Clinical Effect And Safety Study On Combination Therapy Of TCM Syndrome Differentiation And Etanercept On Early As Hip Damage

[Objective] To make an objective assessment on the clinical curative effect and security of the early treatment of hip damage in ankylosing spondylitis, which was treated by Etanercept plus Chinese medicine syndrome differentiation. During widely used in biological agents of the era, with ankylosing spondylitis hip damage as the breakthrough point, we try to provides reference treatment for the treatment of AS model, which is treatd by biological agents plus Chinese medicine syndrome differentiation. Meanwhile, to provide the reference for the clinical diagnosis and treatment plan of integrated traditional Chinese and western medicine, which accords with clinical practice and the effect is is more significant, so that it can play to the traditional Chinese medicine's advantages.[Methods](1) Literature Search:Through consulting a large number of documents, this paper first expounds the etiology and pathogenesis of ankylosing spondylitis in Chinese or western medicine, as well as its characteristics of diagnosis and treatment in clinic. Second, it expatiates on the types and efficacy of current biological agents, and focuses on the role of TNF blockers mechanism and its clinical application research situation.(2) clinical research:Use simple randomized method, choose the criteria AS patients as the research object, divided them into trial group and control group, and there were30patients in each group. In the trial group, Patients were given to simiao powder, plus Etanercept with adequate dosage and duration. In the control group, Patients were only given to Etanercept with adequate dosage and duration. Observe cycle was24weeks. We Observed the situations between two groups, including before and after treatment of the hip, hip pain inflammation MRI, Harris hip functional score, Activity Index of BASDAI, BASFI, Spinal pain, ESR, CRP, as well as ASAS2, ASAS50, ASAS70. We evaluated the i.liieal. curative effect of two groups, before and after treatment, in order to explore the clinical curative effect and security of the treatment of hip damage in ankylosing spondylitis, which was treated by Etanercept plus Chinese medicine syndrome differentiation.[Results] Subcutaneous injection Etanercept with adequate dosage and duration at ankylosing spondylitis can markedly improve the clinical symptoms, spine and joint function, reduce the inflammation index, achieve very significant clinical curative effect. On the other hand, the trial group,which was given to simiao powder plus Etanercept, compared to the control group, which was nly given to Etanercept, after the treatment of4weeks, all the outcome in patients were improved obviously than before, there was no obvious difference between the trial group and the control group.12weeks later, both groups patients'treatment effect improved more obviously than before, the proportion of ASAS20, ASAS50and ASAS70respectively reach to83.33%,33.33%,16.67%in the trial group;80%,40%,13.33%in the control group. Comparison between groups, the BASFI score, BASDAI score, patients'overall evaluation in the trial group is much better than the control group.24weeks later, two groups of patients'outcome were improved dramatically than before, comparison between groups, the BASFI score, BASDAI score, patients'overall evaluation, hip pain VAS score, the hip effusion, and Harris score in the trial group was obviously better than the control group. While patients with the rest of the various indicators such as ESR, CRP, thoracic mobility, From refers to, Schober test, spondylalgia, ASAS20, ASAS50, and ASAS70were not significant difference.[conclusion] It didn't impact the patients'overall effect a lot on the basis of the treatment Etanercept with adequate dosage and duration, however unite the Chinese medicine syndrome differentiation treatment or not. There is no obvious difference between two groups in most patients'observation index and curative effect, even if ASAS20, ASAS50, ASAS70index. But in some function indexes, such as BASFI score, BASDAI score, overall evaluation, after the treatment of12weeks, two groups began to appear obvious difference, the ireatment combination of Chinese medicine is better than without Chinese medicine. And24weeks later, the whole hip function, including hip pain VAS score, hip MRI effusion situation and Harris hip scores of the patients with Chinese medicine treatment were significantly better than the patients in the control group.