验、扩胸度、枕墙距和指地距。②不良事件和副反应。结果:治疗组完成了38例和对照组完成了37例患者的观察。①两组患者主要疗效指标中Bath强直性脊柱炎活动指数和功能指数、晨僵时间、全身疼痛积分、脊柱疼痛积分、患者的总体评价积分、医生的总体评价积分结果:两组治疗4,8和12周与各自0周比较均明显下降(P<0.05);治疗组4周时Bath强直性脊柱炎活动指数、全身和脊柱疼痛Likert4级积分、患者和医生的总体评价积分及8周和12周各指标均较对照组有显著下降(P<0.05)。②两组患者次要疗效指标中血沉、C反应蛋白、Schober试验、扩胸度、枕墙距、指地距的评估结果:治疗组4,8和12周各指标较治疗前显著下降(P<0.05);对照组4周时Schober试验、扩胸度、指地距及8和12周较治疗前显著下降(P<0.05)。治疗组12周时血沉、C反应蛋白、扩胸度、指地距较对照组显著下降。③不良事件和�BACKGROUND： Total glucosides of paeony, effective component extracted from peony, has good inflammatory and analgesic effect. OBJECTIVE： To investigate the curative effect and side effect of total glucosides of paeony combined with methotrexate and sulfasalazine in the treatment of ankylosing spondylitis . DESIGN： Randomized and controlled observation. SETTING： Department of Rheumatology , Guangdong Hospital of Traditional Chinese Medicine PARTICIPANTS： Totally 80 inpatients with ankylosing spondylitis hospitalized in the Clinic of Department of Rheumatology , Guangdong Hospital of Traditional Chinese Medicine from June 2003 to April 2004 were involved. The patients were randomly divided into 2 groups with 40 patients in each group. Informed consent was obtained. METHODS： Experimental group： 2 capsules of total glucosides of peony was taken orally, three times per day ; methotrexate 10 mg/time, once per week; sulfasalazine 0.5 g/time, three times per day. Control group： methotrexate and sulfasalazine were taken orally and the dosage and method were the same as those in the experimental group. Two groups all used the same NSAID （Nimesulide） , 0.1 g/time , twice per day. The period of the treatment was 3 months. Evaluation of spinal column function and laboratory examination was performed before treatment and 4, 8 and 12 weeks after treatment. MAIN OUTCOME MEASURES： Primary outcomes： Bath ankylosing spondylitis activity index, Bath ankylosing spondylitis function index, duration of morning stiffness, systemic pain and spinal pain on a four point Likert scale, overall assessment of patient and physician on a four point scale. Secondary outcomes： ①erythrocyte sedimentation, C-reaction protein, Sehober test, chest expansion , Occiput to wall distance and finger to floor distance.② Adverse events and side effects. RESULTS： The observation of 38 patients in the experiemtnal group and 37 patients in the control group was completed. ①Result of Bath ankylosing spondylitis activity index, B

关 键 词：脊柱炎 强直性 白芍 甲氨蝶呤 柳氮磺胺吡啶 

分 类 号：R681.5[医药卫生—骨科学]