摘要
【目的】观察中药外贴治疗强直性脊柱炎(AS)的临床疗效。【方法】将279例AS患者随机分为治疗组(175例)和对照组(104例),两组均给予柳氮磺吡啶等治疗,治疗组在此基础上同时给予中药(由地龙、穿山龙、土鳖虫、熟地、狗脊、杜仲、续断等制成膏药)敷贴双侧华佗夹脊穴治疗。持续治疗6个月,观察两组临床疗效,比较两组治疗前后患者的健康综合评分(BAS-G)、疾病活动指数(BASDAI)、功能指数(BASFI)、全身痛和脊柱痛L ikert四级评分、晨僵时间、医生总体评价等7项主要疗效指标评分的变化情况,以及两组治疗前后患者的枕墙距、颌柄距、指地距、胸廓活动度、Schober征、脊柱活动度、"4"字试验等体征的变化情况;观察两组的血沉(ESR)、C-反应蛋白(CRP)、补体C3、C4等指标的变化,并观察两组的不良反应情况。【结果】治疗组临床缓解46例,显效65例,有效52例,无效12例,总有效率为93.14%;对照组临床缓解11例,显效27例,有效48例,无效18例,总有效率为82.61%,两组比较,治疗组疗效优于对照组(P<0.01)。治疗后两组患者的7项主要疗效指标评分等均有改善,与治疗前比较,差异均有显著性意义(P<0.05或P<0.01),且治疗组的改善作用更明显(与对照组比较,P<0.01)。治疗后两组患者的枕墙距、颌柄距、指地距、胸廓活动度、Schober征、脊柱活动度,"4"字试验评分等体征均较治疗前有显著性改善(P<0.05或P<0.01),且治疗组的改善作用更为明显(P<0.01或P<0.05)。治疗后两组的ESR、CRP、C3、C4水平均较治疗前有显著性下降(P<0.05或P<0.01),且治疗组的ESR、CRP、C3水平下降更明显(P<0.05或P<0.01)。治疗组有4例出现局部皮疹、瘙痒,2例出现局部瘙痒,对照组未见药物不良反应。【结论】中药外贴治疗AS,可显著改善患者的症状和体征。
Objective To observe the therapeutic effect of external application of herbal medicine for ankylosing spondylitis（AS）.Methods Two hundred and seventy-nine AS patients were randomized into group A（N=175）and group B（N=104）.The two groups received oral use of sulfasalazine,and group A additionally received external application of herbal medical ointment（mainly composed of Pheretima,Squama Manis,Rhizoma Dioscoreae Nipponicae,Radix Rehmanniae Preparata,Rhizoma Cibotii,Cortex Eucommiae,Radix Dipsaci）on 3~4 pairs of bilateral acupoints of Jiaji,dressing change once every three days,for continuous 6 months.After treatment,the therapeutic effect was evaluated.The primary outcome measures of health general score（BAS-G）,disease activity index（BASDAI）,function index（BASFI）,Likert four-grade scores of general pain and rachialgia,duration of morning stiffness,general assessment by physician were observed before and after treatment.The secondary outcome measures of occiput to wall distance,finger to floor distance,chest expansion,Schober＇s test,spinal movement,＂4＂shape test were compared.The changes of erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,complements 3 and 4（C3 and C4）as well as the adverse actions were also observed.Results After treatment,46 patients were clinically relieved,65 markedly effective,52 effective,12 ineffective,and the total effective rate was 93.14% in group A;11 patients were clinically relieved,27 markedly effective,48 effective,18 ineffective,and the total effective rate was 82.61% in group B.The difference of the therapeutic effect was significant between the two groups（P〈0.01）.The primary outcomes were improved in the two groups after treatment（P〈0.05 or P〈0.01 compared with those before treatment）,in particular in group A（P〈0.01 compared with those in group B）.The secondary outcomes were also improved in the two groups after treatment（P〈0.05 or P〈0.01 compared with those before treatment）,in particular in group
出处
《广州中医药大学学报》
CAS
2008年第1期40-43,共4页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
脊柱炎
强直性/穴位疗法
穴
夹脊
外治法
ANKYLOSING SPONDYLITIS / acupoint therapy
POINT EX-B2（JIAJI）
EXTERNAL THERAPY
