Clinical Effect Observation Of Treating Ankylosing Spondylitis With Tongbi Decoction

Background:Ankylosing Spondylitis(ankylosing spondylitis,AS) is a kind of systematic disease that is mainly manifested as chronic inflammation of axial joints and bone attachment points of ligament and tendons.Until now,there is still no satisfactory way of curing the disease,it is internationally recognized as a refractory disease.Although the incidence in China is not high,but due to the large population base,there are a large number of patients.Although AS has little effect on human life span,patients with AS may have apparent stiffness and pains on the back.Advanced AS will lead to rigid spine and spinal deformity,resulting in serious body dysfunctions,therefore,it brings great suffering to patients and serious impact on their quality of life.This paper reviewed the course of understanding AS in areas of both Chinese and Western medicine.It also summarized researches and relative knowledge concerning the etiology,pathogenesis,diagnosis and drug mechanism of AS as well as the main methods of treating AS with drug therapy for the present time.Especially,it discussed the founding law of Tongbi Decoction and its theoretical basis for treating AS.Through the analysis of controlled trials,clinical efficacy Tongbi Decoction was assessed,trying to present my personal ideas and views on the treatment of ankylosing spondylitis with Chinese medicine in the future clinical research.Purpose:Through observing the clinical efficacy of two methods of treating AS with Tongbi decoction and Tongbi Decoction combined with sulfasalazine tablet and applying a number of quantitative indicators to evaluate the efficacy of the two methods,this study aimed at providing literature and data support to establish a efficacy evaluation system for the future treatment of AS with Chinese medicine based on the principle of nourishing kidney and reinforcing Du meridian in Lingnan region,which will further help the researches of treating AS with Chinese medicine.Subjects and Methods:Among the outpatients and inpatients in Zhuhai Branch of Guangdong Provincial TCM Hospital,43 cases were selected who were in accord with the inclusion criteria and were divided randomly into two groups with 23 cases in Chinese medicine group and 20 cases in the Joint Group.Chinese medicine group were treated with Tongbi Decoction cooked in water taken by patients when it was still warm.One dose each day,the decoction was taken twice a day in the morning and in the evening.The joint group were treated with Tongbi Decoction as well as sulfasalazine tablet.The way and frequency of taking Tongbi decoction was the same with the Chinese medicine group,sulfasalazine tablet was taken orally 1.0g per time and 2 times a day.The treatment of both groups lasted for 6 months.Relative data of the patients before treatment,after 1 month' treatment,after 3 months' treatment and at the end of treatment were collected to make evaluations.The main effect indicators used in the two groups include Bath ankylosing spondylitis disease activity index(BASDAI) Scale,Bath ankylosing spondylitis function index(BASFI) Scale,pains(usinglOOmm visual analogue scale VAS to estimate pains caused by AS in the nearest weekand pains caused by AS),morning stiffness time,the patient' s overall assessment(VAS score).Secondary efficacy indicators include Schober test,chest stretching degree,finger-ground distance,pillow-wall distance and ESR.The relevant data were selected into the database so as to establish a database system and statistical analysis software was used to come up with a conclusion.Result:The data of this study showed that:after the treatment with Tongbi decoction for 6 months,the related symptoms,signs and indicators of AS,such as pains,morning stiffness,Schober test,finger-ground distance,BASDAI index,BASFI index,there has been a marked improvement.Comparing the overall efficacy treating AS with Tongbi decoction alone and that of treating AS by Tongbi decoctin combined with sulfasalazine tablets after 6 month' s treatment,the difference was not statistically significant.But comparing the overall efficacy treating AS with Tongbi decoction alone and that of treating AS by Tongbi decoctin combined with sulfasalazine tablets after 3 month' s treatment,the difference was statistically significant.At this point,treating AS by Tongbi decoction combined with sulfasalazine tablet had an better effect than treating AS with Tongbi Decoction alone.Conclusion:Treating AS with Tongbi decoction alone had goo clinical effect.The overall efficacy of treating AS by Tongbi decoction combined with sulfasalazine tablet was no better than using Tongbi decoction alone after 6 months' treatment,but the later had a later effect.