痛风方联合秋水仙碱治疗急性痛风性关节炎临床疗效及其机制探讨

Clinical Efficacy and Mechanism Study of Using Tongfeng Prescription Combined with Colchicine in the Treatment of Acute Gouty Arthritis

目的:观察痛风方联合秋水仙碱对急性痛风性关节炎患者疗效及其机制。方法:选取我院风湿肾病科2018年1月~2020年12月收治急性痛风性关节炎患者104例作为研究对象,随机分为观察组与对照组各52例,对照组采用常规西药治疗,观察组在对照组基础上施以自拟痛风方内服加外用治疗,观察两组疗效及炎性因子表达。结果:①治疗后,观察组总有效率为92%,显著高于对照组78%(P<0.05);②治疗后,两组患者VAS较治疗前显著改善(P<0.05),且观察组VAS评分显著优于对照组(P<0.05),观察组症状缓解时间显著少于对照组(P<0.05);③两组治疗后BUA、ESR水平较前均有好转,且观察组BUA和ESR、Scr水平均优于对照组(P<0.05);④治疗后,两组患者炎性因子表达均较治疗前显著改善(P<0.05),且观察组炎性因子表达改善显著优于对照组(P<0.05);⑤在治疗中,两组患者均发生轻度肠胃不适、皮肤潮红、肾功能、胃肠道不适、瘙痒等不良反应,对照组不良反应发生率19.23%,观察组为11.53%。结论:自拟痛风方内服加外用联合秋水仙碱对急性痛风性关节炎临床疗效显著,改善不适症状,其作用机制与降低炎性水平有关。

Objective:To observe the effect and mechanism of using Tongfeng Prescription combined with Colchicine in the treatment of acute gouty arthritis.Methods:A total of 104 patients with acute gouty arthritis admitted to Department of Rheumatism and Nephrology in our hospital from January 2018 to December 2020 were selected as the research objects.They were randomly divided into an observation group and a controlled group with 52 cases each.The controlled group was treated with conventional western medicine,and the observation group was given Selfmade Tongfeng Prescription on the basis of the controlled group.The Tongfeng Prescription was administered orally and externally to observe the efficacy and inflammatory factor expression in the two groups.Results:①After treatment,the total effective rate of the observation group was 92%,which was significantly higher than 78%of the controlled group(P<0.05);②After treatment,the VAS of the two groups were significantly improved compared with before treatment(P<0.05),and the VAS score of the observation group was significant better than the controlled group(P<0.05),the time of symptom relief in the observation group was significantly shorter than that in the controlled group(P<0.05);③After treatment,the BUA and ESR levels of the two groups improved after treatment,and the observation group BUA and ESR,Scr level was better than the controlled group(P<0.05);④After treatment,the expression of inflammatory factors in the two groups were significantly improved compared with before treatment(P<0.05),and the improvement in the expression of inflammatory factors in the observation group was significantly better than the controlled group(P<0.05);⑤During the treatment,the two groups of patients had mild gastrointestinal discomfort,skin flushing,renal function,gastrointestinal discomfort,pruritus and other adverse reactions.The adverse reaction rate of the controlled group was 19.23%and that of the observation group was 11.53%.Conclusion:Selfmade Tongfeng Prescription taken orally and externally combined with Colchicine has a significant clinical effect on acute gouty arthritis and improves the discomfort symptoms.Its mechanism of action is related to reducing the level of inflammation.