四妙丸联合非甾体抗炎药治疗湿热型强直性脊柱炎的临床研究  

Clinical Study of Simiao Pills Combined with Non-Steroidal Anti-Inflammatory Drugs in the Treatment of Damp-Heat Type Ankylosing Spondylitis

作　　者：王春波 WANG Chunbo(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学附属医院,沈阳110032

出　　处：《中西医结合研究》2019年第1期12-15,共4页Research of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨四妙丸加减联合非甾体抗炎药治疗湿热型强直性脊柱炎的临床疗效,并观察其对血清基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)和组织金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinase-1,TIMP-1)的影响。方法选择100例于本院风湿科治疗的湿热型强直性脊柱炎患者,利用随机数字表法将其分为对照组和观察组,每组50例。对照组采用常规非甾体抗炎药物治疗,观察组在对照组治疗基础上采用四妙丸加减治疗。比较2组治疗前后的临床疗效、中医症状评分、炎性指标及特异性血清MMP-9、TIMP-1的水平变化。结果治疗后,观察组临床总有效率显著高于对照组(P<0.05)。治疗后,观察组大便溏泄、口不渴、关节冷痛、四末不温、僵紧、僵痛等中医症状评分均较前明显下降(P<0.05),对照组仅僵紧、僵痛评分较前下降(P<0.05);与对照组比较,观察组大便溏泄、口不渴、四末不温、关节冷痛评分均显著下降(P<0.05)。治疗后,2组炎性指标均较治疗前明显降低(P<0.05),且观察组降低程度明显大于对照组(P<0.05);治疗后,观察组血清MMP-9、TIMP-1水平较治疗前及对照组明显降低(P<0.05)。结论四妙丸加减联合非甾体抗炎药能显著改善湿热型强直性脊柱炎患者临床症状,改善血清MMP-9、TIMP-1水平,提高临床疗效。Objective To explore the clinical effect of Simiao pills addition and subtraction combined with non-steroidal anti-inflammatory drugs in the treatment of damp-heat type ankylosing spondylitis,and to observe its effect on serum matrix metalloproteinase-9(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1). Methods One hundred patients with damp-heat type ankylosing spondylitis who were treated in our hospital were randomly divided into control group( n =50)and observation group( n =50).The control group was treated with conventional non-steroidal anti-inflammatory drugs.The observation group was treated with Simiao pills on the basis of the control group.The clinical efficacy,the changes of TCM symptom scores,inflammatory indexes and serum MMP-9,TIMP-1 were compared between the two groups before and after treatment. Results After treatment,the total effective rate in the observation group was significantly higher than that in the control group( P <0.05).After treatment,the TCM symptom scores such as loose stools,no thirst,cold joint pain,non-temperature at four limbs,stiffness and pain in the observation group were significantly lower than those before treatment( P <0.05),while the scores of stiffness and pain in the control group were lower than those before treatment( P <0.05).Compared with the control group,the scores of loose stools,no thirst,non-temperature at four limbs and cold joint pain in the observation group were significantly decreased( P <0.05).After treatment,the inflammatory indexes in both groups were significantly lower than those before treatment( P <0.05),and the degree of decrease in the observation group was significantly higher than that in the control group( P <0.05).After treatment,the level of serum MMP-9 and TIMP-1 in the observation group was significantly lower than that in the control group and before treatment( P <0.05). Conclusion The addition and subtraction of Simiao pills combined with non-steroidal anti-inflammatory drugs can significantly relieve the clinical symptoms of

关 键 词：强直性脊柱炎 四妙丸 非甾体抗炎药 基质金属蛋白酶-9 组织金属蛋白酶抑制剂-1 

分 类 号：R593.23[医药卫生—内科学]