补肾通阳法联合西药治疗强直性脊柱炎疗效及对CRP、BGP、CTX-I的影响  

Effect of Kidney Tonifying and Yang Activating Therapy Combined with Western Medicine on Ankylosing Spondylitis and Its Influence on CRP,BGP,CTX-I

作　　者：杨铭 关宏刚[2] 胡容瑞 曾钰淇 YANG Ming;GUAN Honggang;HU Rongrui;ZENG Yuqi(Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China;Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]佛山市中医院,广东佛山528000

出　　处：《辽宁中医药大学学报》2023年第12期217-220,共4页Journal of Liaoning University of Traditional Chinese Medicine

摘　　要：目的观察补肾通阳法联合西药治疗强直性脊柱炎(ankylosing spondylitis,AS)的疗效及对C反应蛋白(CRP)、骨钙素(BGP)、Ⅰ型胶原蛋白C末端肽(CTX-Ⅰ)的影响。方法选择2021年3月—2022年9月该院收治的72例AS患者,按随机抽取法均分为2组,每组各36例,对照组予以常规西药治疗,观察组在西药治疗基础上增加自拟补肾通阳方治疗,观察对比2组治疗前后中医证候积分、视觉模拟量表(VAS)评分、实验室检测指标、脊柱功能及脊柱活动度指标变化,并对比治疗12周后临床疗效,观察治疗期间药物不良反应。结果观察组治疗后的主症、次症、总积分、VAS评分,血清CRP、CTX-I、肿瘤坏死因子α(TNF-α)、转化生长因子β1(TGF-β1),强直性脊柱炎功能指数(BASFI)、强直性脊柱炎计量指数(BASMI)、强直性脊柱炎活动性指数(BASDAI)评分,指地距,枕墙距均对比治疗前明显降低或缩小(P<0.05),BGP比治疗前有所改善,但差异无统计学意义(P>0.05),胸廓活动度对比治疗前明显增大(P<0.05),且改善程度优于对照组(P<0.05);治疗12周后,观察组疗效总有效率为94.4%,明显优于对照组72.2%(P<0.05);2组不良反应率比较无统计学意义(P>0.05)。结论补肾通阳法辅助西药治疗AS可增其疗效,改善脊柱功能和活动,减轻疼痛和临床症状,降低炎症反应,对骨代谢有改善作用,值得合理推广。Objective To observe and discuss the effect of tonifying the kidney and removing Yang combined with Western medicine on ankylosing spondylitis(AS)and the effect on CRP,BGP and CTX-I.Methods 72 patients with AS admitted to our hospital from March 2021 to September 2022 were randomly divided into two groups,36 patients in each group.The control group was treated with conventional Western medicine.The observation group was treated with self-designed tonifying kidney and tonifying Yang formula on the basis of Western medicine.The changes of Chinese medicine score,visual analogue scale(VAS)score,laboratory test index,spinal function and spinal activity index of the two groups were observed and compared before and after treatment,and the clinical effect after 12 weeks of treatment was compared,adverse drug reactions during treatment were observed.Results After treatment,the main symptoms,secondary symptoms,total score,VAS score,serum CRP,CTX-I,TNF-α,TGF-β1,BASFI,BASMI,BASDAI score,fingerto-ground distance and occipital-wall distance of the observation group decreased/decreased significantly compared with those before treatment(P<0.05),BGP was improved compared with that before treatment,which was no significant difference(P>0.05),thoracic mobility was significantly increased compared with that before treatment(P<0.05);After 12 weeks of treatment,the total effective rate of the observation group was 94.4%,which was significantly better than that of the control group(72.2%)(P<0.05);There was no significant difference in the adverse reaction rate between the two groups(P<0.05).Conclusion The method of tonifying the kidney and activating the Yang combined with Western medicine can increase the curative effect of AS,improve the spinal function and mobility,relieve pain and clinical symptoms,reduce inflammatory reaction,and improve bone metabolism,which is worthy of reasonable promotion.

关 键 词：补肾通阳法 强直性脊柱炎 视觉模拟量表评分 脊柱功能 骨代谢 

分 类 号：R242[医药卫生—中医临床基础] R593.23[医药卫生—中医学]