Clinical Study Of Jianpichubi Decoction Combined With Western Medicine On Ankylosing Spondylitis Of Spleen-kidney Deficiency And Phlegm Dampness Obstruction Type

Objective: To investigate the efficiency and safety of Jianpichubi decoction combined with western medicine in treating ankylosing spondylitis(AS)of spleen-kidney deficiency and Phlegm dampness obstruction type,and to apply the evidence of Chinese combined western medicine therapy in AS.Method: From 2016-05-01 to 2017-5-31,forty-six patients with AS in the first affiliated hospital of Guangxi University of Chinese Medicine were selected and randomly divided into the control group(n=23)and the treatment group(n=23)according to random number table.Oral administration of thalidomide and diclofenac were given to the all patients,meanwhile,Jianpichubi decoction was given to the patients in the treatment group extra.After twelve weeks of treatment,the observed cases were evaluated as follows: the bath ankylosing spondylitis global score(BASG),the bath ankylosing spondylitis disease activity index(BASDA),the bath ankylosing spondylitis functional index(BASFI),the VAS sore of spine pain,the moring stiffness duration,the morning stiffness severity,the Chinese medicine symptom score,the laboratory indexes(routine blood,urine and stool test,liver and kidney functions,erythrocyte sedimentation rate,and C-reactive protein)and thesigns(finger-floor distance,occipital wall gap and schober’s text).And then,the evaluation of the clinical therapeutic effect were made by the ASAS criterion(ASAS20 、 ASAS40 and ASAS70),which made by Assessment in Ankylosing Spondylitis international Society(ASAS),and the efficiency standard in the clinical study principles of Chinese new herbal medicine(2002).Results:(1)The percentage of ASAS20 was 69.6% in the treatment group,while 34.8% in the control group.The clinical effect in the treatment group was better than that in the control group(P<0.05).The percentage of ASAS40 and ASAS70 in both groups had no statistical significant differences(P>0.05).(2)The total effective rate was 86.4% in the treatment group,and was 52.4% in the control group.The results of the groups comparison after treatment presented the statistical significant differences(Z=-2.33,P < 0.05).(3)Improvement occurred in BASG,BASDAI,BASFI,the VAS sore of spine pain,the morning stiffness duration,the Chinese medicine symptom score,schober’s text and erythrocyte sedimentation rate(P<0.01 或 P<0.05).and there was more significant improvement in the treatment group with a statistical significance(P<0.01 或 P<0.05).After treatment,there are obviously improved in the finger-floor distance,occipito wall gap and C-reactive protein in the two groups(P < 0.01 或 P < 0.05),but there was no significant difference betweem two groups.(4)There were no abnormality in the blood,urine and stool routine examination,liver and renal function in the two groups.The adverse effects included week,constipation,sleepy and abdominal pain,et al.The rate of adverse events in the treatment group(17%)was lower than that in the control group(52%),and the difference has statistically significant(P<0.05).Conclusion: Combined with western medicine,Jianpichubi decoction can effectively reduce the clinical symptoms of AS,improve the disease activity scores,schober’s text,and erythrocyte sedimentation rate,and enhance the clinical effects in AS.At the same time,its adverse events rate was low.In short,it is value to promote to treat AS in clinic.