目的 探讨解毒除湿通督汤联合小针刀治疗强直性脊柱炎(ankylosing sporidylitis，AS)的疗效及对血清C反应蛋白(C-reactive protein，CRP)、白介素 1-β(interleukin-1β，IL-1β)、肿瘤坏死因子 α(tumor necrosis factor-α，TNF-α)水平的影响。方法 将医院收治的AS患者96例随机分为对照组(48例，小针刀疗法)和治疗组(48例，解毒除湿通督汤联合小针刀)，对比治疗后疗效、证候评分、巴氏强直性脊柱炎活动性指数(Bath ankylosing spondylitis disease activity inde，BASDAI)评分、巴氏强直性脊柱炎测量指数(Bath ankylosing spondylitis metroloty index，BASMI)评分和巴氏强直性脊柱炎功能指数(Bath ankylosing spondylitis functional index，BASFI)评分、健康调查简表(the MOS item short from health survey，SF-36)评分、血清炎性因子水平、枕墙距、指地距、晨僵时间及胸廓活动度变化。结果 治疗组临床疗效明显较高(P＜0。05);治疗后两组BASMI评分、BASDAI评分和BASFI评分较治疗前明显降低(P＜0。05)，且治疗组降低较明显(P＜0。05);治疗两组后血清CRP、IL-1β和TNF-α水平较治疗前显著降低(P＜0。05)，且治疗组降低较明显(P＜0。05);治疗前两组中医证候评分差异无统计学意义(P＞0。05);治疗后两组四肢关节冷痛、颈项脊背僵紧疼痛、腰骶臀胯僵痛评分较治疗前显著降低(P＜0。05)，且治疗组降低较明显(P＜0。05);治疗前两组SF-36评分差异无统计学意义(P＞0。05)，治疗后两组SF-36较治疗前显著升高(P＜0。05)，且治疗组升高较明显(P＜0。05);治疗后两组枕墙距、指地距和晨僵时间较治疗前显著降低升高，胸廓活动度较治疗前明显升高(P＜0。05)，并且治疗组改善程度较大(P＜0。05)。结论 采用解毒除湿通督汤联合小针刀治疗湿热痹阻型强直性脊柱炎具有较好的临床疗效，能够降低血清CRP、IL-1 β和TNF-α水平，值得在临床上推广应用。
Effect of Jiedu Chushi Tongdu Decoction(解毒除湿通督汤)Combined with Small Needle-Knife in Treatment of Damp-Heat Obstruction Type of Arthralgia Ankyloss Spondylitis and Its Effect on Serum Levels of CRP,IL-1β and TNF-α
Objective To investigate the efficacy of Jiedu Chushi Tongdu Decoction(解毒除湿通督汤)combined with small needle-knife in the treatment of ankylosing spondylitis(AS)and its effects on the levels of serum C-reactive protein(CRP),interleukin-1 β(IL-1 β)and tumor necrosis factor-α(TNF-α).Method Ninety-six cases of AS patients admitted to the hospital were randomly divided into control group(48 cases,small needle-knife therapy)and treatment group(48 cases,Jiedu Chushi Tongdu Decoction combined with small needle-knife).The therapeutic effect,symptom scores,Bath ankylosing spondyli-tis disease activity index(BASDAI),Bath ankylosing spondylitis disease activity index(BASDAI),Bath ankylosing spondylitis functional index(BASFI),health survey summary table(the MOS item short from health survey,SF-36)score,the levels of ser-um inflammatory factors,occipital wall distance,digital ground distance,morning stiffness time and changes in thoracic motion of two groups were compared.Results The clinical effect of the treatment group was significantly higher(P＜0.05).The BASMI score,BASDAI score and BASFI score of the two groups were significantly lower than those before treatment(P＜0.05),and the scores of the treatment group decreased significantly(P＜0.05).The serum levels of CRP,IL-1β and TNF-α in the two groups after treatment were significantly lower than those before treatment(P＜0.05),and the levels of the treatment group de-creased significantly(P＜0.05).Before treatment,there was no difference in TCM syndrome scores between the two groups(P＞0.05).After treatment,the scores of cold pain of extremities joint,neck and back stiffness pain,or lumbosacral hip stiffness pain in the two groups were significantly lower than those before treatment(P＜0.05),and those of the treatment group decreased sig-nificantly(P＜0.05).There was no difference in SF-36 score between the two groups before treatment(P＞0.05).After treat-ment,SF-36 score in the two groups was significantly higher than that before treatment(P＜0.05),And the score of the treat-ment group increased significantly(P＜0.05).After treatment,the occipital wall distance,finger-ground distance and morning stiffness time in the two groups were significantly decreased and the changes in thoracic motion increased compared with those be-fore treatment(P＜0.05),and the indexes of the treatment group improved significantly(P＜0.05).Conclusion Jiedu Dishi Tongdu Decoction combined with small needle-knife in the treatment of damp-heat obstruction type of AS has a good clinical effect,which can reduce the levels of serum CRP,IL-1 β and TNF-α,and is worthy of clinical application.
Jiedu Chushi Tongdu Decoction(解毒除湿通督汤)small needle-knifedamp-heat obstruction type of anky-losing spondylitisclinical efficacyCRPIL-1 βTNF-α
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