补肾强督治尪汤加减治疗强直性脊柱炎合并心血管受累患者的临床观察  

Clinical Observation on Modified Bushen Qiangdu Zhiwang Decoction in the Treatment of Patients with Ankylosing Spondylitis Complicated with Cardiovascular Involvement

作　　者：李璇 庞亚飞 张兰玲 万伟 LI Xuan;PANG Yafie;ZHANG Lanling;WAN Wei(Dept.of Rheumatology and Immunology,Shanghai Songjiang Fangta Hospital of Traditional Chinese Medicine,Shanghai 201699,China;Dept.of Rheumatology and Immunology,Shanghai Baoshan Hospital of Integrated Chinese and Western Medicine,Shanghai 201999,China;Dept.of Rheumatology and Immunology,the First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]上海市松江区方塔中医医院风湿免疫科,上海201699 [2]上海市宝山区中西医结合医院风湿免疫科,上海201999 [3]海军军医大学第一附属医院风湿免疫科,上海200433

出　　处：《中国医院用药评价与分析》2024年第6期667-671,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：上海市卫生健康委员会资助项目(No.2022QN060)。

摘　　要：目的:探讨补肾强督治尪汤加减治疗强直性脊柱炎合并心血管受累患者的临床疗效。方法:选择2020年4月至2022年8月于上海市松江区方塔中医医院、上海市宝山区中西医结合医院及海军军医大学第一附属医院就诊的强直性脊柱炎合并心血管受累患者88例,根据随机数字表法分为两组,每组44例。对照组患者给予西医常规治疗,观察组患者在对照组的基础上给予补肾强督治尪汤加减治疗。观察两组患者治疗前后的临床疗效、中医证候评分、相关量表评分(强直性脊柱炎疾病活动指数、强直性脊柱炎疾病功能指数和Framingham风险评分)、血清炎症指标(血清C反应蛋白、红细胞沉降率和肿瘤坏死因子α)水平及脊柱活动度(指地距、枕墙距和脊柱活动度试验),随访1年记录患者主要不良心血管事件发生情况。结果:治疗后,观察组患者的总有效率为90.70%(39/43),显著高于对照组的74.42%(32/43),差异有统计学意义(P<0.05)。治疗后,两组患者中医证候评分、强直性脊柱炎疾病活动指数评分、强直性脊柱炎疾病功能指数评分、Framingham风险评分及血清炎症指标水平较治疗前降低,且观察组患者低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者指地距、枕墙距较治疗前降低,脊柱活动度试验较治疗前改善,且观察组患者优于对照组,差异均有统计学意义(P<0.05)。随访1年,观察组患者主要不良心血管事件发生率低于对照组,差异有统计学意义(P<0.05)。结论:补肾强督治尪汤加减治疗强直性脊柱炎合并心血管受累患者的临床疗效显著。OBJECTIVE:To probe into the clinical efficacy of modified Bushen Qiangdu Zhiwang decoction in the treatment of patients with ankylosing spondylitis complicated with cardiovascular involvement.METHODS:A total of 88 patients with ankylosing spondylitis complicated with cardiovascular involvement admitted into Shanghai Songjiang Fangta Hospital of Traditional Chinese Medicine,Shanghai Baoshan Hospital of Integrated Chinese and Western Medicine and the First Affiliated Hospital of Naval Medical University from Apr.2020 to Aug.2022 were selected to be divided into two groups via random number table method,with 44 cases in each group.The control group was given conventional Western medicine,while the observation group was given modified Bushen Qiangdu Zhiwang decoction based on the control group.The clinical efficacy,traditional Chinese medicine syndrome scores,scores of related scales(ankylosing spondylitis disease activity index,ankylosing spondylitis disease function index,Framingham risk score),serum inflammatory indicators(serum C-reactive protein,erythrocyte sedimentation rate and tumor necrosis factorα)and spinal mobility(finger-to-floor distance,pillow-to-wall distance and spinal mobility test)of both groups before and after treatment were observed,the incidences of major adverse cardiovascular events in 1-year follow-up were recorded.RESULTS:The total effective rate of observation group was 90.70%(39/43),significantly higher than 74.42%(32/43)of the control group,with statistically significant difference(P<0.05).After treatment,the traditional Chinese medicine syndrome scores,ankylosing spondylitis disease activity index scores,ankylosing spondylitis disease function index scores,Framingham risk scores and serum inflammatory indicators of both groups were lower than those before treatment,and the observation group were lower than the control group,with statistically significant differences(P<0.05).After treatment,the finger-to-floor distance and pillow-to-wall distances were lower and the spinal mobility test

关 键 词：补肾强督治尪汤 强直性脊柱炎 心血管受累 血清炎症因子 脊柱活动度 心血管不良事件 

分 类 号：R932[医药卫生—生药学]