清热养阴除湿汤治疗慢性期痛风湿热蕴结兼脾肾亏虚证临床研究

Clinical Study of Qingre Yangyin Chushi decoction on chronic gout with dampness heat accumulation and Spleen and Kidney deficiency syndrome

目的观察清热养阴除湿汤治疗慢性期痛风湿热蕴结兼脾肾亏虚证的临床疗效。方法将60例慢性期痛风湿热蕴结兼脾肾亏虚证患者随机分为2组。2组均予常规非药物治疗,对照组30例加别嘌呤缓释胶囊治疗;治疗组30例在对照组治疗基础上加清热养阴除湿汤。2组疗程均为2个月。比较2组治疗前后关节局部疼痛、肿胀及活动障碍评分,血尿酸、肿瘤坏死因子α(TNF-α)及白细胞介素6(IL-6)水平变化情况,比较2组临床疗效及复发率。结果治疗组总有效率93.33%,对照组86.67%,2组总有效率比较差异无统计学意义(P>0.05),疗效相当。治疗后2组关节局部疼痛、关节局部肿胀及关节活动障碍评分均较本组治疗前明显降低(P<0.05),但2组组间比较差异无统计学意义(P>0.05)。治疗后2组血尿酸、TNF-α及IL-6水平均较本组治疗前明显下降(P<0.05),且治疗组低于对照组(P<0.05)。治疗组复发率3.33%,对照组复发率16.67%,治疗组复发率低于对照组(P<0.05)。结论清热养阴除湿汤治疗慢性期痛风湿热蕴结兼脾肾亏虚证能明显降低血尿酸及炎症因子水平,降低复发率。

Objective To observe the effects of Qingre Yangyin Chushi decoction on chronic gout with dampness heat accumulation and Spleen and Kidney deficiency syndrome. Methods 60 patients with chronic gout with dampness heat accumulation and Spleen and Kidney deficiency syndrome were randomly divided into two groups.Both groups received routine basic treatment. 30 cases in control group were treated by allopurinol sustained-release capsules. 30 cases in treatment group were treated by Qingre Yangyin Chushi decoction on the basis of the control group. Both groups treated for 2 months. The scores of pain,swelling and motion disturbance of joint,the levels of serum uric acid,tumor necrosis factor-alpha（ TNF-α） and interleukin-6（ IL-6） were compared between the two groups before and after treatment. Results The total effective rate was 93. 33% in treatment group and86. 66% in control group. There was no significant difference in the total effective rate between the two groups（ P〈0. 05）. The local joint pain,joint swelling and joint activity disorder scores of the two groups were significantly lower than those before treatment（ P〈0. 05）,and there was no significant difference between the two groups（ P〈0. 05）.The levels of serum uric acid,TNF-α and IL-6 in the two groups were significantly lower than those in the control group（ P〈0. 05）,and the treatment group was lower than the control group（ P〈0. 05）. The recurrence rate was3. 33% in treatment group and 16. 67% in control group. The recurrence rate of the treatment group was lower than that of the control group（ P〈0. 05）. Conclusion The treatment of chronic gout with Qingre Yangyin Chushi decoction can significantly reduce the levels of serum uric acid and inflammatory factors and reduce the recurrence rate.