补肾强脊汤治疗强直性脊柱炎的临床研究
|
摘要
目的:评价补肾强脊汤治疗强直性脊柱炎(AS)肾虚血瘀证的疗效与安全性。
方法:采用随机、对照方法,将60例AS肾虚血瘀证患者随机分为中药组和西药组,中药组予以补肾强脊汤治疗,西药组给予柳氮磺胺吡啶(SASP)治疗,连续用药6个月。采用国际ASAS工作组制定的ASAS20、BASDAI50标准及中医证候疗效标准,评价中药治疗AS的疗效。
结果:两组患者Bath病情活动指数、Bath功能指数、疼痛、炎症指数等临床症状均有明显的改善,腰椎前屈、腰椎侧弯、ESR、CRP亦有改善;治疗组中医临床症状改善明显。
结论:补肾强脊汤治疗AS临床疗效满意,其作用机制可能与抗炎、镇痛、改善血流变、增强免疫、抑制破骨细胞等有关,安全性及依从性好,有广阔的应用前景。
Objective: To evaluate the curative effect and security of the invigorating kidney and stronging ridge soup used to treat kidney deficiency and blood stasis of ankylosing spondylitis (AS) .
Methods: Applying a randomized, control methods, 60 cases of kidney deficiency and blood stasis in patients with AS were randomly divided into traditional Chinese medicine and western medicine group.The first group were given the invigorating kidney and stronging ridge soup, the western medicine group were given sulfasalazine (SASP) treatment, continuous medication for 6 months. Adopting the ASAS20 and BASDAI50 standards developed by international ASAS Working Group and efficiency of TCM Syndromes criteria to evaluate the efficiency of Chinese medicine treatment of AS.
Results: The Bath disease activity index, Bath functional index, pain、inflammation index and clinical symptoms have shown obvious improvement, lumbar flexion, lumbar scoliosis, ESR, CRP were also improved.The treatment group's clinical symptoms improved significantly.
Conclusion: The invigorating kidney and stronging ridge soup used to treat AS has obtained satisfying clinical effects.its function mechanism possibly related to the anti-SARS, the analgesia, the improvement blood stream change, the enhancement immunity, suppressing the osteoclast and so on.its security and the compliance is good, it has the broad application prospect.
方法:采用随机、对照方法,将60例AS肾虚血瘀证患者随机分为中药组和西药组,中药组予以补肾强脊汤治疗,西药组给予柳氮磺胺吡啶(SASP)治疗,连续用药6个月。采用国际ASAS工作组制定的ASAS20、BASDAI50标准及中医证候疗效标准,评价中药治疗AS的疗效。
结果:两组患者Bath病情活动指数、Bath功能指数、疼痛、炎症指数等临床症状均有明显的改善,腰椎前屈、腰椎侧弯、ESR、CRP亦有改善;治疗组中医临床症状改善明显。
结论:补肾强脊汤治疗AS临床疗效满意,其作用机制可能与抗炎、镇痛、改善血流变、增强免疫、抑制破骨细胞等有关,安全性及依从性好,有广阔的应用前景。
Objective: To evaluate the curative effect and security of the invigorating kidney and stronging ridge soup used to treat kidney deficiency and blood stasis of ankylosing spondylitis (AS) .
Methods: Applying a randomized, control methods, 60 cases of kidney deficiency and blood stasis in patients with AS were randomly divided into traditional Chinese medicine and western medicine group.The first group were given the invigorating kidney and stronging ridge soup, the western medicine group were given sulfasalazine (SASP) treatment, continuous medication for 6 months. Adopting the ASAS20 and BASDAI50 standards developed by international ASAS Working Group and efficiency of TCM Syndromes criteria to evaluate the efficiency of Chinese medicine treatment of AS.
Results: The Bath disease activity index, Bath functional index, pain、inflammation index and clinical symptoms have shown obvious improvement, lumbar flexion, lumbar scoliosis, ESR, CRP were also improved.The treatment group's clinical symptoms improved significantly.
Conclusion: The invigorating kidney and stronging ridge soup used to treat AS has obtained satisfying clinical effects.its function mechanism possibly related to the anti-SARS, the analgesia, the improvement blood stream change, the enhancement immunity, suppressing the osteoclast and so on.its security and the compliance is good, it has the broad application prospect.
引文
[1]郑筱萸主编.中药新药临床研究指导原则.北京:中国医药科技出版社,2001∶119—123.
[2]蒋明,David Yu,林孝义,等.中华风湿病学.北京:华夏出版社, 2004∶1018—1019.
[3] Jenkinson TR,Mallorie RA,Whitelock HC,etcal.Defining spinal mobility in ankylosing spondylitis(AS).The Bath AS Metrology Index[J].J Rheumatol,1994,21:1694_1698.
[4] Garrett S, Jenkinson T, Whitelock H, et al. A new approachto defining disease status in AS: the Bath Ankylosing Spondyli-tis Disease Activity Index(BASDAI). J Rheumatol 1994;21(12)∶2286—2291.
[5] Calin A, Garrett S, Whitelock H, et al. A new approach todefining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index(BASFI). J Rheumatol 1994;21(12)∶2281—2285.
[6]李青南,廖进民,吴铁,等.淫羊藿防治羟基脲致雄大鼠骨质疏松的定量研究[ J] .中国中医骨伤科杂志, 1996, 4( 3) : 1.
[7]李青南,黄连芳,谢华,等.淫羊藿防治羟基脲致雄大鼠骨质疏松的定量研究[ J] .中草药, 1997, 28( 6) : 528.
[8]李青南,廖进民,吴铁,等.淫羊藿提取液防治激素所致大鼠骨质疏松的实验研究[ J] .中国药学杂志, 1996, 44( 8) : 647.
[9]张逸凡,于庆海.淫羊藿总黄酮的抗炎作用[ J] .沈阳药科大学学报, 1999, 43( 2) : 47- 49.
[10]张润荃,史凤芹,庞淑珍,等.补骨脂对分离破骨细胞作用的研究[J].现代口腔医学杂志,1995,9(3):136-138.
[11]姜宪辉,张健,刘辉.补骨脂对激发态小鼠的体液免疫影响的实验研究[J].辽宁中医学院学报, 2004, 6(2): 116.
[12]杨光,李发胜,刘辉.补骨脂多糖对小鼠激发态免疫功能的影响[J].中药材,2004, 27(1): 42.
[13]徐诗伦,等.杜仲对机体非特异性免疫功能的影响.中草药,1993,14(8):27.
[14]徐诗伦,等.杜仲对细胞免疫功能的影响.中草药1985,11(9):15.
[15]王蕊,邱明才.单剂量补肾中药防治去卵巢大鼠骨质疏松的骨形态计量学研究[J].天津医药,1999,273:131-134.
[16]石扣兰,李丽芬,李月英,等.川续断对小鼠免疫功能的影响[J].中药药理与临床,1998,14(1):36-37.
[17]肖锦松,崔风军,宁廷选,等.玉竹、菟丝子醇提物对烧伤小鼠免疫功能的影响.中国中药杂志,1990,15(9):45-47.
[18]孙水平,李新华,孙曙光.怀牛膝药理研究续报·河南中医,1985;(1):39怀牛膝水煎液能减轻大白鼠蛋清性脚部炎症.
[19]史玉芬,郑延彬牛膝抗炎、抗菌作用的研究中药通报,1988;13(7):44.
[20]郑宝灿,陈忠科怀牛膝多倍体、单体和二倍体的药理作用比较药学通报,1988;23(11):666.
[21]杨铁虹,商澎,梅其炳.当归多糖硫酸酯对凝血和血小板聚集的作用[J].中草药,2002,33(11):1010-1013.
[22]乐江,彭仁,孔锐,等.当归粗多糖镇痛作用的实验研究[J].中国药学杂志,2002, 37(10):746-748.
[23] Sang Bae Han, Young Hee Kim,Chang Woo Lee, et al.Character-istic immunostimulation by angelan isolated fromAngelica gigas Nakai[J]. Immunopharmacology,1998,40:39-48.
[24]王瑾,刘君炎,夏丰年,等.瘤苗联合当归多糖抗瘤的实验研究[J].湖北医科大学学报,1999,20(4):283-284.
[25]奚瑾磊,彭仁,杨哲琼.当归多糖及其中性组分对巨噬细胞分泌TNF-α的影响[J].武汉大学学报(医学版),2002,23(1):21-23.
[26]刘超,王静,杨军.赤芍总甙活血化瘀作用的研究.中药材,2000; 23(9): 557-560.
[27]宋坤,陆兔林等.莪术不同炮制吕镇痛抗炎作用研究[J]中医药学刊,2005,23(3);443.
[28]王普霞等.莪术不同炮制品活血化瘀作用研究[J]中成药,2004,26(11):905.
[29]徐理纳,徐德成,张向嘉,等.阿魏酸钠抗血小板聚集作用的机理研究-对TXA2/PGI2平衡的影响[J].中国医学科学院学报, 1984, 6(6): 414.
[30]王永发,赵淑雯,陈林芳,等.灯盏细辛口服液治疗痹症的主要药效学[J].云南中医药杂志,2000,21(5):36-38.
[31]张丽丽,关振中,张竞逵细辛脂素体外免疫抑制作用的实验研究中华心血管病杂志2003;31(6):444.
[32]张明发,沈推琴,朱自平,等.羌活的镇痛抗炎抗血栓形成作用研究[J],中医药研究,1996,(6)∶51-53.
[33]张明发,沈推琴,朱自平,等.羌活的镇痛抗炎抗血栓形成作用研究[J],中医药研究,1996,(6)∶51-53.
[34]张小丽,谢人明,冯英菊.四种中药对血小板聚集性的影响[J].西北药学杂志,2000,15(6)∶260-261.
[35] Wang QW,Zeng QY,Xiao ZY,etal. Needle biopsy of spondy loarthropathy pathological features and clinical significance.Chin J Intern Meal,2004,43(11):832-836.
[36] Yilmaz N,Dzaslan J.Biochemical bone turnover markers in patients With ankylosing spondylitis.Clin Rheumatol,2000,19(2):92-98.
[37] Sarikaya S,Basaran A,Tekin Y,etal.Is osteoporosis generalized or Localized to central skeleton in ankylosing spondylitis.J Clin Rheumatol,2007,13:20-24.
[1]王政.陈湘君治疗强直性脊柱炎经验[J].辽宁中医杂志,2000,27(5):196.
[2]黄国平,田常炎,颜倜,等.普渡罗胶囊治疗强直性脊柱炎72例临床观察[J].中医杂志,2000,41(4):221.
[3]段英春,韩宏妮,陈立忠,等.补气活血法治疗强直性脊柱炎23例临床观察[J].吉林中医药,2000,20(4):43.
[4]苗后清,闫平,刘书珍,等.化痰逐瘀解毒汤治疗强直性脊柱炎的临床研究[J].河北中医,2000,22(8):565.
[5]林昌松,刘晓玲,关彤,等.陈纪藩教授治疗强直性脊柱炎经验[J].新中医,2001,33(2):10.
[6]钱森,钱应敏,钱玉勤.等.补肾复骨汤加药浴治疗强直性脊柱炎58例报告[J].中医正骨,2001,13(9):47.
[7]娄明洁,李秧.补阳还五汤加减治疗早期强直性脊柱炎30例小结[J].甘肃中医,2001,14(2):30.
[8]郭中琦,李俊兰.抗风湿散治疗强直性脊柱炎48例疗效观察[J].河北中医,2001,23(4):267.
[9]庞学丰.补肾祛风汤治疗强直性脊柱炎34例[J].广西中医学院学报,2002,5(3):57.
[10]李燕梅.独活寄生汤加味治疗强直性脊柱炎[J].中医正骨,2002,14(11):18.
[11]章天寿.路志正治疗强直性脊柱炎经验[J].中医杂志,2002,43(7):499.
[12]刘树权.金明秀治疗强直性脊柱炎经验[J].辽宁中医杂志,2003,30(4):248.
[13]焦树德.大偻(强直性脊柱炎)病因病机及辨证论治探讨(上)[J].江苏中医药,2003,24(1):1.
[14]朱辉.莫成荣治疗强直性脊柱炎的经验[J].辽宁中医杂志,2004,3(3):184-185
[15]韩善夯.金实教授治疗强直性脊柱炎经验[J].四川中医,2005,23(11):1-3
[16]张俊莉,陈爱琳.徐玲主任医师治疗强直性脊柱炎经验[J].陕西中医,2005,26(11):1200-1201.
[17]马从孝.冯兴华治疗强直性脊柱炎经验[J].山东中医杂志, 2007 ,26(7):487-489.
[18]陆肇中.强直性脊柱炎的辨证论治体会[J].天津中医,1996,13(3):19.
[19]幺远,马松春,卢燕,等.中医辨证治疗儿童强直性脊柱炎34例[J].北京中医,1997,(1):29.
[20]包力,陈志婵,张祥德,等.中西医结合治疗强直性脊柱炎临床观察[J].辽宁中医杂志,1999,26(9):415.
[21]王广生.强直性脊柱炎的中医辨证分型与影像学观察[J].现代中西医结合杂志,2000,10(5):890.
[22]史东静.红花注射液治疗强直性脊柱炎的体会[J].甘肃中医,2001,14(5):43.
[23]关彤.辨证分型治疗强直性脊柱炎33例疗效观察[J].湖南中医杂志,2001,17(3):14.
[24]林昌松,续青.中医治疗强直性脊柱炎经验[J].河北中医,2001,23(2):115.
[25]袁福林.辨证治疗强直性脊柱炎20例报告[J].中医正骨,2001,13(3):34
[26]曹忠贞.强脊合剂治疗强直性脊柱炎的临床研究[J].广西中医药,2002,25(4):14.
[27]陈志军,崔新生,龚环英.中医辨证分型治疗强直性脊柱炎疗效观察[J].中国临床康复,2002,6(24):3754.
[28]李江明,彭忠明,刘洪周,等.综合疗法治疗强直性脊柱炎268例[J].湖北中医杂志,2002,24(11):48.
[29]许峰,戴小明,章光华.强直性脊柱炎从肾论治的证治探讨[J].新中医,2003,35(5):3.
[30]焦树德.大娄(强直性脊柱炎)病因病机及辨证论治探讨(下)[J].江苏中医药,2003,24(2):1-3
[31]姜泉.中医分期治疗强直性脊柱炎的临床研究[J].中医正骨,2001,13(12):31-32.
[32]唐先平.胡荫奇治疗强直性脊柱炎经验[J].中医杂志,2003,44(9):650-652.
[33]朱辉.莫成荣治疗强直性脊柱炎的经验[J].辽宁中医杂志,2004,31(3):184-185.
[34]吴剑涛.独活寄生汤治疗强直性脊柱炎65例[J].河北中医,2005,27(6):428.
[35]王惠民,吴定怀,闫肃.宣痹汤加减治疗强直性脊柱炎30例[J].陕西中医,2007,28(8):1005-1007.
[36]郭琳琳.强肾舒督汤治疗强直性脊柱炎38例[J].中医正骨,2005,17(8):59.
[37]李亚伟,李克强.补肾活血汤治疗强直性脊柱炎89例[J].辽宁中医杂志,2003,30(6):476-477.
[38]张俊莉,赵峰,陈爱琳.独活寄生汤加减治疗强直性脊柱炎58例[J].陕西中医,2005,26(6):498-499.
[39]许超.右归饮治疗强直性脊柱炎临床疗效观察[J].中医正骨,2005,2(17):6-7.
[40]张杰,玉璐.针刺治疗强直性脊柱炎36例[J].中国针灸,2007,27(1):22.
[41]刘维,张磊,刘滨,等.针灸治疗强直性脊柱炎60例疗效观察[J].中国针灸,2002,22(10):665-666.
[42]龚福英.针灸治疗强直性脊柱炎51例[J].上海针灸杂志,2005,24(5):22.
[43]郭玉海,史红霞,王明喜,等.强脊汤治疗强直性脊柱炎的疗效及其与免疫性炎症因子关系的实验研究[J].中医正骨,2002,14(11):3-5
[44]刘迅,高根德,程春葵,等.通痹灵胶囊对体外培养的强直性脊柱炎成纤维细胞的影响[J].中医正骨,2002,14(2):3-6
[45]王建明,阎小萍,周童亮.壮督方对强直性脊柱炎患者T辅助细胞亚群的影响[J].中国医药学报,2004,19(6):349-351.
[1]黄烽,杨春花.强直性脊柱炎临床及免疫发病机制的研究进展[J].中国免疫学杂志,2001,17(6):281-285.
[2]戴生明,韩星海.上海五角场地区强直性脊柱炎的流行病学调查[J].第二军医大学学报,1999,20(11):1135.
[3] Khan M.A. current perspective on ankylosing spondylitis andrelated spondyloarthropathies[J]. J Ind Rheum Asso,1999,7(1):16-21.
[4]郭春江,华川.强直性脊柱炎研究进展[J].现代中西医结合杂志,2005,14(20):2757-2758.
[5]陶赞英,郑明慈. HLA-B27和强直性脊柱炎[J].华夏医学,2006,19(2):352-354.
[6] Khan M A, Ball E J. Genetic aspects of ankylosing spondylitis [J]. Best Pract Res Clin Rheumatol,2002,16(4):675-690.
[7]马海军,扈凤平.强直性脊柱炎遗传因素研究进展[J].中南大学学报,2005,30(3):352-355.
[8]李彦博,郭斯启,奚永志.人类白细胞抗原-B27与强直性脊柱炎关联的研究新进展[J].中华风湿病学杂志,2005,9(5):306-308.
[9]黄烽.强直性脊柱炎基础研究进展与临床治疗变革[J].解放军医学杂志,2004,29(6):468-471.
[10] Braun J, Brehan M, trial Maksymowych W. Therapy for an-kylosing spondylitis: new treatment modalities[J]. Best Practice Res Clin Rheumatol,2002,16:631-651.
[11]杨宇,苏卓娃,陈群.基因多态性与强直性脊柱炎发病相关性的研究进展[J].热带医学杂志,2006,6(10):1138-1141.
[12] Gonzalez S, Torre-Alonso J C, Martinez-Borra J, etal. TNF238 A promoter polymorphism contributes to susceptibility to ankylosing spondylitis in HLA-B27 negativepatients.J Rheumatol,2001,28(6):1288-1293.
[13] Francois R J, Gardener D L, Degrave E J, et al. Histopathologic evidence that sacroiliitis in ankylosing spondylitis is not merely enthesitis[J]. Arthritis Rheum, 2000,43(9):2011-2024.
[14]王庆文.强直性脊柱炎骶髂关节的病理学表现[J].实用医学杂志,2002,18(2):115-116.
[15] Suzuki Y, Tsutsumi Y, Nakagawa M, et al.Osteoclast- like cells in an in vitro model of bone destruction by rheumatoid synovium[J]. Rheumatology( Oxford) , 2001, 40: 673- 682.
[16] Redlich K, Haye r S, Ricci R, et al. Osteoclasts are essential for TNF-a mediated joint destruction [J]. J Clin Invest, 2002, 110( 10) : 1419- 1427.
[17] Lijnen H.R. Elements of the fibrinolytic system[J]. Ann N Y Acad Sci, 2001, 936: 226-236.
[18] DougadosM, Behier JM, Jolchine I, etal·Efficacy of cele-coxib, a cyclooxygenase 2-specific inhibitor, in the treatment of ankylosingspondylitis: a six-week controlled study with comparison against placebo and against a conventional nonsteroidal antiinflammatory drug·Arthritis Rheum, 2001, 44(1): 180-185.
[19] Chen J,Liu C.Is sulfasalazine effective in ankylosing spon-dylitis A systematic review of randomized controlled trials. JRheumato,l 2006, 33(4): 722-731.
[20] Gonzalez-Lopez L,Garcia-GonzalezA,Vazquez-Del-Merca-doM,etal.Efficacy ofmethotrexate in ankylosing spondylitis: a randomized, double blind, placebo controlled trial.JRheumato,l 2004, 31(8)1568-1574.
[21] MaksymowychWP, PooleAR, HiebertL, etal.Etanerceptexerts beneficial effects on articular cartilage biomarkers of degradation and turnover in ptientswith ankylosing spondylitis.JRheumato,2005, 32 (10): 1911- 1917.
[22] Braun J, BaraliakosX, Brandt J, etal.Therapy of ankylosing spondylitis. Part II:biological therapies in the spondy- loarthritides. Scand J Rheumato,l 2005, 34(3): 178-190.
[23] BaraliakosX, ListingJ, BrandtJ,etal.Clinical response to discontinuation of anti-TNF therapy in patientswith ankylosing spondylitis after 3 years of continuous treatment with infliximab. ArthritisResTher,2005, 7(3): 439-444.
[24]黄烽,古洁若,赵伟,等.反应停治疗强直性脊柱炎的临床与实验研究.中华风湿病学杂志, 2002, 6(1):309-315.
[25] AkerkarSM, Bichile LS.Pamidronatea promising new candidate for the management of spondyloarthropathy.Indian J Med Sc,i 2005, 59 (4): 165 -170.
[2]蒋明,David Yu,林孝义,等.中华风湿病学.北京:华夏出版社, 2004∶1018—1019.
[3] Jenkinson TR,Mallorie RA,Whitelock HC,etcal.Defining spinal mobility in ankylosing spondylitis(AS).The Bath AS Metrology Index[J].J Rheumatol,1994,21:1694_1698.
[4] Garrett S, Jenkinson T, Whitelock H, et al. A new approachto defining disease status in AS: the Bath Ankylosing Spondyli-tis Disease Activity Index(BASDAI). J Rheumatol 1994;21(12)∶2286—2291.
[5] Calin A, Garrett S, Whitelock H, et al. A new approach todefining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index(BASFI). J Rheumatol 1994;21(12)∶2281—2285.
[6]李青南,廖进民,吴铁,等.淫羊藿防治羟基脲致雄大鼠骨质疏松的定量研究[ J] .中国中医骨伤科杂志, 1996, 4( 3) : 1.
[7]李青南,黄连芳,谢华,等.淫羊藿防治羟基脲致雄大鼠骨质疏松的定量研究[ J] .中草药, 1997, 28( 6) : 528.
[8]李青南,廖进民,吴铁,等.淫羊藿提取液防治激素所致大鼠骨质疏松的实验研究[ J] .中国药学杂志, 1996, 44( 8) : 647.
[9]张逸凡,于庆海.淫羊藿总黄酮的抗炎作用[ J] .沈阳药科大学学报, 1999, 43( 2) : 47- 49.
[10]张润荃,史凤芹,庞淑珍,等.补骨脂对分离破骨细胞作用的研究[J].现代口腔医学杂志,1995,9(3):136-138.
[11]姜宪辉,张健,刘辉.补骨脂对激发态小鼠的体液免疫影响的实验研究[J].辽宁中医学院学报, 2004, 6(2): 116.
[12]杨光,李发胜,刘辉.补骨脂多糖对小鼠激发态免疫功能的影响[J].中药材,2004, 27(1): 42.
[13]徐诗伦,等.杜仲对机体非特异性免疫功能的影响.中草药,1993,14(8):27.
[14]徐诗伦,等.杜仲对细胞免疫功能的影响.中草药1985,11(9):15.
[15]王蕊,邱明才.单剂量补肾中药防治去卵巢大鼠骨质疏松的骨形态计量学研究[J].天津医药,1999,273:131-134.
[16]石扣兰,李丽芬,李月英,等.川续断对小鼠免疫功能的影响[J].中药药理与临床,1998,14(1):36-37.
[17]肖锦松,崔风军,宁廷选,等.玉竹、菟丝子醇提物对烧伤小鼠免疫功能的影响.中国中药杂志,1990,15(9):45-47.
[18]孙水平,李新华,孙曙光.怀牛膝药理研究续报·河南中医,1985;(1):39怀牛膝水煎液能减轻大白鼠蛋清性脚部炎症.
[19]史玉芬,郑延彬牛膝抗炎、抗菌作用的研究中药通报,1988;13(7):44.
[20]郑宝灿,陈忠科怀牛膝多倍体、单体和二倍体的药理作用比较药学通报,1988;23(11):666.
[21]杨铁虹,商澎,梅其炳.当归多糖硫酸酯对凝血和血小板聚集的作用[J].中草药,2002,33(11):1010-1013.
[22]乐江,彭仁,孔锐,等.当归粗多糖镇痛作用的实验研究[J].中国药学杂志,2002, 37(10):746-748.
[23] Sang Bae Han, Young Hee Kim,Chang Woo Lee, et al.Character-istic immunostimulation by angelan isolated fromAngelica gigas Nakai[J]. Immunopharmacology,1998,40:39-48.
[24]王瑾,刘君炎,夏丰年,等.瘤苗联合当归多糖抗瘤的实验研究[J].湖北医科大学学报,1999,20(4):283-284.
[25]奚瑾磊,彭仁,杨哲琼.当归多糖及其中性组分对巨噬细胞分泌TNF-α的影响[J].武汉大学学报(医学版),2002,23(1):21-23.
[26]刘超,王静,杨军.赤芍总甙活血化瘀作用的研究.中药材,2000; 23(9): 557-560.
[27]宋坤,陆兔林等.莪术不同炮制吕镇痛抗炎作用研究[J]中医药学刊,2005,23(3);443.
[28]王普霞等.莪术不同炮制品活血化瘀作用研究[J]中成药,2004,26(11):905.
[29]徐理纳,徐德成,张向嘉,等.阿魏酸钠抗血小板聚集作用的机理研究-对TXA2/PGI2平衡的影响[J].中国医学科学院学报, 1984, 6(6): 414.
[30]王永发,赵淑雯,陈林芳,等.灯盏细辛口服液治疗痹症的主要药效学[J].云南中医药杂志,2000,21(5):36-38.
[31]张丽丽,关振中,张竞逵细辛脂素体外免疫抑制作用的实验研究中华心血管病杂志2003;31(6):444.
[32]张明发,沈推琴,朱自平,等.羌活的镇痛抗炎抗血栓形成作用研究[J],中医药研究,1996,(6)∶51-53.
[33]张明发,沈推琴,朱自平,等.羌活的镇痛抗炎抗血栓形成作用研究[J],中医药研究,1996,(6)∶51-53.
[34]张小丽,谢人明,冯英菊.四种中药对血小板聚集性的影响[J].西北药学杂志,2000,15(6)∶260-261.
[35] Wang QW,Zeng QY,Xiao ZY,etal. Needle biopsy of spondy loarthropathy pathological features and clinical significance.Chin J Intern Meal,2004,43(11):832-836.
[36] Yilmaz N,Dzaslan J.Biochemical bone turnover markers in patients With ankylosing spondylitis.Clin Rheumatol,2000,19(2):92-98.
[37] Sarikaya S,Basaran A,Tekin Y,etal.Is osteoporosis generalized or Localized to central skeleton in ankylosing spondylitis.J Clin Rheumatol,2007,13:20-24.
[1]王政.陈湘君治疗强直性脊柱炎经验[J].辽宁中医杂志,2000,27(5):196.
[2]黄国平,田常炎,颜倜,等.普渡罗胶囊治疗强直性脊柱炎72例临床观察[J].中医杂志,2000,41(4):221.
[3]段英春,韩宏妮,陈立忠,等.补气活血法治疗强直性脊柱炎23例临床观察[J].吉林中医药,2000,20(4):43.
[4]苗后清,闫平,刘书珍,等.化痰逐瘀解毒汤治疗强直性脊柱炎的临床研究[J].河北中医,2000,22(8):565.
[5]林昌松,刘晓玲,关彤,等.陈纪藩教授治疗强直性脊柱炎经验[J].新中医,2001,33(2):10.
[6]钱森,钱应敏,钱玉勤.等.补肾复骨汤加药浴治疗强直性脊柱炎58例报告[J].中医正骨,2001,13(9):47.
[7]娄明洁,李秧.补阳还五汤加减治疗早期强直性脊柱炎30例小结[J].甘肃中医,2001,14(2):30.
[8]郭中琦,李俊兰.抗风湿散治疗强直性脊柱炎48例疗效观察[J].河北中医,2001,23(4):267.
[9]庞学丰.补肾祛风汤治疗强直性脊柱炎34例[J].广西中医学院学报,2002,5(3):57.
[10]李燕梅.独活寄生汤加味治疗强直性脊柱炎[J].中医正骨,2002,14(11):18.
[11]章天寿.路志正治疗强直性脊柱炎经验[J].中医杂志,2002,43(7):499.
[12]刘树权.金明秀治疗强直性脊柱炎经验[J].辽宁中医杂志,2003,30(4):248.
[13]焦树德.大偻(强直性脊柱炎)病因病机及辨证论治探讨(上)[J].江苏中医药,2003,24(1):1.
[14]朱辉.莫成荣治疗强直性脊柱炎的经验[J].辽宁中医杂志,2004,3(3):184-185
[15]韩善夯.金实教授治疗强直性脊柱炎经验[J].四川中医,2005,23(11):1-3
[16]张俊莉,陈爱琳.徐玲主任医师治疗强直性脊柱炎经验[J].陕西中医,2005,26(11):1200-1201.
[17]马从孝.冯兴华治疗强直性脊柱炎经验[J].山东中医杂志, 2007 ,26(7):487-489.
[18]陆肇中.强直性脊柱炎的辨证论治体会[J].天津中医,1996,13(3):19.
[19]幺远,马松春,卢燕,等.中医辨证治疗儿童强直性脊柱炎34例[J].北京中医,1997,(1):29.
[20]包力,陈志婵,张祥德,等.中西医结合治疗强直性脊柱炎临床观察[J].辽宁中医杂志,1999,26(9):415.
[21]王广生.强直性脊柱炎的中医辨证分型与影像学观察[J].现代中西医结合杂志,2000,10(5):890.
[22]史东静.红花注射液治疗强直性脊柱炎的体会[J].甘肃中医,2001,14(5):43.
[23]关彤.辨证分型治疗强直性脊柱炎33例疗效观察[J].湖南中医杂志,2001,17(3):14.
[24]林昌松,续青.中医治疗强直性脊柱炎经验[J].河北中医,2001,23(2):115.
[25]袁福林.辨证治疗强直性脊柱炎20例报告[J].中医正骨,2001,13(3):34
[26]曹忠贞.强脊合剂治疗强直性脊柱炎的临床研究[J].广西中医药,2002,25(4):14.
[27]陈志军,崔新生,龚环英.中医辨证分型治疗强直性脊柱炎疗效观察[J].中国临床康复,2002,6(24):3754.
[28]李江明,彭忠明,刘洪周,等.综合疗法治疗强直性脊柱炎268例[J].湖北中医杂志,2002,24(11):48.
[29]许峰,戴小明,章光华.强直性脊柱炎从肾论治的证治探讨[J].新中医,2003,35(5):3.
[30]焦树德.大娄(强直性脊柱炎)病因病机及辨证论治探讨(下)[J].江苏中医药,2003,24(2):1-3
[31]姜泉.中医分期治疗强直性脊柱炎的临床研究[J].中医正骨,2001,13(12):31-32.
[32]唐先平.胡荫奇治疗强直性脊柱炎经验[J].中医杂志,2003,44(9):650-652.
[33]朱辉.莫成荣治疗强直性脊柱炎的经验[J].辽宁中医杂志,2004,31(3):184-185.
[34]吴剑涛.独活寄生汤治疗强直性脊柱炎65例[J].河北中医,2005,27(6):428.
[35]王惠民,吴定怀,闫肃.宣痹汤加减治疗强直性脊柱炎30例[J].陕西中医,2007,28(8):1005-1007.
[36]郭琳琳.强肾舒督汤治疗强直性脊柱炎38例[J].中医正骨,2005,17(8):59.
[37]李亚伟,李克强.补肾活血汤治疗强直性脊柱炎89例[J].辽宁中医杂志,2003,30(6):476-477.
[38]张俊莉,赵峰,陈爱琳.独活寄生汤加减治疗强直性脊柱炎58例[J].陕西中医,2005,26(6):498-499.
[39]许超.右归饮治疗强直性脊柱炎临床疗效观察[J].中医正骨,2005,2(17):6-7.
[40]张杰,玉璐.针刺治疗强直性脊柱炎36例[J].中国针灸,2007,27(1):22.
[41]刘维,张磊,刘滨,等.针灸治疗强直性脊柱炎60例疗效观察[J].中国针灸,2002,22(10):665-666.
[42]龚福英.针灸治疗强直性脊柱炎51例[J].上海针灸杂志,2005,24(5):22.
[43]郭玉海,史红霞,王明喜,等.强脊汤治疗强直性脊柱炎的疗效及其与免疫性炎症因子关系的实验研究[J].中医正骨,2002,14(11):3-5
[44]刘迅,高根德,程春葵,等.通痹灵胶囊对体外培养的强直性脊柱炎成纤维细胞的影响[J].中医正骨,2002,14(2):3-6
[45]王建明,阎小萍,周童亮.壮督方对强直性脊柱炎患者T辅助细胞亚群的影响[J].中国医药学报,2004,19(6):349-351.
[1]黄烽,杨春花.强直性脊柱炎临床及免疫发病机制的研究进展[J].中国免疫学杂志,2001,17(6):281-285.
[2]戴生明,韩星海.上海五角场地区强直性脊柱炎的流行病学调查[J].第二军医大学学报,1999,20(11):1135.
[3] Khan M.A. current perspective on ankylosing spondylitis andrelated spondyloarthropathies[J]. J Ind Rheum Asso,1999,7(1):16-21.
[4]郭春江,华川.强直性脊柱炎研究进展[J].现代中西医结合杂志,2005,14(20):2757-2758.
[5]陶赞英,郑明慈. HLA-B27和强直性脊柱炎[J].华夏医学,2006,19(2):352-354.
[6] Khan M A, Ball E J. Genetic aspects of ankylosing spondylitis [J]. Best Pract Res Clin Rheumatol,2002,16(4):675-690.
[7]马海军,扈凤平.强直性脊柱炎遗传因素研究进展[J].中南大学学报,2005,30(3):352-355.
[8]李彦博,郭斯启,奚永志.人类白细胞抗原-B27与强直性脊柱炎关联的研究新进展[J].中华风湿病学杂志,2005,9(5):306-308.
[9]黄烽.强直性脊柱炎基础研究进展与临床治疗变革[J].解放军医学杂志,2004,29(6):468-471.
[10] Braun J, Brehan M, trial Maksymowych W. Therapy for an-kylosing spondylitis: new treatment modalities[J]. Best Practice Res Clin Rheumatol,2002,16:631-651.
[11]杨宇,苏卓娃,陈群.基因多态性与强直性脊柱炎发病相关性的研究进展[J].热带医学杂志,2006,6(10):1138-1141.
[12] Gonzalez S, Torre-Alonso J C, Martinez-Borra J, etal. TNF238 A promoter polymorphism contributes to susceptibility to ankylosing spondylitis in HLA-B27 negativepatients.J Rheumatol,2001,28(6):1288-1293.
[13] Francois R J, Gardener D L, Degrave E J, et al. Histopathologic evidence that sacroiliitis in ankylosing spondylitis is not merely enthesitis[J]. Arthritis Rheum, 2000,43(9):2011-2024.
[14]王庆文.强直性脊柱炎骶髂关节的病理学表现[J].实用医学杂志,2002,18(2):115-116.
[15] Suzuki Y, Tsutsumi Y, Nakagawa M, et al.Osteoclast- like cells in an in vitro model of bone destruction by rheumatoid synovium[J]. Rheumatology( Oxford) , 2001, 40: 673- 682.
[16] Redlich K, Haye r S, Ricci R, et al. Osteoclasts are essential for TNF-a mediated joint destruction [J]. J Clin Invest, 2002, 110( 10) : 1419- 1427.
[17] Lijnen H.R. Elements of the fibrinolytic system[J]. Ann N Y Acad Sci, 2001, 936: 226-236.
[18] DougadosM, Behier JM, Jolchine I, etal·Efficacy of cele-coxib, a cyclooxygenase 2-specific inhibitor, in the treatment of ankylosingspondylitis: a six-week controlled study with comparison against placebo and against a conventional nonsteroidal antiinflammatory drug·Arthritis Rheum, 2001, 44(1): 180-185.
[19] Chen J,Liu C.Is sulfasalazine effective in ankylosing spon-dylitis A systematic review of randomized controlled trials. JRheumato,l 2006, 33(4): 722-731.
[20] Gonzalez-Lopez L,Garcia-GonzalezA,Vazquez-Del-Merca-doM,etal.Efficacy ofmethotrexate in ankylosing spondylitis: a randomized, double blind, placebo controlled trial.JRheumato,l 2004, 31(8)1568-1574.
[21] MaksymowychWP, PooleAR, HiebertL, etal.Etanerceptexerts beneficial effects on articular cartilage biomarkers of degradation and turnover in ptientswith ankylosing spondylitis.JRheumato,2005, 32 (10): 1911- 1917.
[22] Braun J, BaraliakosX, Brandt J, etal.Therapy of ankylosing spondylitis. Part II:biological therapies in the spondy- loarthritides. Scand J Rheumato,l 2005, 34(3): 178-190.
[23] BaraliakosX, ListingJ, BrandtJ,etal.Clinical response to discontinuation of anti-TNF therapy in patientswith ankylosing spondylitis after 3 years of continuous treatment with infliximab. ArthritisResTher,2005, 7(3): 439-444.
[24]黄烽,古洁若,赵伟,等.反应停治疗强直性脊柱炎的临床与实验研究.中华风湿病学杂志, 2002, 6(1):309-315.
[25] AkerkarSM, Bichile LS.Pamidronatea promising new candidate for the management of spondyloarthropathy.Indian J Med Sc,i 2005, 59 (4): 165 -170.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |