痛风舒片联合薏柏痛风巴布剂治疗痛风性关节炎湿热痹阻证的临床观察

Clinical Observation of Effect of Tongfengshu Pian Combined with Yibai Tongfeng Cataplasm Patch in Treating Rheumatic Arthritis with Dampness-heat Blockage Syndrome

目的:探讨痛风舒片联合薏柏痛风巴布剂治疗痛风湿性关节炎湿热痹阻证的临床疗效及对血清白细胞介素-1β(IL^(-1)β),肿瘤坏死因子-α(TNF-α),基质金属蛋白酶-3(MMP-3)和环氧化酶-2(COX-2)水平的影响。方法:将150例患者根据入院先后顺序按1∶1比例随机分成对照组和观察组各75例。对照组口服依托考昔片,120 mg·d^(-1),和雪山金罗汉止痛涂膜剂,涂抹患处,3次/d。观察组服用依托考昔片同对照组,并口服痛风舒片,4片/次,3次/d,和薏柏痛风巴布剂,贴患处,每日1贴。两组疗程均为14 d。采用视觉模拟评分(VAS)进行疼痛评价,进行治疗前后压痛、关节肿胀及关节活动障碍情况评分;检测治疗前后血沉(ESR),C-反应蛋白(CRP),血尿酸(UA),IL^(-1)β,TNF-α,MMP-3和COX-2水平。结果:经Ridit检验,观察组临床疗效优于对照组,差异有统计学意义(P<0.05);观察组在治疗后第3,7,14天的VAS评分均低于对照组(P<0.01);治疗后观察组关节压痛、肿胀、活动障碍评分均低于对照组(P<0.01);观察组ESR,CRP,UA水评均低于对照组(P<0.01);观察组血清IL^(-1)β,TNF-α,MMP-3和COX-2水平均低于对照组(P<0.01)。结论:在口服依托考昔片的同时服用痛风舒片及外贴敷薏柏痛风巴布剂治疗AGA,能快速减轻患者疼痛、改善临床症状,减轻炎症反应,近期效果显著。

Objective： To discuss the clinical effect of Tongfengshu pian combined with Yibai Tongfeng Cataplasm in treating rheumatic arthritis（ dampness-heat blockage syndrome） and the effect on levels of serum interleukin^（-1）β（ IL^（-1）β）, tumor necrosis factor-α（ TNF-α）, matrix metalloproteinase-3（ MMP-3） and cyclooxygenase-2（ COX-2）. Method： One hundred and fifty patients were randomly divided into control group（ 75 cases） and observation group（ 75 cases） according to the sequence of their hospitalization. The patients in control group received etoricoxib tablets,120 mg/day,and Xueshan Jinluohan odynolysis plastics at affected part,3 times/day. Those in the observation group were given the same dose of etoricoxib tablets as control group,Tongfengshu pian,4 tablets/time,3 times/day,and Yibai Tongfeng Cataplasm,1 paste/day. The course of treatment for the two groups lasted for 14 days. Pain was scored by visual analgesia score（ VAS）. Before and after the treatment,pressing pain,swelling of joint and articular dyskinesia were scored. And levels of erythrocyte sedimentation rate（ ESR）,C-reactive protein（ CRP）,blood uric acid（ UA）,IL^（-1）β,TNF-α,MMP-3 and COX-2were detected. Result： The clinical effect of observation group was superior to that of control group by RIDIT analysis,with statistically significant differences between the two groups（ P〈0. 05）. And at the 3rd,7thand 14 th day after the treatment,VAS in observation group was lower than that in control group（ P〈0. 01）. Scores of joint pressing pain,swelling,activity obstacle were all lower than those in control group（ P〈0. 01）,and levels of ESR,CRP,UA,IL^（-1）β,TNF-α,MMP-3 and COX-2 were lower than those in control group（ P〈0. 01）.Conclusion： Tongfengshu pian combined with Yibai Tongfeng Cataplasm can relieve patients＇ pain quickly,ameliorate clinical symptoms,and relieve inflammatory response,with obvious short-term effects.