许甜甜 沈炳香 李向阳 晋霞 万磊

【摘 要】目的：统计强直性脊柱炎患者中药使用情况，探索治疗强直性脊柱炎的处方中药使用规律。方法：收集安徽中医药大学第一附属医院风湿科2018年1月至2019年6月临床诊断为强直性脊柱炎的患者共计126例，共使用中药方剂255首，患者基本情况、疾病证型、使用中药的频次、种类等为指标进行分类分析。结果：强直性脊柱炎患者50岁以下的发病率高;使用频次最高的5类中药分别是活血化瘀药、补虚药、祛风湿药、利水渗湿药、清热药;使用频次最高的5种中药分别是杜仲、红花、桃仁、甘草、丹参。结论：强直性脊柱炎的中医药治疗以补益肝肾、活血通络、祛风湿强筋骨为主，配以其他药物，辨证施治，临证加减，体现了中医学的精髓。

【关键词】 脊柱炎，强直性;中药;临床使用规律

【ABSTRACT】Objective：To collect the information of patients with ankylosing spondylitis in the rheumatology department of a third-grade top TCM hospital as well as prescriptions，in order to explore the rule of using Chinese medicine.Methods：A total of 126 patients with ankylosing spondylitis who had been clinically diagnosed in the hospital from January 2018 to June 2019 were chosen.A total of 255 TCM prescriptions were used.The basic information of patients，types of disease，frequency and types of using Chinese medicine were classified and analyzed.Results：The incidence rate of ankylosing spondylitis is high in patients under fifty.Five kinds of Chinese medicine with the highest frequency were blood-activating and stasis-resolving medicine，correcting-deficiency medicine，wind-dampness-dispelling medicine，dampness-removing medicine and heat-clearing medicine.The five medicines with highest frequency were Duzhong（Eucommia ulmoides），Honghua（Flos Carthami），Taoren（Semen Persicae），Gancao（Glycyrrhiza uralensis Fisch）and Danshen（Radix Salviae Miltiorrhiae）.Conclusion：The TCM treatment for ankylosing spondylitis mainly includes tonifying the liver and kidney，promoting blood circulation and unblocking collaterals，removing wind and dampness，strengthening the muscles and bones，combining with other medicines.Treating according to syndrome differentiation and modifying medicine accordingly are the essence of TCM.

【Keywords】 spondylitis，ankylosing;TCM;clinical rules

強直性脊柱炎（ankylosing spondylitis，AS）以中轴关节受累为主，可伴发关节外表现，严重者可发生脊柱畸形和关节强直，是一种慢性自身炎症性疾病[1]。骶髂关节是本病最早累及的部位，主要表现有滑膜炎，软骨变性、破坏等，典型的晚期表现是出现椎体方形变、韧带钙化、脊柱“竹节样”，若不及时诊治可发生脊柱强直和关节严重畸形[2]。临床上AS的西医诊断按照1987年美国风湿病学会（ACR）修订的分类诊断标准[3]，中医诊断按照国家中医药管理局《中医病证诊断疗效标准》[4]。临床上西医治疗AS主要采用免疫抑制类药物（柳氮磺吡啶、甲氨蝶呤、沙利度胺）、糖皮质激素（甲泼尼龙、醋酸泼尼松）、生物制剂等，但存在严重的不良反应[5]，且治疗费用昂贵。……