强脊通络颗粒治疗肾虚痰瘀型强直性脊柱炎的临床观察  

Clinical observation on Qiangji Tongluo Granules in the treatment of ankylosing spondylitis with syndrome of kidney deficiency and phlegm stasis

作　　者：韩善夯[1] 王敏[1] 纪伟[1] 

机构地区：[1]南京中医药大学附属医院(江苏省中医院),江苏南京210029

出　　处：《上海中医药杂志》2016年第12期53-56,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：江苏省中医药局科技项目(LZ13005);国家中医药管理局重点学科"中医痹病学开放基金课题"项目(BBXK2013105);国家自然科学基金青年项目(81403240)

摘　　要：目的观察强脊通络颗粒治疗肾虚痰瘀型强直性脊柱炎的临床疗效。方法将60例肾虚痰瘀型强直性脊柱炎患者随机分为治疗组与对照组,每组30例。治疗组予强脊通络颗粒,对照组予复方颗粒剂(不含雷公藤)。两组疗程均为3个月,观察临床疗效,比较相关症状(晨僵时间、下腰痛程度评分、总体疼痛评分、外周关节肿胀数及患者总体症状评分)与体征(枕墙距、指地距、血沉、C反应蛋白、AS疾病活动性指数、AS疾病功能性指数)指标、中医证候积分的变化情况。结果 1最终完成试验者治疗组28例、对照组25例。2治疗组、对照组临床总有效率分别为96.43%和64.00%;组间临床疗效比较,差异有统计学意义,治疗组明显优于对照组(P<0.05)。3组间治疗后比较,晨僵时间、下腰痛程度、总体疼痛、外周关节肿胀数及患者总体症状评分差异有统计学意义,提示治疗组较对照组临床症状显著缓解(P<0.05)。组间治疗后比较,枕墙距、指地距、血沉、CRP、BASDAI、BASDFI水平差异有统计学意义,提示治疗组较对照组体征恢复更加显著(P<0.05)。4组间治疗前后中医证候积分差值比较,差异有统计学意义(P<0.05)。5治疗前后,两组受试者血、二便常规及肝肾功能均未出现异常。试验期间,两组均未见不良反应事件发生。结论强脊通络颗粒治疗肾虚痰瘀型强直性脊柱炎,可显著改善患者的临床症状与体征;复方中加用雷公藤后疗效得到提高,且短期内未见不良反应的出现。Objective To observe the clinical efficacy of Qiangji Tongluo Granules in the treatment of ankylosing spondylitis with syndrome of kidney deficiency and phlegm stasis. Methods 60 patients of ankylosing spondylitis with syndrome of kidney deficiency and phlegm stasis were randomly divided into the treatment group and control group,30 cases in each group. The treatment group was treated with Qiangji Tongluo Granules,the control group was treated with compound granules（ without Tripterygium Wilfordii）,with a course of 3 months. The clinical efficacy was observed. The changes of related symptoms（ the time of early morning stiffness,degree score of low back pain,score of total pain,swelling number of peripheral joint,overall symptom score of patients） and sign indexes（ pillowwall distance,finger-ground distance,erythrocyte sedimentation rate（ ESR）,C reactive protein（ CRP）,bath ankylosing spondylitis disease activity index（ BASDAI）,bath ankylosing spondylitis disease function index（ BASDFI））,TCM syndrome scores were compared. Results ①28 cases in the treatment group and 25 cases in the control group finally completed the trials.②The total effective rate of the treatment group and the control group were 96. 43% and 64. 00%respectively. There was statistically significant difference on the clinical efficacy between the two groups,and the effect of the treatment group was better than that of the control group（ P〈0. 05）. ③Comparison between the two groups after treatment,there were statistically significant differences on the time of early morning stiffness,degree score of low back pain,score of total pain,swelling number of peripheral joint,overall symptom score of patients（ P〈0. 05）,which suggested that the clinical symptoms in the treatment group were significantly relieved compared with the control group. Comparison between the two groups after treatment,there were statistically significant differences on the levels of pillow-wall distance,finger-ground distance,ESR,CRP,BAS

关 键 词：强直性脊柱炎 肾虚 痰瘀 强脊通络 雷公藤 减毒增效 

分 类 号：R259[医药卫生—中西医结合]