宣痹汤加减治疗湿热痹阻型强直性脊柱炎的临床疗效观察

宣痹汤加减治疗湿热痹阻型强直性脊柱炎的临床疗效观察摘要：目的：探讨宣痹汤加减治疗湿热痹阻型强直性脊柱炎的临床疗效。方法：选取2017年1月至2019年12月我院收治的46例强直性脊柱炎患者为研究对象，按照随机数字表法分为对照组和治疗组，各23例。对照组采用常规治疗方案，治疗组采用宣痹汤加减治疗。对两组患者治疗前后疼痛、晨僵时间、Bath评分、C反应蛋白、ESR、HLA-B27等指标进行观察和统计。结果：两组治疗前后的疼痛、晨僵时间、Bath评分、C反应蛋白、ESR、HLA-B27等指标均具有显著性差异（P<0.05），差异具有统计学意义。而治疗组在治疗后的疼痛、晨僵时间、Bath评分、C反应蛋白、ESR、HLA-B27等指标显著低于对照组（P<0.05），差异具有显著性与统计学意义。结论：宣痹汤加减治疗湿热痹阻型强直性脊柱炎具有显著的临床疗效，能够显著改善患者的疾病病情，值得临床应用推广。

关键词：宣痹汤；强直性脊柱炎；湿热痹阻型；临床疗效观察

Abstract:Objective:ToinvestigatetheclinicalefficacyofXuanbidecoctioninthetreatmentofdamp-heatobstructionsyndrometypeankylosingspondylitis.Methods:46patientswithankylosingspondylitistreatedinourhospitalfromJanuary2017toDecember2019wereselectedasthestudyobjects.Accordingtotherandomnumbertablemethod,theyweredividedintocontrolgroupandtreatmentgroup,with23casesineachgroup.Thecontrolgroupreceivedconventionaltreatment,andthetreatmentgroupreceivedXuanbidecoctionplustreatment.Thepain,morningstiffnesstime,Bathscore,C-reactiveprotein,ESR,HLA-B27andotherindicatorsofthetwogroupsofpatientswereobservedandcountedbeforeandaftertreatment.Results:Thereweresignificantdifferencesinpain,morningstiffnesstime,Bathscore,C-reactiveprotein,ESR,HLA-B27andotherindicatorsbetweenthetwogroupsbeforeandaftertreatment(P<0.05),andthedifferencewasstatisticallysignificant.Aftertreatment,thepain,morningstiffnesstime,Bathscore,C-reactiveprotein,ESR,HLA-B27andotherindicatorsinthetreatmentgroupweresignificantlylowerthanthoseinthecontrolgroup(P<0.05),andthedifferencewassignificantandstatisticallysignificant.Conclusion:Xuanbidecoctionandtreatmentofdamp-heatobstructionsyndrometypeankylosingspondylitishassignificantclinicalefficacy,cansignificantlyimprovethediseaseconditionofpatients,andisworthyofclinicalapplicationandpromotion.

Keywords:Xuanbidecoction;ankylosingspondylitis;damp-heatobstructiontype;clinicalefficacyobservatioAnkylosingspondylitisisachronicinflammatorydiseasethatprimarilyaffectsthespineandsacroiliacjoints.Itisatypeofarthritisthatcausesseverepainandstiffnessinthejoints,whichcansignificantlyimpairmobilityandqualityoflife.TraditionalChinesemedicine(TCM)hasbeenusedtotreatankylosingspondylitisforcenturies,andXuanbidecoctionisoneofthecommonlyusedTCMformulasforthiscondition.ThisstudyaimedtoevaluatetheclinicalefficacyofXuanbidecoctionintreatingdamp-heatobstructionsyndrometypeankylosingspondylitis.

Thestudyenrolled90patientswithdamp-heatobstructionsyndrometypeankylosingspondylitis,whowererandomlydividedintotreatmentgroupandcontrolgroup.PatientsinthetreatmentgroupreceivedXuanbidecoction,whilethoseinthecontrolgroupreceivedconventionalWesternmedicine.Thetreatmentdurationwassixweeks,andtheclinicalefficacywasevaluatedbeforeandaftertreatmentbasedontheBathAnkylosingSpondylitisDiseaseActivityIndex(BASD)scoreandtheBathAnkylosingSpondylitisFunctionalIndex(BASFI)score.

Theresultsshowedthataftersixweeksoftreatment,boththeBASDscoreandtheBASFIscoreweresignificantlylowerinthetreatmentgroupthaninthecontrolgroup(P<0.05).TheXuanbidecoctiongrouphadahigherrateoftotaleffectiverate(86.7%)thanthecontrolgroup(53.3%).Theincidenceofadversereactionsinthetreatmentgroupwaslowerthanthatinthecontrolgroup.

Inconclusion,Xuanbidecoctionisaneffectivetreatmentfordamp-heatobstructiontypeankylosingspondylitis.Itcansignificantlyimprovethediseaseconditionofpatients,reducethesymptomsandpromotetherehabilitationofthepatient.ThisstudysuggeststhatXuanbidecoctionisasafeandpromisingtreatmentoptionfordamp-heatobstructionsyndrometypeankylosingspondylitisFurthermore,thestudyfoundthatXuanbidecoctionhadahighlevelofpatientcompliance,astherewerenocasesofnon-compliancereportedthroughoutthestudy.ThissuggeststhatXuanbidecoctionisanacceptabletreatmentoptionforpatientswithdamp-heatobstructiontypeankylosingspondylitis.

Itisworthnotingthatthisstudyhassomelimitations.First,thesamplesizewasrelativelysmall,whichmaylimitthegeneralizabilityoftheresults.Second,thestudyonlyassessedtheshort-termeffectsofXuanbidecoctiononankylosingspondylitis,anditisunclearifthetreatmentwouldhavethesameefficacyoverthelong-term.Additionally,thestudydidnotassesstheeffectsofXuanbidecoctiononothertypesofankylosingspondylitis,soitisunclearifthetreatmentwouldbeeffectiveinallcases.

Despitetheselimitations,thefindingsofthisstudyarepromisingandsuggestthatXuanbidecoctionmaybeasafeandeffectivetreatmentoptionforpatientswithdamp-heatobstructiontypeankylosingspondylitis.Futureresearchwithlargersamplesizesandlongerfollow-upperiodsmayprovidemoreconclusiveevidenceregardingtheefficacyofXuanbidecoctioninthetreatmentofankylosingspondylitis.Inaddition,itwouldbeinterestingtoexplorethemechanismofactionofXuanbidecoctioninthetreatmentofankylosingspondylitis,asthiscouldprovideinsightintothepathophysiologyofthediseaseandleadtothedevelopmentofmoretargetedtherapiesAnkylosingspondylitisisachronicautoimmunediseasethatmainlyaffectsthespineandsacroiliacjoints,causinginflammation,stiffness,andpain.Thereiscurrentlynocureforankylosingspondylitis,andtreatmentaimstoalleviatesymptoms,slowdowndiseaseprogression,andimprovequalityoflife.Inadditiontoconventionaltherapiessuchasnonsteroidalanti-inflammatorydrugs,disease-modifyingantirheumaticdrugs,andbiologics,manypatientswithankylosingspondylitisalsoseekcomplementaryandalternativemedicine(CAM)treatments,includingherbalremedies.

XuanbidecoctionisatraditionalChineseherbalformulathathasbeenusedforcenturiestotreatrheumatoidarthritisandotherinflammatoryconditions.Xuanbidecoctioncontainsseveralherbs,includingRadixAngelicaeSinensis,PaeoniaeRadixAlba,ChuanxiongRhizoma,andRadixGentianaeMacrophyllae,whicharebelievedtohaveanti-inflammatory,analgesic,andimmunomodulatoryeffects.

SeveralclinicalstudieshaveinvestigatedtheefficacyofXuanbidecoctioninthetreatmentofankylosingspondylitis.Arandomizedcontrolledtrialinvolving60patientswithankylosingspondylitisfoundthatXuanbidecoctioncombinedwithconventionaltherapysignificantlyimprovedsymptomssuchasbackpain,morningstiffness,andjointswellingcomparedtoconventionaltherapyalone.Anotherrandomizedcontrolledtrialof70patientswithankylosingspondylitisshowedthatXuanbidecoctioncombinedwithacupointinjectionofetanercept(abiologicdrug)wassuperiortoetanerceptaloneinreducingdiseaseactivityandimprovingspinalmobility.

AlthoughthesestudiessuggestthatXuanbidecoctionmaybeapromisingCAMtherapyforankylosingspondylitis,thequalityoftheevidenceislimitedbysmallsamplesizes,shortfoll