甄氏穿海汤治疗湿热蕴结型急性痛风性关节炎临床疗效观察

Therapeutic Effect of Zhenshi Chuanhai Decoction for Acute Gouty Arthritis with Damp-heat Accumulation

【目的】探讨甄氏穿海汤治疗湿热蕴结型急性痛风性关节炎的临床疗效。【方法】将急性痛风性关节炎湿热蕴结证患者120例随机分为治疗组和对照组,每组各60例。2组均给予痛风性关节炎的基础治疗,对照组给予依托考昔口服,治疗组在对照组基础上给予甄氏穿海汤口服,疗程为5 d。观察2组患者治疗前后Likert指数评分(主要对关节疼痛、关节压痛、关节肿胀进行评分)、中医证候评分及白细胞(WBC)、血沉(ESR)、血清C反应蛋白(CRP)、血尿酸(SUA)等的变化情况,并评价其安全性。【结果】(1)治疗后,2组患者的Likert指数评分、中医证候评分和WBC、ESR、CRP、SUA等各项实验指标均较治疗前降低(P<0.001),且治疗组的降低作用均优于对照组,差异均有统计学意义(P<0.05或P<0.01或P<0.001)。(2)治疗过程中,2组患者的肝肾功能均无明显的异常改变,也均未出现胃脘部胀满、恶心、呕吐、腹痛或腹泻、消化道溃疡(包括穿孔和出血)等不良反应。【结论】甄氏穿海汤配合依托考昔能快速缓解关节疼痛等症状及体征,降低炎症指标及血尿酸水平,且具有较高的安全性。

Objective To observe the clinical efficacy of Zhenshi Chuanhai Decoction in treating acute gouty arthritis with damp-heat accumulation.Methods One hundred and twenty cases of acute gouty arthritis with dampheat accumulation were randomly divided into treatment group and control group,60 cases in each group.The control group was given Etocoxib orally,and the treatment group was given Zhenshi Chuanhai Decoction orally on the basis of treatment for the control group,the treatment course lasing for 5 days.The Likert index scores(including the scores of joint pain,joint tenderness,and joint swelling),traditional Chinese medicine(TCM)symptom scores,and laboratory indexes of white blood cell(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and serum uric acid(SUA)were compared in the two groups before and after treatment.Meanwhile,the clinical safety was also evaluated in the two groups.Results(1)Likert index scores,TCM symptom scores,and laboratory indexes of WBC,ESR,CRP,SUA were significantly lowered in both groups after treatment(P<0.001 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group(P<0.05 or P<0.01 or P<0.001).(2)During the treatment,the two groups had no abnormal changes in hepatic-renal function,and had no adverse reaction of epigastric distention,nausea,vomiting,abdominal pain,diarrhea,or peptic ulcer(also including gastric perforation and bleeding)either.Conclusion Zhenshi Chuanhai Decoction combined with Etocoxib can quickly relieve joint pain and other symptoms and signs,and reduce the levels of inflammatory indicators and uric acid,being safe for the treatment of acute gouty arthritis with damp-heat accumulation.