基于名老中医经验传承寒热辨治强直性脊柱炎的临床研究  

Clinical Research of Pattern/Syndrome Differentiation and Treatment of Ankylosing Spondylitis Based on the Experiences of Distinguished Veteran Doctor of Traditional Chinese Medicine

作　　者：陶庆文[1] 徐愿[1] 孔维萍[1] 王建明[1] 阎小萍[1] 

机构地区：[1]中日友好医院,北京100029

出　　处：《世界中西医结合杂志》2013年第7期730-733,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：北京中医药科技项目(JJ2011-89);中医药行业专项(200807031)

摘　　要：目的总结阎小萍教授采用寒热辨治强直性脊柱炎的经验,评价其临床疗效和安全性。方法归纳阎小萍教授辨治强直性脊柱炎规律,形成肾虚督寒证和肾虚湿热证证候标准,将242例AS患者分两组,分别以补肾强督祛寒汤和补肾强督清化汤治疗4周,采用前瞻性、自身前后对照的临床研究方法进行评价。结果治疗后,肾虚督寒证组和肾虚湿热证组腰骶脊背疼痛等症状、枕墙距等体征、脊柱痛等评价指标、血沉等实验室指标较治疗前改善明显,差异有统计学意义(P<0.05或P<0.01);达到ASAS(the Assessment in SpondyloArthritis international Society,ASAS)20、50、70标准者分别为64.05%、29.75%、14.04%;达到BASDAI疾病活动指数(Bath Ankylosing Spondylitis Disease Activity Index,BASDAI)50者45.04%;中医疗效评估临床缓解23.97%,显效50.41%,总有效率达91.73%;寒热证候间差异无统计学意义。安全性评价:出现恶心呕吐1例,转氨酶轻度升高1例,大便偏稀6例,皮疹1例。结论阎小萍教授寒热辨治强直性脊柱炎疗效明确,安全可靠,值得临床推广。Objective To summarize Prof. Yan Xiao - ping＇s experiences in the treatment of anky losing spondylitis（AS） based on cold and heat pattern/syndrome differentiation and assess the clinical effica cy and safety. Methods The rule of Prof. Yah Xiao - ping＇s treatment of AS based on pattern/syndrome dif ferentiation was synthesized and the symptom criteria of kidney deficiency and Du - meridian cold pattern/ syndrome（ Group No. 1 ）and kidney deficiency and damp heat pattern/syndrome（ Group No. 2）were formed. Two hundred and forty - one patients of AS were divided into two groups and treated with Bushen Qiangdu Quhan Decoction and Bushen Qiangdu Qinghua Decoction for 4 weeks separately. The prospective and self controlling clinical research method was adopted. Results After treatment, the symptoms such as lumbosa cral and back pain, the physical signs such as occiput - to - wall distance, the assessment indexes such as spinal pain and laboratory indexes such as ESR in Group No. 1 and Group No. 2 were all improved apparently as compared with those before treatment, indicting the significant difference （ P 〈 0.05 or P 〈 0.01 ）. The per centages of standards 20,50 and 70 in ASAS （ Assessment in SpondyloArthritis International Society ） were 64.05% ,29.75% and 14.04% separately. The percentage of DASDAI 50（ Bath Ankylosing Spondylitis Dis ease Activity Index）was 45.04%. In the efficacy assessment of traditional Chinese medicine, the remarkably effective rate was 23.97%, the improving rate was 50.51% and the total effective rate was 91.73%. The differences were not significant statistically between cold pattern/syndrome and heat pattern/syndrome. Con cerning to safety assessment, 1 case had nausea and vomiting, 1 case mild increase of aminopherase,6 cases loss stool and 1 case skin rashes. Conclusion Prof. Yan Xiao - ping＇s experiences in the treatment of anky- losing spondylitis（ AS） based on cold and heat pattern/syndrome differentiation present definite efficacy and reliable safety a

关 键 词：强直性脊柱炎 寒热辨治 肾虚督寒证 肾虚湿热证 

分 类 号：R249[医药卫生—中医临床基础] R593.23[医药卫生—中医学]