肾着汤对强直性脊柱炎活动期的疗效及部分机制  

Curative Effects of Shenzhuo Decoction on Active Period of Ankylosing Spondylitis and Some Study on Mechanisms

作　　者：尹晓霞 彭剑虹 尹文耀 YIN Xiaoxia;PENG Jianhong;YIN Wenyao(The Eighth Department of Internal Medicine,Dongguan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine,Dongwan 523000,China)

机构地区：[1]广州中医药大学附属东莞中医院内八科,东莞523000

出　　处：《世界中医药》2020年第4期573-577,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(81273736)。

摘　　要：目的:探讨肾着汤对强直性脊柱炎(AS)活动期疗效。方法:选取2017年5月至2019年4月广州中医药大学附属东莞中医院收治的AS活动期患者102例作为研究对象,按照就诊的先后顺序随机分为对照组和观察组,每组51例。对照组常规西医治疗,观察组加用肾着汤治疗,连续治疗4周。观察2组治疗前、完成4周末在AS相关疼痛积分、体征积分、炎性反应递质、血小板参数、T淋巴细胞亚群变化并比较。结果:观察组患者治疗后Bath强直性脊柱炎疾病活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BAsFI)、血小板因子(PGF)、脊柱疼痛、脊柱炎症积分、C反应蛋白(CRP)、红细胞沉降率(ESR)、IL-17、IL-23、血小板计数(PLT)、血小板压积(PCT)、CD8+降低效果较对照组更优,在提升CD3+、CD4+、CD4+/CD8+、枕墙距、跟臀距较治疗前显著下降,胸廓扩展度、Schober试验、脊柱活动度方面较对照组更优(P<0.05)。结论:肾着汤能抑制AS活动期炎性反应,调节血小板参数,提高免疫功能,从而改善症状和脊柱活动度。Objective:To explore the therapeutic effects of Shenzhe Decoction on ankylosing spondylitis(as)in active stage.Methods:A total of 102 patients in Dongguan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine with were randomly divided into a control group and a study group,with 51 cases in each group.The control group was treated with Western medicine and the study group was treated with Shenzhuo Decoction for 4 weeks.The changes of pain score,physical sign score,inflammatory factor,platelet parameter and T lymphocyte subsets were observed and compared between the 2 groups before treatment and 4 weeks after treatment.Results:After treatment,BASDAI,BASFI,PGF,spinal pain,spondylitis score,CRP,ESR,IL-17,IL-23,PLT,PCT,CD8+decreased more effectively in the study group than in the control group,and the improvement of CD3+、CD4+、CD4+/CD8+,occipital wall distance,heel hip distance in the study group were significantly lower than those in the control group before treatment.Chest expansion,Schober test,spinal mobility were better than those in the control group(P<0.05).Conclusion:Shenzhuo Decoction can inhibit inflammatory response,regulate platelet parameters,improve immune function,and improve symptoms and spinal activity.

关 键 词：肾着汤 强直性脊柱炎 活动期 炎性反应递质 血小板参数 T淋巴细胞亚群 疼痛积分 脊柱活动度 

分 类 号：R289.5[医药卫生—方剂学] R593[医药卫生—中药学]