白虎加桂枝汤合四妙散辨治急性痛风性关节炎湿热蕴结证临床研究

White Tiger Decoction Plus Cinnamon Twig Combined with Wonderfully Effective Four Powder for Treating Acute Gouty Arthritis Due to Damp-Heat Accumulation

目的:观察白虎加桂枝汤合四妙散化裁辨治湿热蕴结证急性痛风性关节炎的临床疗效。方法:将96例湿热蕴结证急性痛风性关节炎患者随机分为对照组和治疗组各48例。两组患者均给予低嘌呤饮食摄入、禁酒、规律作息、多饮水、不熬夜等干预,对照组患者在此基础上给予美洛昔康口服治疗;治疗组则给予白虎加桂枝汤合四妙散化裁治疗,日1剂,连续治疗1周。观察治疗前后患者痛感的缓解情况,记录疼痛的缓解时间,用VAS疼痛视觉模拟评分评价痛感;检测治疗前后血沉(ESR)、C反应蛋白(CRP)水平的变化情况,计算临床治疗的有效率及不良反应发生率。结果:两组患者经治疗后疼痛缓解明显,治疗组的疼痛缓解时间较对照组短,VAS评分降低更明显,差异有统计学意义(P<0.05);两组患者ESR、CRP水平均较治疗前降低,治疗组较对照组降低更明显,差异有统计学意义(P<0.05);治疗组的有效率91.7%明显高于对照组有效率72.9%,而不良反应发生率6.2%则明显低于对照组不良反应发生率27.1%,差异有统计学意义(P<0.05)。结论:白虎加桂枝汤合四妙散化裁能有效缓解湿热蕴结证急性痛风性关节炎的痛感,缩短病程,降低ESR、CRP水平,疗效确切,副作用少。

Objective：To observe the clinical effect of White Tiger Decoction Plus Cinnamon Twig combined with Wonderfully Ef- fective Four Powder on acute gouty arthritis due to damp-heat accumulation. Methods ：96 cases with acute gouty arthritis due to damp-heat accumulation were randomized into control group and treatment group,with 48 cases in each group. Both groups were conducted the interventions of low purine diet, alcoholic prohibition, regular work and rest, much water drinking and non-staying up late, etc. Based on this, control group were orally given Meloxicam and treatment group were given modified White Tiger Decoc- tion Plus Cinnamon Twig combined with Wonderfully Effective Four Powder for 1 dosage a day and for one week. After the treat- ment, the pain relief was observed, relieving time of the pain was recorded, the pain was evaluated by VAS, ESR and changes of the level of CRP were determined before and after the treatment, the effective rates and adverse reaction rates of the clinical treat- ment were calculated. Results：After the treatment, the pain in both groups got obviously relieved and the relieving time of treat- ment group was shorter than that in control group and the decline of the VAS score in treatment group was more obvious than that of control group,with statistical significance（ P 〈 0.05 ）. The levels of ESR, CRP in both group declined and the decline in treat- ment group was much greater,with statistical significance（ P 〈 0.05 ）. The effective rate of treatment group （91.7% ） was higher than that of control group（72.9% ） ;while the adverse reaction rate of treatment group（6.2% ） was significantly lower than that of control group（ 27.1% ）, with statistical significance （ P 〈 0. 05 ）. Conclusion： White Tiger Decoction Plus Cinnamon Twig com- bined with Wonderfully Effective Four Powder can effectively relieve the pain of acute gouty arthritis due to damp-heat accumula- tion, shorten the disease process and decrease the levels of ESR and CRP,which is of definite efficacy and few side effects.