中国骨质疏松杂志

重骨颗粒对强直性脊柱炎患者疾病活动及骨代谢的影响

Effect of the Chonggu granule on disease activity and bone metabolism in patients with ankylosing spondylitis

DOI：10.3969/j.issn.1006-7108.2023.05.004

英文关键词:traditional Chinese medicine ankylosing spondylitis Chonggu granule disease activity bone metabolism

基金项目:国家自然科学基金项目（81473672）；国家自然科学基金青年基金项目（82104782）；安徽省高校协同创新项目（GXXT-2021-085）；安徽省高校自然科学研究基金重点项目（KJ2020A0395，KJ2021A0556）；安徽省红十字基金会中医药传承创新发展项目（2021ZYZD03）；安徽省名中医工作室建设项目（中发展[2022]5号）；安徽中医药大学研究生科技创新基金项目（2021YB06）

作者	单位
汤忠富# 尚双双# 陈君洁戈扬程丽丽徐昌萍束龙武庞利君李云飞付皖兰李明* 黄传兵*	安徽中医药大学第一附属医院风湿科，安徽合肥 230031

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中文摘要:

目的观察重骨颗粒对强直性脊柱炎（ankylosing spondylitis，AS）患者疾病活动及骨代谢的影响。方法将84例AS患者随机分成对照组和观察组，每组42例。对照组予以基础治疗，口服柳氮磺吡啶片联合塞来昔布胶囊，观察组在对照组的基础上加重骨颗粒口服，疗程均为12周。观察治疗前后巴氏AS疾病活动度指数（BASDAI）、AS疾病活动度评分（ASDAS）、巴氏AS功能指数（BASFI）和中医症状评分的变化，检测治疗前后C反应蛋白（C-reactive protein，CRP）、红细胞沉降率(erythrocyte sedimentation rate，ESR）、抑炎因子[白介素10（IL-10）]、促炎因子[白介素1β（IL-1β）、白介素17（IL-17）]、骨代谢指标[骨特异性碱性磷酸酶（BALP）、血清β胶原降解产物（β-CTX）、I型前胶原氨基末端肽（PINP）]水平。结果两组均无脱落病例，治疗后观察组ASAS20达标率83.33%，显著优于对照组的64.29%（?2=3.941，P＜0.05）；ASAS50达标率为71.43%，显著优于对照组的47.62%（?2=4.941，P＜0.05）。与治疗前比较，两组治疗后BASDAI、ASDAS、BASFI、中医症状评分、CRP、ESR、IL-1β、IL-17、β-CTX水平均显著降低（P＜0.05或P＜0.01），IL-10、BALP显著升高（P＜0.01）。观察组治疗后BASDAI、ASDAS、BASFI、中医症状评分、CRP、ESR、IL-1β、IL-17、β-CTX均显著低于对照组治疗后（P＜0.05或P＜0.01），IL-10、BALP、PINP显著高于对照组（P＜0.05或P＜0.01）。观察期间两组均未见不良反应。结论重骨颗粒可明显降低AS患者疾病活动度，上调抑炎因子，下调促炎因子，改善骨代谢，安全性高。

英文摘要:

Objective To observe the effect of the Chonggu granule on disease activity and bone metabolism in patients with ankylosing spondylitis (AS). Methods Eighty-four AS patients were randomly divided into control group and observation group, with 42 cases in each group. Patients in the control group received basic treatment with the sulfasalazine tablet combined with the celecoxib capsule orally. Patients in the observation group received oral Chonggu granule on the basis of the control group, and the course of treatment was 12 weeks. The changes of BASDAI, ASDAS, BASFI, and TCM symptom score before and after the treatment were observed. C-reactive protein (CRP), ESR, anti-inflammatory factor interleukin 10 (IL-10), proinflammatory factor interleukin 1β (IL-1β) and interleukin 17 (IL-17), bone metabolism indexes bone-specific alkaline phosphatase (BALP), serum β collagen degradation product (β-CTX), type I procollagen, and amino terminal peptide (PINP) levels were detected before and after the treatment. Results There was no drop case in both groups. After the treatment, the ASAS20 standard rate was 83.33%, which was significantly higher than that in the control group (64.29%) (χ2=3.941, P<0.05). ASAS50 compliance rate was 71.43% in the observation group, which was significantly higher than that in the control group (47.62%, χ2=4.941, P<0.05). Compared to those before the treatment, the levels of BASDAI, ASDAS, BASFI, TCM symptom score, CRP, ESR, IL-1β, IL-17, and β-CTX in both groups decreased significantly after the treatment (P<0.05 or P<0.01), while the levels of IL-10 and BALP increased significantly (P<0.01). After the treatment, BASDAI, ASDAS, BASFI, TCM symptom score, CRP, ESR, IL-1β, IL-17, and β-CTX levels in the observation group were significantly lower than those in the control group (P<0.05 or P<0.01), while IL-10, BALP, and PINP were significantly higher than those in the control group (P<0.05 or P<0.01). There was no adverse reaction in both groups during the observation period. Conclusion Chonggu granule significantly reduces the disease activity in AS patients, up-regulates anti-inflammatory factors, down-regulates pro-inflammatory factors, and improves bone metabolism, with high safety.

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