补肾强督法为主的综合疗法治疗强直性脊柱炎临床和实验系列研究  

Comprehensive Therapy of Invigorating the Kidney and Du meridian on Ankylosing Spondylitis:A Series Study of Clinical and Experimental Research

作　　者：阎小萍[1] 陶庆文[1] 孔维萍[1] 王建明[1] 徐愿[1] 王昊[1] 张英泽[1] 朱俊岭 罗薇[1] 路平[1] 金笛儿[1] 马骁[1] 张楠[1] 颜珏[1] 张卫[1] 鞠海[1] 彭建英[3] 易竞阳 邱新萍 

机构地区：[1]中日友好医院,北京100029 [2]河南省平顶山市消防支队卫生队,河南平顶山467544 [3]贵州省安顺市人民医院,贵州安顺561000 [4]甘肃省武威市人民医院,甘肃武威733000 [5]北京市顺义区中医医院,北京顺义101300

出　　处：《风湿病与关节炎》2012年第3期10-18,共9页Rheumatism and Arthritis

基　　金：国家科技支撑计划(2007BAI10B02-05);首都医学发展基金(03Ⅱ03);国家中医药管理局科技项目(04-05LP08);北京中医药发展经费(JJ-2006-114)

摘　　要：目的:创立强直性脊柱炎的中医病名及辨证论治体系;从临床和实验两个方面研究补肾强督法为主的综合疗法治疗强直性脊柱炎的有效性及其作用机理。方法:以继承与发扬为宗旨结合临床实践经验,创立强直性脊柱炎中医病名及辨证论治体系。研究补肾强督法为主的综合疗法治疗强直性脊柱炎的有效性及其作用机理。临床研究采用前瞻对照方法,以主要症状、体征、免疫炎性指标、骨密度等为观测指标,并以ASAS20作为疗效评价体系评价疗效;实验研究采用细胞培养、ELISA、RT-PCR等方法,观察效方对炎性因子、骨代谢指标、骨破坏相关因子、成纤维细胞等的调节作用。结果:创立强直性脊柱炎的中医病名——"大偻"和"寒热为纲",以及其辨治体系;提出以补肾强督法为主的"五连环"和"综合强化序贯"疗法治疗强直性脊柱炎;研发出一种用于治疗强直性脊柱炎的中药——补肾舒脊颗粒;证实强直性脊柱炎早期即存在骨量丢失,补肾强督法能双向调节强直性脊柱炎骨代谢、提高强直性脊柱炎骨密度、改善血瘀证候,调节促炎性细胞因子、T细胞平衡,调节骨破坏因子、成纤维细胞、成骨细胞功能。结论:创立的"大偻"及"寒热为纲"辨治体系对强直性脊柱炎的辨证论治有较好的指导作用;经临床、实验研究证实,补肾强督法为主的"五连环"和"综合强化序贯"疗法疗效显著,并具有调节强直性脊柱炎免疫失调、减轻炎症、抗纤维化、抗骨破坏等作用。Objective： To found the name and syndrome differentiation and treatment system of ankylosing spondylitis in traditional Chinese medicine （TCM）, and study the validity and mechanism of the comprehensive therapy based on invigorating the kidney and Du meridian on ankylosing spondylitis by clinical and experimental research.Methods：For inheriting and improving and combining with clinical and practical experience, we founded the name and syndrome differentiation and treatment system ofankylosing spondylitis in TCM, and study the validity and mechanism of the comprehensive therapy based on invigorating the kidney and Du meridian on ankylosing spondylitis. By prospective control clinical research, the mare symptoms, signs, inflammatory indexes, and bone mineral density were as the observation indexes, and ASAS20 as the evaluation system of curative effect. In experimental research, by cell culture, ELISA, RT-PCR method, we observed the effects of the comprehensive therapy based on invigorating the kidney and Du meridian on inflammatory factors on bone metabolic marker （BMM）, bone damage correlation factors, fibroblasts, etc, study the mechanism of the BuShenQiangDu treatment of ankylosing spondylit from the pro-inflammatory cytokines, T cell balance, bone destruction factor, fibroblast cells, osteoblasts. Results： Created ＂Da Lou＂ （disease name of TCM） and ＂Syndrome Differentiation Based on Cold and Heat＂ and differential treatment system, we proposed the five serial comprehensive, reinforced and sequential therapy based on invigorating the kidney and Du meridian on ankylosing spondylit, and developed a new Chinese medicine treating ankylosing spondylit： Bushenshuji Granula. In the study, it was confirmed there was bone mass loss in early stage of ankylosing spondylit, by invigorating the kidney and Du meridian bone metabolism in ankylosing spondylit was regulated, bone mineral density in ankylosing spondylit increased, blood stasis syndrome improved, the balance of pro-inflammatory cytokine

关 键 词：脊柱炎 强直性 大偻 寒热为纲辨证体系 补肾强督法 五连环和综合强化序贯疗法 临床研究 实验研究 

分 类 号：R259[医药卫生—中西医结合]