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目的:观察蠲痹汤联合西药治疗活动期强直性脊柱炎(AS)的临床疗效。方法:将60例活动期AS患者随机分为2组各30例,对照组给予口服西药治疗,试验组在对照组治疗方案的基础上口服中药汤剂蠲痹汤,疗程12周。观察2组患者治疗0周、4周、12周的总体背痛评分、PGA评分、BASDAI评分、BSAFI评分、晨僵时间、脊柱活动度以及CRP、ESR等指标,并监测2组患者的一般生命体征、肝肾功能和具体不良反应。结果:治疗12周后,试验组达ASAS20疗效标准的比例为90.0%,对照组为69.0%,经χ2检验,差异有统计学意义(P<0.05)。2组患者治疗4周和12周后总体背痛评分、PGA评分、BASDAI评分、BASFI评分、晨僵时间均较治疗前降低,差异有统计学意义(P<0.05)。治疗12周后,试验组PGA和BASDAI评分较对照组降低更明显,差异有统计学意义(P<0.05)。2组治疗4周和12周后Schober试验、脊柱侧弯度、指地距较治疗前改善,差异有统计学意义(P<0.05)。2组患者治疗后CRP、ESR均较治疗前降低,差异有统计学意义(P<0.05)。结论:采用蠲痹汤联合西药治疗活动期AS,能减轻患者的临床症状,延缓病情进展,疗效更好,且更安全,值得临床推广应用。
Objective: To observe the clinical effect of Weibi Decoction combined with western medicine in treatment of active ankylosing spondylitis (AS). Methods: Sixty active AS patients were randomly divided into two groups of 30 cases. The control group was treated with western medicine. The experimental group was treated with traditional Chinese medicine Decoction Bibi Decoction for 12 weeks on the basis of the control group. The total back pain score, PGA score, BASDAI score, BSAFI score, morning stiffness time, spine activity, CRP, ESR and other indicators of the two groups were observed at 0, 4 and 12 weeks of treatment, and the general life Signs, liver and kidney function and specific adverse reactions. Results: After 12 weeks of treatment, the ASAS20 efficacy criteria in the test group was 90.0% and in the control group 69.0%. There was significant difference (P <0.05) by χ2 test. Total back pain score, PGA score, BASDAI score, BASFI score and morning stiffness time of two groups of patients after treatment for 4 weeks and 12 weeks were lower than those before treatment, the difference was statistically significant (P <0.05). After 12 weeks of treatment, the PGA and BASDAI scores of the experimental group decreased more significantly than those of the control group, with significant difference (P <0.05). The Schober test showed that the scoliosis and mean distance between the two groups improved 4 and 12 weeks after treatment, with significant difference (P <0.05). The CRP and ESR of the two groups after treatment were lower than those before treatment, the difference was statistically significant (P <0.05). Conclusion: The treatment of active phase AS with Tongbi Decoction combined with western medicine can alleviate the clinical symptoms, delay the progression of the disease, have better curative effect, and are safer and worthy of clinical application.