ABSTRACT
Objective:To observe the clinical efficacy of modified Chushi Juanbitang combined with pedicle vertebrotomy on kyphosis of ankylosing spondylitis due to syndrome of dampness-heat obstruction. Method:The 90 cases were randomly divided into control group and observation group， 45 cases in each group. The patients in control group received pedicle vertebrotomy + <italic>Tripterygium</italic> glycosides， and the patients in observation group received pedicle vertebrotomy + modified Chushi Juanbitang. The treatment course was 6 months in both groups. Their bath ankylosing spondylitis disease activity index （BASDAI）， bath ankylosing spondylitis measure index （BASMI）， imaging index， traditional Chinese medicine syndromes， serum proinflammatory factor， anti-inflammatory factor， bone metabolism index ［bone-specific alkaline phosphatase （BALP）， tartrate resistant acid phosphatase isomer-5b （TRACP-5 b）， bone morphogenetic protein-2 （BMP-2）， osteocalcin （BGP）］， ossification related proteins ［bone morphogenetic protein-7 （BMP-7）， dickkopf-related protein-1 （DKK-1）， and tissue inhibitor matrix metalloproteinase-2 （TIMP-2）， sclerostin（SOST）］ were observed and detected. The clinical efficacy， recurrence rate and safety indexes were followed up for 12 months and compared. Result:The total effective rate was 97.73% （43/44） in the observation group， higher than 80.95% （34/42） in the control group （<italic>χ</italic><sup>2</sup>=5.172， <italic>P</italic><0.05）. In the comparison with control group after treatment， the BASDAI， BASMI， imaging index， traditional Chinese medicine syndromes， proinflammatory factors， TRACP-5b， BMP-7 and TIMP-2 were lower in observation group （<italic>P</italic><0.05）， and the anti-inflammatory factors， BALP， BMP-2， BGP， DKK-1 and SOST were higher in observation group （<italic>P</italic><0.05）. During the follow-up for at least 12 months， the recurrence rate was 4.65% （2/43） in observation group， lower than 26.47% （9/34） in control group （<italic>χ</italic><sup>2</sup>=4.261， <italic>P</italic><0.05）. There was no significant difference in the incidence of postoperative complications between the two groups. The incidence of adverse reactions was 2.27% （1/44） in observation group， lower than 38.64% （17/44） in control group （<italic>χ</italic><sup>2</sup>=5.763， <italic>P</italic><0.05）. Conclusion:Modified Chushi Juanbitang combined with pedicle vertebrotomy is effective in the treatment of kyphosis of ankylosing spondylitis due to syndrome of dampness-heat obstruction.
ABSTRACT
Objective:To investigate the clinical efficacy of acupuncture combined with modified Shengyutang in treatment of cervical spondylotic radiculopathy with Qi-blood deficiency and its effect on T-lymphocyte subsets. Method:Totally 201 cases of cervical spondylotic radiculopathy with blood deficiency were randomly divided into 3 groups, with 67 cases in each group. Group A was treated with modified Shengyutang. Group B was treated with acupuncture. Group C was treated with modified Shengyutang combined with acupuncture. The effective rate of each group and the therapeutic effect of deficiency of Qi and blood were observed. Neck disabilitv index（NDI）, visual analogue score（VAS）, SF-36 mental component summary（SF-36MCS）and SF-36 physical component summary（SF-36PCS） were compared before and after treatment. Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and calcitonin related peptide (CGRP) were measured before and after treatment. The levels of CD3+, CD4+, CD8+ and the ratio of CD4+/CD8+ were compared before and after treatment. The therapeutic safety indexes of each group were observed. Result:After treatment, the total clinical effective rate of group C was significantly higher than that of group A and B (P<0.05). NDI and VAS scores were significantly reduced (P<0.05). The scores of SF-36MCS and SF-36PCS were significantly increased (P<0.05). The score of Qi-blood deficiency syndrome was significantly lower (P<0.05). Serum levels of IL-1β, IL-6 and CGRP were significantly lower (P<0.05). The levels of CD3+, CD4+ and CD4+/CD8+ were significantly increased (P<0.05, P<0.01), whereas CD8+ was significantly decreased (P<0.05, P<0.01). No significant adverse reactions occurred in each group during the treatment. Conclusion:acupuncture combined with Shengyutang has a significant clinical effect on cervical spondylosis with Qi-blood deficiency, and is worth popularizing.
ABSTRACT
Objective:To observe the efficacy and safety of warm acupuncture combined with Congrong Duhuosan in treating ankylosing spondylitis （AS） with deficiency of kidney-Yang. Method:Totally 186 patients with AS of deficiency of kidney Yang type were randomly divided into observation group and control group, with 93 patients in each group. The control group was treated with meloxicam dispersive tablets combined with Sulfasalazine enteric-coated tablets, while the observation group was treated with warm acupuncture combined with Congrong Duhuosan, with a course of treatment of 63 d. Bath ankylosing spondylitis patient global score (BAS-G), visual analogue score (VAS), bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis functional index (BASFI), physicians global assessment (PGA) and syndrome differentiation of kidney-Yang deficiency syndrome in traditional Chinese medicine （TCM） were observed before and after treatment. Interleukin-17 (IL-17)，interleukin-23 (IL-23) mRNA expression levels, T helper cell 17（Th17） and regulatory cells（Treg）levels and Th17/Treg ratio were detected before and after treatment. Efficacy and incidence of adverse reactions were compared between two groups. Result:There were 7 cases falling off in control group and 1 case in observation group. After treatment, the total effective rate of observation group was 85.87%（79/92）, which was better than 60.47%（52/86）of control group (χ2=6.08，P<0.01). The scores of BAS-G, VAS, BASDAI, BASFI, PGA and TCM kidney-Yang deficiency syndrome in observation group were significantly improved than those in control group (P<0.05, P< 0.01). IL-17 and IL-23 mRNA expression levels, Th17 and Treg levels and Th17/Treg ratio in observation group were significantly improved compared with control group (P<0.01). The incidence of adverse reactions in observation group was significantly lower than that in control group (P<0.01). Conclusion:Warm acupuncture combined with Congrong Duhuosan can effectively relieve pain, inflammatory reaction and other clinical symptoms of patients with kidney-Yang deficiency AS, and restore the activity function of patients with small adverse reactions. Therefore, it is a safe and effective clinical therapy.
ABSTRACT
Objective:To observe the efficacy of modified Chushi Huqianwan combined with core decompression on Ⅰ， Ⅱ stage osteonecrosis of femoral head due to hot and humid syndrome， and the effect on bone metabolism index ［osteocalcin （BGP）， bone morphogenetic protein-2 （BMP-2）， bone isoenzyme alkaline phosphatase （BALP）］， blood lipid ［apolipoprotein A （ApoA）， apolipoprotein B （ApoB）， apolipoprotein C3 （ApoC3）］， protein expression ［matrix metalloproteinase-2 （MMP-2）， matrix metalloproteinase-9 （MMP-9）， tissue inhibitor of matrix metalloproteinase-2 （TIMP-2）］. Method:A total of 90 cases were divided into control group and observation group， with 45 cases in each group. The control group was given core decompression + Xianling Gubao， while the observation group was given core decompression + modified Chushi Huqianwan for 6 months. The hip harris score （HHS）， lateral head index （LHI） and traditional Chinese medicine （TCM） syndrome were observed between two groups. The serum bone metabolic indices （BGP， BMP-2， BALP）， blood lipid （ApoA， ApoB， ApoC3）， protein expressions （MMP-2， MMP-9， TIMP-2） were detected between two groups. The clinical efficacy， adverse reaction and recurrence in 36-month follow-up were compared between two groups. Result:The total effective rate was 97.73% （43/44） in observation group， which was higher than 80.95% （34/42） in control group （χ2=5.915， P<0.05）. The recurrence rate was 4.65% （2/43） in observation group， which was lower than 35.29% （12/34） in control group （χ2=5.317， P<0.05） during the 36-month follow-up. HHS and LHI in observation group were significantly higher than those in control group （P<0.05）， and TCM syndrome score was significantly lower than that in control group （P<0.05）. Compared with control group after treatment， BGP， BMP-2， BALP， MMP-2 and MMP-9 in observation group were significantly increased （P<0.05）， whereas ApoA， ApoB， ApoC3， TIMP-2 were significantly decreased （P<0.05）. No obvious adverse reactions were observed during the treatment. Conclusion:Modified Chushi Huqianwan combined with core decompression can significantly improve clinical symptoms， bone metabolism indexes， blood lipid and protein expressions of patients with Ⅰ， Ⅱ stage osteonecrosis of femoral head due to hot and humid syndrome.