未分化脊柱关节病的中医临床研究

【作者】 高燕；

【导师】 周翠英；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2001， 硕士

【摘要】 本研究运用祖国医学和中西医结合理论，从理论、临床研究两方面系统探讨了未分化脊柱关节病（undiffderentiated spondylarthropathies，uSpA）的病因病机和治疗方法。认为伏邪是贯穿疾病始终的内在因素，湿热内伏是uSpA急性发作期病机转化的关键。据此拟定了清热解毒，利湿通络为法的痹消宁处方，治疗uSpA42例。并根据年龄分为幼年uSpA（15例）和成年uSpA（27例）两组，对其起病形式，临床特点及对治疗的反应性等多方面进行初步探讨。经临床观察，幼年组与成年组相比，起病形式以急性为主，关节外表现多，骶髂关节受累轻（这可能与其发育特点有关），髋关节受累率高（P＜0.05）；而成年组则以隐匿性起病为主，腰（骶）痛或臀区痛发病者较多（P＜0.05）。两组对治疗的反应性无明显差异（P＞0.05），经治疗患者多项临床症状和体征以及实验室检查指标均得到明显改善。并结合临床及相关文献，探讨该方法的作用机理，证实了清热利湿通络法对uSpA具有确切的治疗作用。更多还原

【Abstract】 This study based on the theory of T.C.M and integrated Traditional chinese and western medicine, systematically explored the cause, patbogenesis am1 therapeutic method of undifferentiated spondyloaithropathy from theoretical and clinical aspects. re- seareh suggested that hiden pathogenic factor was the internal factor exsitimg during the whole course of the disease. Heat and dampness hiding in body is the key factor of pathogenesis progress. Accordingly, Bi Xiao Mug decoction was given based on the therapeutic method of clearing away heat and toxic materias, eliminating dampness iUid removing the obstruction in meridians. Clinical data of 42 uspA were analyzed, To e- validate their onset, clinical features, response to therapy, these cases were divided in- to two groups. The JuSpA group had acute onset, prominent manifestations of ex- traspinal, mild sacioiliitis (may be relevant to their growth characters), high hip joint involment compared with those of AuSpA(P<0.05),whileAuSpA group with axial in- flammatoiy back pain or hip pain as initial manifestations, having chronic onset are pre- dominent( P <0.05) . There was no significant difference in response to treatment (P> 0.05) Clinical and laboratory manifestations were improved significantly after therapy. Combined with the results of clinical and relative literature, the operating mechanisms of this method was investigated. All of these indicated that this method had the pro- nounced effect for the therapy of uSpA.更多还原