四妙散加味治疗急性痛风性关节炎的临床观察及对胰岛素抵抗指数的影响

Clinical Observation on Modified Simiao Decoction in Treatment of Acute Gout Arthritis and Its Effect on Insulin Resistance Index

目的观察四妙散加味治疗急性痛风性关节炎的临床疗效以及对胰岛素抵抗指数的影响。方法84例急性痛风性关节炎患者被随机分为治疗组和对照组,每组各42例。治疗组给予中药四妙散加味治疗,对照组给予秋水仙碱片口服治疗,疗程结束后观察血尿酸、C-反应蛋白,胰岛素抵抗指数、相关症状体征评分以及副反应量表评分,并评定疗效。结果治疗组中总有效率为92.86%,对照组总有效率为90.48%,两组总有效率经统计学处理,无显著差异(P>0.05);两组血尿酸(BUA)、C-反应蛋白(C-RP)、胰岛素抵抗指数(HOMA-IR)、关节疼痛评分、关节肿胀评分、关节压痛、关节活动障碍、副反应量表评分有显著性差异(P<0.05)。结论四妙散加味治疗急性痛风性关节炎疗效好、副反应小,并且可显著改善胰岛素抵抗,为研究加味四妙散治疗急性痛风性关节炎的作用机制提供新思路。

Objective To observe the clinical effect of modified Simiao decoction in treatment of acute gout arthritis and its effect on HOMA-IR. Methods 84 cases of acute gout arthritis patients were randomly divided into treatment group and control group,42 cases in each group. Treatment group was given modified Simiao decoction, control group was given oral treatment with colchicine tablets. Blood uric acid, C- reactive protein, HOMA-IR, symptoms and signs score were observed, the curative effect was evaluated at the end of treatment. Results The total effective rate was 92.86% in treatment group and 90.48% in control group, there was no significant difference （P〉0.05）; BUA, C-RP, HOMA-IR, and scores of joint pain, joint swelling, joint tenderness, joint movement disorder were significantly different between the two groups（P〈0.05 ）. Conclusion The results showed that modified Simiao decoction has good effect, minor side effects in the treatment of acute gout arthritis. It can significantly improve the insulin resistance and provide new ideas for the study of the mechanism of modified Simiao decoction in treatment of acute gouty arthritis.