牛貝活血祛痰方治療強直性脊柱炎痰瘀痹阻證臨床觀察
發(fā)布時間：2018-07-28 09:21
【摘要】：研究目的:分析比較強直性脊柱炎痰瘀痹阻證治療前后各項觀察指標(biāo)的改善情況,對牛貝活血祛痰方治療強直性脊柱炎痰瘀痹阻證的有效性和安全性進(jìn)行臨床評價,為臨床推廣提供可信依據(jù)。研究內(nèi)容及方法:本研究共收集病例66例,采用隨機(jī)對照法隨機(jī)分為試驗組和對照組,試驗過程中試驗組脫落1例,對照組脫落2例,最終試驗組32例,對照組31例。對照組服用柳氮磺吡啶腸溶片和洛索洛芬鈉片治療,試驗組在對照組基礎(chǔ)上加服牛貝活血祛痰方。兩組均要求患者進(jìn)行常規(guī)肢體功能鍛煉,減少負(fù)重和勞累,觀察時間兩個月,記錄各項觀察指標(biāo),用統(tǒng)計軟件SPSS24.0綜合分析,評定臨床療效。研究結(jié)果:1基線比較兩組患者入組時年齡、性別、病程、主要癥狀積分、BASDAI、脊柱疼痛VAS評分、PGA及實驗室指標(biāo)(ESR、CRP)比較,均無統(tǒng)計學(xué)差異(p0.05),兩組具有可比性。2療效比較中醫(yī)證候療效中,試驗組總有效率為84.39%,對照組為58.07%,差異有統(tǒng)計學(xué)意義(P0.05)。3中醫(yī)證候積分組內(nèi)療效比較,試驗組治療前后比較有統(tǒng)計學(xué)意義(p0.05)。對照組在腰骶疼痛、脊背疼痛、腰脊活動受限、夜間疼痛、晨僵、外周關(guān)節(jié)腫脹方面治療前后療效比較有統(tǒng)計學(xué)意義(p0.05);在肌膚紫暗、肢體困重、腰膝酸軟方面治療前后療效比較無統(tǒng)計學(xué)意義(p0.05)。組間療效比較,兩組在腰骶疼痛、脊背疼痛、腰脊活動受限、夜間疼痛、四肢關(guān)節(jié)腫脹、肌膚紫暗、腰膝酸軟方面組間療效比較有統(tǒng)計學(xué)意義(p0.05);在晨僵、肢體困重方面,組間療效比較無統(tǒng)計學(xué)意義(p0.05)。4 BASDAI、脊柱VAS評分、PGA評分試驗組、對照組的BASDAI、脊柱VAS評分、PGA評分組內(nèi)和組間療效比較均有統(tǒng)計學(xué)意義(p0.05)。5實驗室指標(biāo)試驗組、對照組的ESR、CRP組內(nèi)和組間療效比較均有統(tǒng)計學(xué)意義(p0.05)。6安全性分析試驗組有1例患者在治療過程中出現(xiàn)惡心、嘔吐等胃腸不適,對照組有1例患者出現(xiàn)輕度腹瀉、1例患者肝功能出現(xiàn)異常。經(jīng)過對癥處理后均得到好轉(zhuǎn),按時完成試驗。兩組其余患者在試驗過程中并未發(fā)現(xiàn)血常規(guī)、便常規(guī)、肝腎功等異常現(xiàn)象。研究結(jié)論:柳氮磺砒啶腸溶片、洛索洛芬鈉片聯(lián)合牛貝活血祛痰方與單用柳氮磺砒啶腸溶片、洛索洛芬鈉片治療痰瘀痹阻型強直性脊柱炎在改善患者癥狀、體征、脊柱功能及炎癥指標(biāo)方面均有效果,使病情得以延緩;但聯(lián)合牛貝活血祛痰方比單用柳氮磺砒啶腸溶片、洛索洛芬鈉片總體療效更好,總有效率更高,改善中醫(yī)癥候方面效果更確實�？梢�,牛貝活血祛痰方聯(lián)合柳氮磺吡啶腸溶片、洛索洛芬鈉片治療強直性脊柱炎痰瘀痹阻證能獲得滿意臨床療效和安全性。
[Abstract]:Objective: to analyze and compare the improvement of observation indexes before and after treatment of ankylosing spondylitis phlegm stasis obstruction syndrome, and to evaluate the efficacy and safety of Niubai Huoxue Quphan recipe in treating ankylosing spondylitis with phlegm stasis obstruction syndrome. To provide reliable basis for clinical popularization. Contents and methods: a total of 66 cases were randomly divided into two groups: the experimental group (1 case), the control group (2 cases), the final test group (32 cases) and the control group (31 cases). The control group was treated with sulfasalopyridine enteric-coated tablets and losuprofen sodium tablets, while the experimental group was treated with Niubai Huoxue Ququan recipe on the basis of the control group. The patients in both groups were required to perform routine limb function exercises to reduce the burden and tiredness, observe for two months, record the observation indexes, and evaluate the clinical efficacy by comprehensive analysis of statistical software SPSS24.0. Results the age, sex, course of disease, main symptom score, VAS score of spinal pain and laboratory index (ESR-CRP) were compared between the two groups at baseline of 1: 1. There was no statistical difference between the two groups (p0.05). In the two groups, the total effective rate was 84.39 in the experimental group and 58.07 in the control group, and the difference was statistically significant (P0.05) in the TCM syndromes integral group, and the total effective rate was 84.39 in the experimental group and 58.07 in the control group, and the difference was statistically significant (P0.05). There was significant difference before and after treatment in the experimental group (p 0.05). In the control group, there were significant differences before and after treatment in lumbosacral pain, back pain, limited lumbar spinal activity, nocturnal pain, morning stiffness and swelling of peripheral joints (p0.05). There was no significant difference in the curative effect before and after treatment (p0.05). There was significant difference between the two groups in lumbosacral pain, back pain, limited lumbar spinal movement, nocturnal pain, swelling of extremities, dark skin and sore waist and knee (p0.05); There was no significant difference in curative effect between groups (p0.05) 4.BASDAI, spinal VAS score and PGA score in test group, control group, spinal VAS score and VAS score in group A and between groups were statistically significant (p0.05). The efficacy of ESR-CRP in the control group was statistically significant (p0.05) the safety analysis showed that one patient in the trial group had gastrointestinal discomfort such as nausea and vomiting during the course of treatment. In the control group, 1 patient had mild diarrhea and 1 patient had abnormal liver function. After the symptomatic treatment were improved, the test was completed on time. The other patients in the two groups did not find blood routine, liver and kidney function and other abnormal phenomena. Conclusion: salbutamuridine enteric-coated tablets, iosoprofen sodium tablets combined with Niubei Huoxue Quphan decoction and single salicylobuprofen enteric-coated tablets can improve the symptoms and signs of ankylosing spondylitis of phlegm-stasis type. The spinal function and inflammation index were all effective, so that the disease could be delayed, but the combination of Niubai Huoxue Quphan recipe was better and the total effective rate was higher than that of salbutamuridine enteric-coated tablet alone, and the total effective rate was higher than that of single salicyloprofen sodium tablet. The improvement of TCM symptoms is more effective. It can be seen that Niubai Huoxue Quphan recipe combined with sulfampyridine enteric-coated tablets and losuprofen sodium tablets can obtain satisfactory clinical efficacy and safety in treating ankylosing spondylitis with phlegm stasis obstruction syndrome.
【學(xué)位授予單位】：中國中醫(yī)科學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
本文編號：2149639
[Abstract]:Objective: to analyze and compare the improvement of observation indexes before and after treatment of ankylosing spondylitis phlegm stasis obstruction syndrome, and to evaluate the efficacy and safety of Niubai Huoxue Quphan recipe in treating ankylosing spondylitis with phlegm stasis obstruction syndrome. To provide reliable basis for clinical popularization. Contents and methods: a total of 66 cases were randomly divided into two groups: the experimental group (1 case), the control group (2 cases), the final test group (32 cases) and the control group (31 cases). The control group was treated with sulfasalopyridine enteric-coated tablets and losuprofen sodium tablets, while the experimental group was treated with Niubai Huoxue Ququan recipe on the basis of the control group. The patients in both groups were required to perform routine limb function exercises to reduce the burden and tiredness, observe for two months, record the observation indexes, and evaluate the clinical efficacy by comprehensive analysis of statistical software SPSS24.0. Results the age, sex, course of disease, main symptom score, VAS score of spinal pain and laboratory index (ESR-CRP) were compared between the two groups at baseline of 1: 1. There was no statistical difference between the two groups (p0.05). In the two groups, the total effective rate was 84.39 in the experimental group and 58.07 in the control group, and the difference was statistically significant (P0.05) in the TCM syndromes integral group, and the total effective rate was 84.39 in the experimental group and 58.07 in the control group, and the difference was statistically significant (P0.05). There was significant difference before and after treatment in the experimental group (p 0.05). In the control group, there were significant differences before and after treatment in lumbosacral pain, back pain, limited lumbar spinal activity, nocturnal pain, morning stiffness and swelling of peripheral joints (p0.05). There was no significant difference in the curative effect before and after treatment (p0.05). There was significant difference between the two groups in lumbosacral pain, back pain, limited lumbar spinal movement, nocturnal pain, swelling of extremities, dark skin and sore waist and knee (p0.05); There was no significant difference in curative effect between groups (p0.05) 4.BASDAI, spinal VAS score and PGA score in test group, control group, spinal VAS score and VAS score in group A and between groups were statistically significant (p0.05). The efficacy of ESR-CRP in the control group was statistically significant (p0.05) the safety analysis showed that one patient in the trial group had gastrointestinal discomfort such as nausea and vomiting during the course of treatment. In the control group, 1 patient had mild diarrhea and 1 patient had abnormal liver function. After the symptomatic treatment were improved, the test was completed on time. The other patients in the two groups did not find blood routine, liver and kidney function and other abnormal phenomena. Conclusion: salbutamuridine enteric-coated tablets, iosoprofen sodium tablets combined with Niubei Huoxue Quphan decoction and single salicylobuprofen enteric-coated tablets can improve the symptoms and signs of ankylosing spondylitis of phlegm-stasis type. The spinal function and inflammation index were all effective, so that the disease could be delayed, but the combination of Niubai Huoxue Quphan recipe was better and the total effective rate was higher than that of salbutamuridine enteric-coated tablet alone, and the total effective rate was higher than that of single salicyloprofen sodium tablet. The improvement of TCM symptoms is more effective. It can be seen that Niubai Huoxue Quphan recipe combined with sulfampyridine enteric-coated tablets and losuprofen sodium tablets can obtain satisfactory clinical efficacy and safety in treating ankylosing spondylitis with phlegm stasis obstruction syndrome.
【學(xué)位授予單位】：中國中醫(yī)科學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
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