补肾强督方治疗强直性脊柱炎肾虚督寒血瘀证的临床与实验研究

【作者】 薛相虎；

【导师】 阎小萍；

【作者基本信息】 北京中医药大学 ， 中医内科， 2005， 硕士

【摘要】 强直性脊柱炎(Ankylosing Spondylitis，AS)是以中轴关节慢性炎症为主、原因不明的全身性疾病。其特点为几乎全部累及骶髂关节，晚期可发生脊柱强直、严重的关节功能障碍甚至畸形。其特征性病理变化为肌腱端炎和滑膜炎。强直性脊柱炎的发病率不尽相同，美国的调查报告为0.13-0.22％，日本为0.05-0.2％。近几年通过与国际抗风湿病联盟合作调查，确定中国AS患病率约为0.3％，即在中国13亿多人口中约有400万人患本病。 AS患者不仅中轴关节疼痛、运动受限、生活质量下降，而且给家庭与社会带来巨大的经济和精神上的负担。目前本病尚缺乏满意的治疗方法，早诊断早治疗是控制病情降低致残率的关键。近年来中医药防治AS取得了良好的效果，越来越受到重视。远红外热成像能够直接、准确观测AS患者脊背软组织的情况，且远红外热成像在强直性脊柱炎病情分级、疗效评价及预后判定中也显示了较大优势。 本课题运用阎小萍教授总结出的补肾强督方治疗AS(肾虚督寒血瘀证)患者，1．对比观察治疗两个月前后的患者临床症状、中医证侯、体征、实验室检查等；2．观察治疗前后AS患者远红外线热成像的变化；分析法为使用Photoshop图像分析软件设定异温区、计算出异温区的面积。 结果显示：1．经补肾强督方治疗后，AS患者各项临床症状、体征、实验室指标较治疗前均有好转，治疗前后比较均有显著性差异(p＜0.05)，说明补肾强督方治疗强直性脊柱炎有效；2．远红外线热成像显示健康对照组未见异温区，AS患者均有异温区、平均温度比健康对照组低3.86℃；3．经补肾强督方治疗后，远红外线热像图显示AS患者脊背部异温区温度、异温区面积与治疗前比较有显著性差异(p＜0.01)；4．AS患者纤溶六项及血液流变学指标存在异常改变；5．纤溶六项中DD、FDP、AT-Ⅲ、TPA治疗前后比较有显著性差异(p＜0.05)。 补肾强督方是导师阎小萍教授经多年临床实践总结而成的。本课题的研究进一步证实了补肾强督方治疗AS肾虚督寒血瘀证患者的疗效，总疗效率为93.33％。补肾强督方能够显著改善AS患者的临床症状、体征、实验室指标及远红外线热成像图的异常变化。更多还原

【Abstract】 Ankylosing Spondylitis(AS) is a progressive form of spinal arthritis which leads to spontaneous fusion of the vertebra. It oftens manifests itself as low back pain or sacroiliac joint arthritis. Spontaneous sacroiliac joint fusion may be an early sign of this disorder. Ankylosing Spondylitis may occur by itself, or be associated with other disorders such as psoriasis or inflammatory bowel disease. Patients with ankylosing spondylitis may develop several problems regarding their spines.The morbidity of AS is not same, North American’s 0.13-0.22%, Japanese’s 0.05-0.2%. Recently the morbidity of China is 0.26%.This research studied effect of Medical thermography that is no hurt and functional check technique is used in the observation of AS, and observed the relationship between Medical thermography and the Chinese Traditional Medicine identify classifications of AS. Objective: The patient of 30 persons which is diagnosed to the as. Methods: This clinic research uses the bsqdf of professor yanxiaoping and cures as for 2months. And observed a clinic symptoms of the patient of a treatment whole afterward. l)Before treatment, observe a clinical symptoms of patients 2)After treatment patients by the bsqdf, and observe a clinical symptoms of patients again 3) Analyze the results of symptom and blood inspections.Method of infrared inspection: 1) Use IR inspection check the back of AS patients 2) Use Photoshop program analyze ache region by Majic tool 3) Analyze the region by Histogram tool of Photoshop 4) Use SPSS program, compare the regions of IR inspections Results:1. After treatment 30 AS patients, each blood inspections and symptoms have improved(ESR, CRP, Plt, symptoms).(P<0.05) It means that BSQDF has good effects to clinical symptom, joint activity function, immunity inflammation.2.Results of IR thermography*, TPA, AT-III, DD, FDP** of kidney-asthenia and Du-cold AS patients have improved. (* :P<0.01, * *: P<0.05) Conclusion:1. This clinical research for using the BSQDF treatment kidney-asthenia and Du-cold AS patients, and it can improve symptoms, blood inspections, so the BSQDF has good effect to clinical symptom, joint activity function, immunity inflammation.2. After 2months treatment, each ache regions, temperature of patient’s back on IR thermography, TPA, AT-III, DD, FDP, represent the BSQDF can reduce body blood stasis dgree.更多还原