【摘要】 目的：探讨温肾健脾定脊汤辅助治疗强直性脊柱炎的临床效果。方法：选择2019年1月-2021年1月在建瓯市立医院接受治疗的103例强直性脊柱炎患者，采用随机数表法将其分为试验组(n=52)和对照组(n=51)。对照组给予甲氨蝶呤治疗，试验组在对照组的基础上给予温肾健脾定脊汤治疗。比较两组临床疗效、血清可溶性白介素-2受体(sIL-2)、Ⅰ型胶原蛋白C末端肽(CTX-Ⅰ)、胸廓呼吸差、Schober试验、指-地距、枕-墙距、颌-柄距、C反应蛋白(CRP)、红细胞沉降率(ESR)、症状积分变化情况(脊柱痛、晨僵程度、晨僵时间)及不良反应发生情况。结果：治疗后，试验组总有效率高于对照组，差异有统计学意义(P<0.05)。治疗前，试验组和对照组血清sIL-2、CTX-Ⅰ水平比较，差异无统计学意义(P>0.05)；治疗后，试验组和对照组血清sIL-2、CTX-Ⅰ水平均较治疗前下降，且试验组低于对照组，差异有统计学意义(P<0.05)。治疗前，试验组和对照组脊柱活动度比较，差异无统计学意义(P>0.05)；治疗后，试验组和对照组胸廓呼吸差、Schober试验均较治疗前升高，且试验组高于对照组，指-地距、枕-墙距及颌-柄距均较治疗前下降，且试验组低于对照组，差异有统计学意义(P<0.05)。治疗前，试验组和对照组血清CRP、ESR水平检验结果比较，差异无统计学意义(P>0.05)；治疗后，试验组和对照组血清CRP、ESR水平均较治疗前下降，且试验组低于对照组，差异有统计学意义(P<0.05)。治疗前，试验组和对照组症状积分水平比较，差异无统计学意义(P>0.05)；治疗后，试验组和对照组脊柱痛、晨僵程度、晨僵时间均较治疗前下降，且试验组低于对照组，差异有统计学意义(P<0.05)。两组不良反应总发生率相比，差异无统计学意义(P>0.05)。结论：在强直性脊柱炎患者中应用温肾健脾定脊汤辅助治疗效果显著，可有效改善患者血清sIL-2、CTX-Ⅰ、脊柱活动度、血清CRP、ESR水平及临床症状积分，且不增加不良反应。更多还原

【Abstract】 Objective:To study the clinical efficacy of adjuvant treatment of Wenshen Jianpi Dingji Decoction on ankylosing spondylitis.Method:A total of 103 patients with ankylosing spondylitis who received treatment in Jian’ou Municipal Hospital from January 2019 to January 2021 were selected and divided into experimental group (n=52) and control group (n=51) by random number table method.The control group was given Methotrexate treatment,the experimental group was given Wenshen Jianpi Dingji Decoction treatment on the basis of the control group.The clinical efficacy,serum soluble interleukin-2 receptor (sIL-2),C-terminal peptide of type Ⅰ collagen (CTX-Ⅰ),thoracic respiratory difference,Schober test,finger-ground distance,occipito-wall distance,jaw-stem distance,C-reactive protein (CRP),erythrocyte settler rate (ESR),changes in symptom scores (spinal pain,morning stiffness degree,morning stiffness time) and incidence of adverse reactions were compared between the two groups.Result:After treatment,the total effective rate of the experimental group was higher than that of the control group,the difference was statistically significant (P<0.05).Before treatment,there were no significant differences in serum sIL-2 and CTX-Ⅰ between the experimental group and the control group (P>0.05).After treatment,serum sIL-2 and CTX-Ⅰ levels in experimental group and control group decreased than those before treatment,and the indexes in the experimental group were lower than those in the control group,the differences were significant (P<0.05).Before treatment,there were no significant differences between the experimental group and the control group in the levels of spinal range of motion (P>0.05).After treatment,the thoracic respiration difference and Schober test level of the experimental group and the control group increased than those before treatment,and the indexes in the experimental group were higher than those of the control group,the finger-ground distance,occipito-wall distance and jaw-stalk distance all decreased than those before treatment,and the indexes in the experimental group were lower than those in the control group,the differences were statistically significant (P<0.05).Before treatment,there were no significant differences in serum CRP and ESR levels between the experimental group and the control group (P>0.05).After treatment,serum CRP and ESR levels of experimental group and control group decreased than those before treatment,and the indexes in the experimental group were lower than those in the control group,the differences were statistically significant (P<0.05).Before treatment,there were no significant differences in symptom scores level between the experimental group and the control group (P>0.05).After treatment,the levels of spinal pain,morning stiffness and morning stiffness time in the experimental group and the control group decreased,and the indexes in the experimental group were lower than those in the control group,the differences were significant (P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05).Conclusion:In patients with ankylosing spondylitis,Wenshen Jianpi Dingji Decoction can effectively improve serum sIL-2,CTX-Ⅰ,spinal range of motion,serum CRP,ESR levels and clinical symptom score,without increasing adverse reactions.更多还原