健脾化湿解毒方治疗缓解期痛风的临床疗效及其对相关炎性因子的影响

Clinical Effect of “Jianpi Huashi Jiedu Decoction”for Patients with Gout in Remission Stage and Its Influence on Related Inflammatory Cytokines

目的:观察健脾化湿解毒方治疗缓解期痛风的临床疗效及其对相关炎性因子的影响。方法:采用随机、对照的研究方法,纳入缓解期脾虚湿热证痛风患者60例,分为治疗组和对照组,每组30例。治疗组给予健脾化湿解毒方治疗,对照组给予别嘌醇口服,疗程均为6个月。观察并比较两组的临床疗效、中医证候积分、相关实验室指标及痛风的复发情况等。结果:治疗后,治疗组和对照组综合疗效的总有效率分别为63.33%和56.67%,两组综合疗效比较差异无统计学意义(P>0.05);治疗组的中医证候疗效总有效率为93.33%,对照组为66.67%,两组疗效比较差异有统计学意义(P<0.01)。治疗后,两组患者的中医证候积分均显著降低(P<0.01),且治疗组患者的积分低于对照组(P<0.01);两组患者的尿酸、IL-6、IL-8水平均显著降低(P<0.05,P<0.01),且对照组患者的尿酸水平低于治疗组(P<0.01),治疗组患者的IL-8水平低于对照组(P<0.05)。治疗过程中,治疗组和对照组的复发率分别为26.67%和53.33%,两组比较差异有统计学意义(P<0.05);治疗组的复发程度积分明显低于对照组(P<0.05),用药起效时间短于对照组(P<0.05),服用怡美力人数和剂量均少于对照组(P<0.05,P<0.01)。结论:健脾化湿解毒方治疗脾虚湿热型痛风缓解期患者具有较好的疗效,能够有效缓解患者的症状,降低血尿酸及白介素水平,预防痛风复发,减轻炎症反应。

Objective：To observe the clinical curative effect of＂Jianpi Huashi Jiedu Decoction＂for patients with gout in remission stage and its influence on related inflammatory cytokines.Methods：The randomized,controlled study method was applied,and 60 patients with gout of spleen-deficiency and damp-heat syndrome in remission stage were selected and divided into treatment group（ n = 30） and control group（ n = 30）.The treatment group was treated with ＂Jianpi Huashi Jiedu Decoction＂and the control group was treated with allopurinol,with a course of 6 months.The clinical curative effect,Chinese medical syndrome scores,laboratory indexes and the relapse of gout were observed.Results：After treatment,the total effective rates of treatment group and control group on comprehensive therapeutic effect were 63.33% and 56.67% respectively,with no statistical difference between two groups（ P 0.05）; the total effective rates of treatment group and control group on Chinese medical syndrome were 93.33% and 66.67% respectively,with statistical difference between two groups（ P 0.01）.After treatment,the syndrome scores of two groups were significantly decreased（ P 0.01）,and the scores of treatment group were lower than those of control group（ P 0.01）; the levels of uric acid,IL-6 and IL-8 in both groups were obviously decreased（ P 0.05,P 0.01）,and the level of uric acid of control group was lower than that of treatment group（ P 0.01）,the level of IL-8 of treatment group was lower than that of control group（ P 0.05）.During the treatment course,the recurrence rates of treatment group and control group were 26.67% and 53.33%,with statistical difference between two groups（ P 0.05）; the recurrence scores of treatment group were lower than those of control group（ P 0.05）,the drug onset time of treatment group was shorter than that of control group（ P 0.05）,the number of the patients who took nimesulide tablets and the doses of nimesulide in treatment group were less than those in control group（ P 0.05,P 0.01）.Conclusion：＂Jianpi Huashi Jiedu Decoction＂has good effect for patients with gout of spleen-deficiency and damp-heat syndrome in remission stage,and can effectively alleviate the symptoms,reduce the levels of uric acid and interleukin,prevent the recurrence of gout,and reduce the inflammation reactions.