Liu Wei, Zhang Di, Wu Yuan-hao, Yang Hui-jun
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Jun;36(6):663-7.
To observe the clinical effect of Chinese medical (CM) syndrome differentiation based Chinese herbs and recombinant human tumor necrosis factor receptor II-antibody fusion protein (etanercept) for treating ankylosing spondylitis (AS) patients.
Totally 35 AS patients were treated with syndrome differentiation based Chinese herbs and etanercept. Reinforcing Shen and strengthening Du channel, activating meridians to stop pain was principle used in syndrome differentiation based treatment. Etanercept was subcutaneously injected, 25 mg each time; twice per week for the first three months and once a week for the latter three months. The clinical efficacy was evaluated after 3 and 6 months of treatment. Meanwhile, ASAS20 and ASAS50 standards arriving rates were also observed. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), visual analog score (VAS) for spine pain, VAS for night pain, patient global assessment (PGA), VAS for physician global assessment, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, cervical rotation, Schober improved test, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were observed before treatment, 3 and 6 months after treatment.
Compared with before treatment, BASDAI, BASFI, VAS for spine pain, night pain, physician global assessment, PGA, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, Schober improved test, ESR, and CRP all decreased after 3 and 6 months of treatment, with statistical difference (P < 0.05). Cervical rotation also decreased after 6 months of treatment, with statistical difference (P < 0.05). Compared with 3 months of treatment, total effective rate of CM syndrome, ASAS20 and ASAS50 standards arriving rates increased after 6 months of treatment, with statistical difference (P < 0.05). There were statistical differences in all indices mentioned above between after 3 months of treatment and after 6 months of treatment (P < 0.05).
Syndrome differentiation based Chinese herbs combined etanercept could alleviate inflammatory reaction favorably, control the progression of active AS, and improve joint functions.
观察中医辨证论治联合重组人肿瘤坏死因子受体Ⅱ-抗体融合蛋白(依那西普)治疗强直性脊柱炎(AS)患者的临床疗效。
35例AS患者采用中医辨证论治联合依那西普治疗。辨证论治以补肾强督、通络止痛为原则。依那西普皮下注射,每次25mg;前3个月每周2次,后3个月每周1次。治疗3个月和6个月后评估临床疗效。同时,观察ASAS20和ASAS50标准达标率。观察治疗前、治疗3个月和6个月后的巴斯强直性脊柱炎疾病活动指数(BASDAI)、巴斯强直性脊柱炎功能指数(BASFI)、脊柱疼痛视觉模拟评分(VAS)、夜间疼痛VAS、患者整体评估(PGA)、医生整体评估VAS、中医证候评分、指地距、胸廓活动度、耳屏-墙距离、腰椎侧弯、颈椎旋转度、Schober改良试验、红细胞沉降率(ESR)和C反应蛋白(CRP)。
与治疗前比较,治疗3个月和6个月后BASDAI、BASFI、脊柱疼痛VAS、夜间疼痛VAS、医生整体评估、PGA、中医证候评分、指地距、胸廓活动度、耳屏-墙距离、腰椎侧弯、Schober改良试验、ESR和CRP均降低,差异有统计学意义(P<0.05)。治疗6个月后颈椎旋转度也降低,差异有统计学意义(P<0.05)。与治疗3个月比较,治疗6个月后中医证候总有效率、ASAS20和ASAS50标准达标率升高,差异有统计学意义(P<0.05)。治疗3个月后与治疗6个月后的上述各项指标比较,差异有统计学意义(P<0.05)。
中医辨证论治联合依那西普能较好地减轻炎症反应,控制活动期AS的进展,改善关节功能。