清热利湿祛瘀针刺法治疗急性痛风性关节炎的临床分析

Clinical Observation on Acupuncture Treatment of Acute Gouty Arthritis in Terms of Clearing Heat,Eliminating Dampness and Stasis

目的:寻求治疗急性痛风性关节炎的有效方法。方法:将急性痛风性关节炎患者130例随机分为两组。观察组66例,采用清热利湿祛瘀针刺法治疗;对照组64例,采用口服美洛昔康胶囊治疗。经2个疗程治疗后,以视觉模拟评分(VAS)、血尿酸(血UA)、尿尿酸(尿UA)、尿2β微球蛋白(尿β2-mG)为观察指标,对两组疗效进行比较。结果:两组均有明显的止痛效果,总有效率及VAS评分差异无显著性意义;观察组的临床治愈率显著高于对照组,差异有显著性意义;观察组在血UA、尿2β-mG的下降及尿UA的增加方面明显优于对照组。结论:针刺是治疗急性痛风性关节炎的理想方法,且能有效改善早期肾功能损害。

Objective： To observe the therapeutic effect of acupuncture in the treatment of acute gouty arthritis so as to seek an effective therapy for it. Methods： A total of 130 patients suffering from acute gouty arthritis were randomized into acupuncture group （66 cases） and medication group （64 cases）. In acupuncture group, bilateral Bafeng （EX-HE 10）, Sanyinjiao （SP 6）, Yinlingquan （SP 9）, Xuehai （SP 10）, etc. were punctured by inserting the needle rapidly, twirling it with reducing technique and removing it swiftly （needling for clearing heat and eliminating dampness and stasis）. The treatment was given twice daily in the first 10 days and once daily in the second 10 days. Patients of medication group were ordered to orally take Meloxicam Capsules （7.5 mg/time/d, Non-steroid antiphologistic） continuously for 20 days. Visual analog scale （VAS） and changes of clinic manifestations were recorded, and blood uric acid, urine uric acid and uric β2-microglobulin were detected with enzymatic method, phosphotungstic acid reduction method and solid phase radioimmunoassay respectively. Results. Of the 66 and 64 cases in acupuncture and medication groups, 37 （56.06%） and 14 （21.88%） were cured, 26 （39.39%） and 45 （70.31%） had marked improvement in clinical symptoms, 3 （4.55%） and 5 （7. 81% ） failed in the treatment separately. The cure rate of acupuncture group was significantly higher than that of medication group （P〈0.01）. After the treatment VAS, blood uric acid and uric β2-mi- croglobulin values of two groups decreased nearly all obviously （P〈0.05）, while urine uric acid increased significantly in acupuncture group （P〈0.01 ）; and the effects of acupuncture were significantly better than those of medication in lowering blood uric acid and uric β2-microglobulin, and raising urine uric acid （P〈0.01 ）. No significant differences were found between two groups in VAS （P〉0.05）. Conclusion： Acupuncture treatment is one of the best therapies in dealing with acute gouty arthritis and can help improve renal impairment in the early stage of this disease.