【摘要】 目的:创立强直性脊柱炎的中医病名及辨证论治体系;从临床和实验两个方面研究补肾强督法为主的综合疗法治疗强直性脊柱炎的有效性及其作用机理。方法:以继承与发扬为宗旨结合临床实践经验,创立强直性脊柱炎中医病名及辨证论治体系。研究补肾强督法为主的综合疗法治疗强直性脊柱炎的有效性及其作用机理。临床研究采用前瞻对照方法,以主要症状、体征、免疫炎性指标、骨密度等为观测指标,并以ASAS20作为疗效评价体系评价疗效;实验研究采用细胞培养、ELISA、RT-PCR等方法,观察效方对炎性因子、骨代谢指标、骨破坏相关因子、成纤维细胞等的调节作用。结果:创立强直性脊柱炎的中医病名——"大偻"和"寒热为纲",以及其辨治体系;提出以补肾强督法为主的"五连环"和"综合强化序贯"疗法治疗强直性脊柱炎;研发出一种用于治疗强直性脊柱炎的中药——补肾舒脊颗粒;证实强直性脊柱炎早期即存在骨量丢失,补肾强督法能双向调节强直性脊柱炎骨代谢、提高强直性脊柱炎骨密度、改善血瘀证候,调节促炎性细胞因子、T细胞平衡,调节骨破坏因子、成纤维细胞、成骨细胞功能。结论:创立的"大偻"及"寒热为纲"辨治体系对强直性脊柱炎的辨证论治有较好的指导作用;经临床、实验研究证实,补肾强督法为主的"五连环"和"综合强化序贯"疗法疗效显著,并具有调节强直性脊柱炎免疫失调、减轻炎症、抗纤维化、抗骨破坏等作用。更多还原

【Abstract】 Objective:To found the name and syndrome differentiation and treatment system of ankylosing spondylitis in traditional Chinese medicine(TCM),and study the validity and mechanism of the comprehensive therapy based on invigorating the kidney and Du meridian on ankylosing spondylitis by clinical and experimental research.Methods:For inheriting and improving and combining with clinical and practical experience,we founded the name and syndrome differentiation and treatment system ofankylosing spondylitis in TCM,and study the validity and mechanism of the comprehensive therapy based on invigorating the kidney and Du meridian on ankylosing spondylitis.By prospective control clinical research,the main symptoms,signs,immune inflammatory indexes,and bone mineral density were as the observation indexes,and ASAS20 as the evaluation system of curative effect.In experimental research,by cell culture,ELISA,RT-PCR method,we observed the effects of the comprehensive therapy based on invigorating the kidney and Du meridian on inflammatory factors on bone metabolic marker (BMM),bone damage correlation factors,fibroblasts,etc,study the mechanism of the BuShenQiangDu treatment of ankylosing spondylit from the pro-inflammatory cytokines,T cell balance,bone destruction factor,fibroblast cells, osteoblasts.Results:Created "Da Lou"(disease name of TCM) and "Syndrome Differentiation Based on Cold and Heat" and differential treatment system,we proposed the five serial comprehensive,reinforced and sequential therapy based on invigorating the kidney and Du meridian on ankylosing spondylit,and developed a new Chinese medicine treating ankylosing spondylit:Bushenshuji Granula.In the study,it was confirmed there was bone mass loss in early stage of ankylosing spondylit,by invigorating the kidney and Du meridian bone metabolism in ankylosing spondylit was regulated,bone mineral density in ankylosing spondylit increased,blood stasis syndrome improved,the balance of pro-inflammatory cytokines and T cell was regulated,and the functions of bone destruction factors,fibroblast cells,osteoblasts were adjusted.Conclusion:It established the "Da Lou" and differential treatment system based on cold and heat has good guidance to the syndrome differentiation and treatment of ankylosing spondylit.By the clinical and experimental studies it was confirmed that the curative effects of the five serial comprehensive,reinforced and sequential therapy based on invigorating the kidney and Du meridian was distinct,and it has the functions of regulating immune disorders in ankylosing spondylit,reducing inflammation,anti-fibrosis,restraining bone destructive role.更多还原