脊得舒膏方加减对强直性脊柱炎髋关节强直肝肾不足证患者全髋关节置换术后康复的影响  

in the Rehabilitation After Total Hip Arthroplasty for Ankylosing Spondylitis Patients with Hip Ankylosis of Liver and Kidney Deficiency Syndrome

作　　者：赵建磊 孙永强 阎亮[2] ZHAO Jianlei;SUN Yongqiang;YAN Liang(Zhengzhou Branch of Luoyang Orthopedic-Traumatological Hospital(Henan Provincial Orthopedic Hospital),Zhengzhou,450016;Henan Hospital of Traditional Chinese Medicine)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)郑州院区,450016 [2]河南省中医院

出　　处：《中医杂志》2020年第12期1069-1074,共6页Journal of Traditional Chinese Medicine

基　　金：河南省高等学校重点科研项目(15A360002)。

摘　　要：目的观察脊得舒膏方加减对强直性脊柱炎(AS)髋关节强直肝肾不足证患者全髋关节置换术(THA)术后康复的影响。方法将48例AS晚期髋关节强直患者随机分成治疗组和对照组各24例。对照组THA术后进行常规治疗;治疗组在对照组基础上联合口服脊得舒膏方加减进行治疗,共治疗1个月。观察两组患者术前及术后1、3、6、12个月红细胞沉降速率(ESR)、C反应蛋白(CRP)、髋关节Harris评分、髋关节活动度(ROM)、视觉模拟评分(VAS评分)、中医临床症状评分、生存质量评分,判定中医证候疗效及安全性分析。结果术后12个月两组患者ESR、CRP、Harris评分、髋关节ROM、VAS评分及SF36质量评分(包括生理机能、生理职能、躯体疼痛、一般健康状况、精力、情感职能、社会功能、精神健康)均得到明显改善。治疗组术后第3、6个月的VAS评分显著优于对照组(P<0.05);治疗组术后12个月中医证候疗效控显率(79.17%)优于对照组(33.33%);治疗组在术后12个月生存质量各维度评分方面优于对照组(P<0.05)。两组患者治疗前后肝、肾功能均无明显异常变化,且未发生任何药物不良反应。结论脊得舒膏方加减在AS髋关节强直肝肾不足证患者THA术后减轻疼痛、提高疗效及改善患者生存质量方面有明显优势。Objective To observe the effect of Jideshu Ointment Formula(脊得舒膏方)on rehabilitation after total hip arthroplasty(THA)for ankylosing spondylitis(AS)patients with hip ankylosis of liver and kidney deficiency syndrome.Methods A total of 48 patients were randomly divided into a treatment group and a control group with 24 in each group.The control group was treated with routine treatment after THA;the treatment group was treated with Jideshu Ointment Formula on the basis of the control group for one month.Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),Harris score of hip joint,range of motion(ROM),visual analogue scale(VAS),traditional Chinese medicine(TCM)syndrome score,and quality of life score were compared and observed before and 1,3,6,12 months after operation,to evaluate the curative effects of TCM syndromes and the safety.Results After 12 months of the surgery,the ESR,CRP,Harris scores,hip joint ROM,VAS and SF36 scores including physiological function(PF),physiological function(RP),physical pain(BP),general health status(GH),energy(VT),emotional function(RE),social function(SF),mental health(MH)were significantly improved.VAS of the treatment group was significantly lower than that of the control group at the 3 rd and 6 th month after operation(P<0.05);12 months after the surgery,the curative effects of TCM syndrome in the treatment group was significant(79.17%),which was supperior to that in the control group(33.33%);12 months after the surgery,SF scores of all dimensions of the treatment group was supperior to that of the control group(P<0.05).There was no significant abnormal change of liver and kidney functions and no adverse drug reactions in both groups after treatment.Conclusion Modifed Jideshu Ointment Formula has obvious advantages in reducing pain,improving curative effect and improving the quality of life of patients with AS hip joint ankylosis and liver kidney deficiency after THA.

关 键 词：强直性脊柱炎 全髋关节置换术 脊得舒膏方 肝肾不足证 生存质量 

分 类 号：R274.9[医药卫生—中西医结合]