本文選題：強(qiáng)直性脊柱炎 + 陽(yáng)虛寒濕證��； 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:強(qiáng)直性脊柱炎的患者,因長(zhǎng)期疼痛造成生活上的不便;而西藥的治療,對(duì)于其臨床癥狀的療效有限。加減陽(yáng)和湯是導(dǎo)師汪悅教授臨床治療強(qiáng)直性脊柱炎陽(yáng)虛寒濕證的經(jīng)驗(yàn)方,通過(guò)系統(tǒng)性的臨床研究,客觀評(píng)價(jià)加減陽(yáng)和湯對(duì)強(qiáng)直性脊柱炎陽(yáng)虛寒濕證患者的治療效果,尤其是對(duì)臨床癥狀、體征、實(shí)驗(yàn)室檢測(cè)指標(biāo)等方面的變化,并評(píng)價(jià)其臨床療效及提升患者的生活質(zhì)量,為臨床應(yīng)用提供客觀依據(jù)。方法:根據(jù)平行對(duì)照的臨床試驗(yàn)原則。將60例符合陽(yáng)虛寒證的強(qiáng)直性脊柱炎患者分為三組。中藥組、西藥組、中西藥組,每組20例。中藥組予以加減陽(yáng)和湯,西藥組予以塞來(lái)昔布膠囊、柳氮磺胺吡啶腸溶片,中西藥組則予以加減陽(yáng)和湯、塞來(lái)昔布膠囊、柳氮磺胺吡啶腸溶片。4周為一療程,共2療程后以患者的中醫(yī)證候積分、ASQoL、ASAS20標(biāo)準(zhǔn)評(píng)估療效。主要采用ASAS20、BASFI評(píng)分及ESR、CRP等,評(píng)估病情整體變化程度,并以ASQoL評(píng)分評(píng)估患者治療前后的生活質(zhì)量。同時(shí)監(jiān)測(cè)患者安全性指標(biāo)。結(jié)果:通過(guò)60例患者8周的臨床觀察,總體在減輕患者疾病活動(dòng)度、臨床癥狀和體征、中醫(yī)辨證證候、實(shí)驗(yàn)室指標(biāo)及生活質(zhì)量方面均有明顯療效(P0.05)。中西藥組在疼痛、炎癥指標(biāo)、BASFI等臨床癥狀有明顯改善(P0.05),三組的ESR、CRP均有明顯改善(P0.05),中西藥組的ASQoL明顯高于中藥組、西藥組。三組患者中,僅出現(xiàn)2例不良反應(yīng),均為西藥組服用塞來(lái)昔布后出現(xiàn)輕度胃部不適,泄瀉,與患者溝通后,表示繼續(xù)服藥,未予特殊處理,余后患者未出現(xiàn)明顯不適。結(jié)論:加減陽(yáng)和湯結(jié)合西藥治療強(qiáng)直性脊柱炎以溫腎壯督、溫經(jīng)散寒為治法,在臨床上獲得了肯定的療效,除了改善患者的癥狀體征,對(duì)患者的疾病活動(dòng)度、生活質(zhì)量等方面都去有療好的療效,安全性良好,具有廣闊的應(yīng)用前景。
[Abstract]:Objective: in patients with ankylosing spondylitis, it is difficult to live because of long-term pain, but the curative effect of western medicine is limited to its clinical symptoms. Jiajiayanghe decoction is an experiential prescription for professor Wang Yue's clinical treatment of Yang deficiency and cold dampness syndrome of ankylosing spondylitis. Through systematic clinical research, the therapeutic effect of Jiajiayanghe decoction on ankylosing spondylitis with Yang deficiency and cold dampness syndrome is evaluated objectively. Especially, the changes of clinical symptoms, signs, laboratory indicators and so on, and the evaluation of its clinical efficacy and improve the quality of life of patients, to provide an objective basis for clinical application. Methods: according to the principle of parallel control clinical trial. Sixty patients with ankylosing spondylitis were divided into three groups. Chinese medicine group, western medicine group, Chinese and western medicine group, 20 cases in each group. The western medicine group was given celecoxib capsule and sulfamyridine enteric coated tablets, while the Chinese and western medicine group was treated with Xianyang he decoction, celecoxib capsule and salicylosulfampyridine enteric-coated tablet for a course of 4 weeks. After 2 courses of treatment, the curative effect was evaluated by ASQOL ASAS 20 standard. The ASAS20 BASFI score and ESR-CRP were used to evaluate the overall changes of the disease and the quality of life of the patients before and after treatment was evaluated by ASQoL score. At the same time, the patient safety index was monitored. Results: according to the clinical observation of 60 patients for 8 weeks, there were obvious curative effects on reducing disease activity, clinical symptoms and signs, syndrome differentiation of TCM, laboratory indexes and quality of life (QOL). The clinical symptoms such as pain and inflammation index were significantly improved in the Chinese and western medicine group, and the ESR-CRP in the three groups were significantly improved. The ASQoL in the Chinese and western medicine group was significantly higher than that in the traditional Chinese medicine group and the western medicine group, and that in the western medicine group was significantly higher than that in the traditional Chinese medicine group and western medicine group. There were only 2 adverse reactions in the three groups, all of which were mild gastric discomfort after celecoxib in the western medicine group, diarrhea. After communication with the patients, the patients continued to take the medicine without special treatment, and the remaining patients did not have obvious discomfort after taking celecoxib. Conclusion: the treatment of ankylosing spondylitis by adding and reducing Yang and decoction combined with western medicine, with warming the kidney and strengthening the governor, warming the meridian and dispersing cold as the treatment method, has obtained the definite curative effect clinically, besides improving the patients' symptoms and signs, it can also improve the patients' disease activity. Quality of life and other aspects have good therapeutic efficacy, good safety, has a broad application prospects.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 吳超;婁玉鈐;楊亞飛;許平英;;強(qiáng)直性脊柱炎中醫(yī)辨證分型研究進(jìn)展[J];風(fēng)濕病與關(guān)節(jié)炎;2015年06期

2 李紅偉;孟祥樂(lè);;地黃化學(xué)成分及其藥理作用研究進(jìn)展[J];藥物評(píng)價(jià)研究;2015年02期

3 邵萌;王啟瑞;范欽;孫學(xué)剛;蔡紅兵;GONG Xianling;;露蜂房的化學(xué)成分和藥理作用研究進(jìn)展[J];中國(guó)中醫(yī)藥現(xiàn)代遠(yuǎn)程教育;2015年04期

4 郭云柯;紀(jì)偉;汪悅;;陽(yáng)和湯加減治療強(qiáng)直性脊柱炎腎虛寒濕證臨床研究[J];山東中醫(yī)雜志;2014年12期

5 張婧卓;林U，

本文編號(hào)：2045727