加味四妙丸联合西药治疗急性痛风性关节炎28例临床研究

Clinical Study on 28 Patients with Acute Gouty Arthritis Treated by Jiawei Simiao Pills(加味四妙丸) Combined with Western Medicine

目的评价加味四妙丸治疗急性痛风性关节炎(AGA)的临床疗效。方法选取AGA患者60例,随机分为西药组和中西药组各30例。西药组予双氯芬酸钠缓释片口服,每次75 mg,每日1次;碳酸氢钠片口服,每次1000 mg,每日3次。中西药组在西药组基础上联合加味四妙丸。两组均治疗3天,治疗期间患者如因关节疼痛加重经评定改用糖皮质激素治疗。分别于治疗前后检测患者血白细胞(WBC)、C反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血尿酸(UA)、血肌酐(Cr)水平,并进行关节疼痛评分和关节红肿评分。比较两组患者改用糖皮质激素的比例。结果中西药组改用糖皮质激素治疗2例,明显低于西药组的9例(P<0.05);中西药组治疗后WBC、CRP、UA水平及关节疼痛评分、关节红肿评分均较治疗前明显降低(P<0.01),且CRP、UA水平及关节疼痛评分、关节红肿评分均低于西药组(P<0.05)。结论加味四妙丸治疗AGA可抑制炎症反应,缓解关节肿痛症状,减少糖皮质激素使用。

Objective To evaluate the clinical efficacy of Jiawei Simiao Pills in treating acute gouty arthritis （AGA）. Methods Sixty patients with AGA were randomly divided into a western medicine group and a Chinese and western medicine group, with 30 cases in each group. The western medicine group was given Diclofenac Sodium Sustained Release Tablets orally, 75 mg each time, once a day, and Sodium Bicarbonate Tablets, 1000 mg each time, 3 times a day orally. The Chinese and western medicine group was given Jiawei Simiao Pills in addition to the treat- ment same as in the western medicine group. The patients in the two groups were both treated for 3 days. During the treatment, if the joint pain got worse, patients switched to be treated with glucocorticoids after judgment. Before and after treatment, levels of white blood cells （WBC）, C reactive protein （CRP）, alanine aminotransferase （ALT）, as- partate aminotransferase （AST） , blood uric acid （UA） , and serum creatinine （Cr） were tested, and scores of joint pain, joint redness and swelling were evaluated respectively. The proportion of patients switching to glucocorticoids was compared between the two groups. Results There were 2 cases in the Chinese and western medicine group switching to glucocorticoids, significantly lower than 9 cases in the western medicine group （ P 〈 0.05 ）. After treat- ment, levels of WBC, CRP, and UA, as well as scores of joint pain and joint swelling in the Chinese and western medicine group were significantly lower than that before treatment （P 〈0. 01 ） , and levels of CRP and UA, as well as scores of joint pain, joint redness and swelling were all lower than those in the western medicine group （ P 〈 0. 05 ）. Conclusion Jiawei Simiao Pills could inhibit inflammatory reaction, relieve joint swelling and pain symptoms, and reduce the use of glucocortieoids in the treatment of AGA.