【摘要】 目的观察南蛇四妙汤配合功能锻炼治疗湿热痹阻型强直性脊柱炎的临床疗效。方法将64例湿热痹阻型强直性脊柱炎患者随机分为治疗组与对照组,每组32例。治疗组予自拟方南蛇四妙汤配合功能锻炼治疗;对照组予柳氮磺吡啶胶囊等口服。两组疗程均为3个月,观察临床疗效,比较临床症状指标(脊柱晨僵时间、脊柱炎症评分、脊柱疼痛评分、病人总体评价及BASFI指数)、脊柱活动度指标(指地距、枕墙距、胸廓扩张度及Schober试验距离)及相关生化指标(CRP、ESR及血常规、肝肾功能)的变化情况。结果 1治疗组、对照组疗效达标率分别为78.13%和56.25%;组间疗效达标率比较,差异有统计学意义(P<0.05)。2治疗前后组内比较,两组脊柱晨僵时间、脊柱疼痛评分、脊柱炎症评分、病人总体评价及BASFI指数均显著减少,差异有统计学意义(P<0.05)。组间治疗后比较,治疗组前述各指标的减少较对照组更加显著(P<0.05)。3治疗前后组内比较,除对照组枕墙距(P>0.05)、治疗组枕墙距(P<0.05)外,两组其他各指标均差异有统计学意义(P<0.05)。组间治疗后比较,指地距、胸廓扩张度及Schober试验距离差异有统计学意义(P<0.05)。4治疗前后,两组患者血常规,肝、肾功能检查,均未发现明显异常。同时,治疗前后组内比较,两组CRP及ESR水平均显著下降(P<0.05)。组间治疗后比较,治疗组CRP及ESR水平下降程度较对照组更加显著(P<0.05)。结论南蛇四妙汤配合功能锻炼治疗湿热痹阻型强直性脊柱炎,可显著缓解临床症状,改善脊柱关节功能。更多还原

【Abstract】 Objective To observe the clinical therapeutic effect on ankylosing spondylitis of damp-heat obstruction type by"Nanshe Simiao Decoction"combined with functional exercises. Methods 64 ankylosing spondylitis patients of damp-heat obstruction type were randomly divided into treatment group and control group,32 in each group. Treatment group was given self-made "Nanshe Simiao Decoction " accompanied by functional exercises; control group was given salfasalazine capsules orally. Total course of treatment was 3 months for the two groups. Standard-reaching rate for curative effect was recorded,and changes in clinical symptom indices( duration of morning stiffness,spinal pain score,spinal inflammation score,overall patient evaluation and BASFI index),spinal mobility index( finger to floor distance,occiput to wall distance,chest expansion and Schober test) and relevant biochemical indices( CRP,ESR,blood routines,liver and kidney function) were compared. Results 1 Standard-reaching rate of curative effect in treatment group and control group was 78. 13% and 56. 25%respectively; there was statistical significance in the difference of inter-group curative effect( P < 0. 05). 2Comparison inside groups before and after treatment,duration of morning stiffness,Spinal pain score,Spinal inflammation score,Overall patient evaluation and BASFI index were all significantly decreased,difference being statistically significant( P < 0. 05). Comparison between groups after treatment,above-mentioned indices decreased more significantly in treatment group than that in control group( P < 0. 05). 3Inside-group comparison before and after treatment,all differences but occiput to wall distance in control group( P > 0. 05),occiput to wall distance in treating group( P < 0. 05) are statistically significant( P < 0. 05). Inter-group comparison after treatment: there are statistical significance in differences of finger to floor distance,chest expansion and distance of Schober test( P < 0. 05). 4 There were no obvious abnormality in blood routines,liver and kidney function test. At the same time,both CRP and ESR levels lower significantly,according to the comparison inside group before and after treatment( P < 0. 05); CRP and ESR level in treating group descend more significantly than that in control group after treatment( P < 0. 05). Conclusion Clinical symptoms can be significantly relieved,spinal and joint function can be improved by"Nanshe Simiao Decoction"accompanied by functional exercises.更多还原