壮骨强脊颗粒治疗强直性脊柱炎的疗效及其对TNF-α、BMP-2的影响  

Effect of Zhuanggu Qiangji Granule on Ankylosing Spondylitis(AS)and its Effect on TNF-αand BMP-2

作　　者：路占忠 刘进子[1] 陈翠柳 段皓云 付素兰[1] LU Zhan-zhong;LIU Jin-zi;CHEN Cui-liu;DUAN Hao-yun;FU Su-lan(Department of Rheumatology and Immunology,Shijiazhuang Third Hospital,Shijiazhuang 050011)

机构地区：[1]石家庄市第三医院风湿免疫科,石家庄050011

出　　处：《河北中医药学报》2020年第5期11-15,共5页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：河北省中医药管理局科研计划项目:No.2018261.

摘　　要：目的:研究壮骨强脊颗粒治疗强直性脊柱炎(AS)肾虚督寒证的临床疗效及其对炎症因子肿瘤坏死因子α(TNF-α)、骨形态发生蛋白-2(BMP-2)的影响。方法:将73例活动期强直性脊柱炎肾虚督寒证患者随机分为2组。对照组37例予西医常规治疗;治疗组36例在对照组治疗基础上加服壮骨强脊颗粒。观察3个月,比较2组治疗前后脊柱痛视觉模拟评分(VAS)、患者总体评估指数(PGA)、Bath强直性脊柱炎病情活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、Bath强直性脊柱炎测量指数(BASMI)及超敏C反应蛋白(h-CRP)、红细胞沉降率(ESR)变化,TNF-α、BMP-2的水平,强直性脊柱炎国际工作组20疗效评价标准(ASAS20)、BASDAI50达标率并观测治疗安全性。结果:70例患者完成研究,2组各35例。治疗组和对照组ASAS20达标率分别为82.86%和65.71%,差异无显著性(P>0.05)。BASDAI50达标情况治疗组为65.71%,对照组40.00%,治疗组高于对照组(P<0.05)。治疗后2组脊柱痛VAS、PGA、BASDAI、BSAFI、BASMI均明显低于治疗前(P<0.01),治疗后治疗组同对照组相比各指标均减低(P<0.05或<0.01)。治疗后2组ESR、h-CRP、BMP-2、TNF-α水平均明显低于治疗前(P<0.01),治疗组低于对照组(P<0.05或<0.01)。2组安全性差异无显著性(P>0.05)。结论:壮骨强脊颗粒治疗AS肾虚督寒证能够安全有效改善患者临床症状,降低炎症因子水平,缓解病情。Objective:To study the clinical efficacy of Zhuanggu Qiangji Granule in the treatment of AS with kidney deficiency and governor vessel cold syndrome and its effect on inflammatory factors tumor necrosis factor-α(TNF-α)and bone morphogenetic protein-2(BMP-2).Methods:73 cases of active AS were randomly divided into two groups.The control group(37 cases)was treated with routine western medicine,while the treatment group(36 cases)was given Zhuanggu Qiangji Granule besides the same western medicine.After three months’observation,compare the following index before and after treatment:the visual analogue scale(VAS),patient global assessment index(PGA),Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Bath Ankylosing Spondylitis Functional Index(BASFI)and Bath Ankylosing Spondylitis measurement index(BASMI),high sensitivity C-reactive protein(h-CRP),erythrocyte sedimentation rate(ESR),erythrocyte sedimentation rate(ESR),TNF-α,BMP-2,compliance rate of assessment in ankylosing Spondylitis 20(ASAS20)and BASDAI50,and observe the safety of treatment.Results:70 patients completed the study,35 cases in each group.The ASAS20 of the treatment group and control group were 82.9%and 65.7%respectively and there was no significant difference between the two groups(P>0.05).The BASDAI50 of the treatment group was 65.71%,and that of the control group was 4.00%,which was higher than that of the control group(P<0.05).After treatment,VAS,PGA,BASDAI,BSAFI and BASMI of spinal pain in two groups were significantly lower than those before treatment(P<0.01),and all indexes in treatment group were lower than those in control group(P<0.05 or P<0.01).After treatment,the levels of ESR,h-CRP,BMP-2 and TNF-αin the two groups were significantly lower than those before treatment(P<0.01),while those in the treatment group were lower than those in the control group(P<0.05 or P<0.01).There was no significant difference in safety between the two groups(P>0.05).Conclusion:Zhuanggu Qiangji Granule can safely and effectively improve the clinical

关 键 词：壮骨强脊颗粒 强直性脊柱炎 腰痛 大偻 骨痹 肾痹 肾虚督寒证 TNF-Α BMP-2 

分 类 号：R259.593.22[医药卫生—中西医结合]