桂枝附子汤加味配合外用药治疗寒湿痹阻型痛风性关节炎疗效观察

Clinical Observation of Modified Guizhi Fuzi Decoction Combined with External Application of Herbal Medicine for Treatment of Gouty Arthritis with Cold-damp Blockage

【目的】观察桂枝附子汤加味联合中药外敷治疗寒湿痹阻型痛风性关节炎的疗效。【方法】将120例寒湿痹阻型痛风性关节炎患者随机分为治疗组和对照组,每组各60例。对照组给予苯溴马隆片和碳酸氢钠口服治疗,治疗组在对照组基础上给予桂枝附子汤加味和中药外敷治疗,2组均以治疗14 d为1个疗程。观察2组患者治疗前后疼痛视觉模拟法(VAS)评分和超敏C-反应蛋白(hs-CRP)、血沉(ESR)、血尿酸(BUA)等实验指标的变化情况,并评价其安全性。【结果】(1)治疗后,2组患者的VAS评分均较治疗前明显降低(P<0.05或P<0.01),且治疗组的降低作用明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者BUA、hs-CRP及ESR均较治疗前下降(P<0.05),且治疗组的下降作用均明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗过程中,2组患者均无明显不良反应情况发生。【结论】桂枝附子汤加味联合中药外敷治疗寒湿痹阻型痛风性关节炎有良好疗效,可有效改善患者的临床症状和降低血尿酸水平。

Objective To observe the curative effect of Guizhi Fuzi Decoction combined with external application of herbal medicine for the treatment of cold-damp blockage type of gouty arthritis. Methods One hundred and twenty patients with cold-damp blockage type of gouty arthritis were randomly divided into treatment group and control group, 60 cases in each group. The two groups were medicated with Benzbromarone Tablets and Sodium Bicarbonate orally,and additionally the treatment group was given Guizhi Fuzi Decoction orally combined with external application of herbal medicine. The two groups were treated for 14 days as a course of treatment. Before and after treatment, the visual analogue scale(VAS) pain scores and the changes in laboratory indexes of hypersensitive C-reactive protein(hs-CRP),erythrocyte sedimentation rate(ESR)and blood uric acid(BUA)in the two groups were observed. And after treatment,the clinical safety in the two groups was evaluated. Results(1)After treatment,the VAS pain scores in the two groups were obviously decreased(P<0.05 or P < 0.01 compared with those before treatment), and the decrease in the treatment group was superior to that in the control group,the difference being significant(P<0.05).(2)After treatment,BUA,hs-CRP and ESR in the two groups were decreased(P<0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group,the difference being significant(P<0.05).(3)During the treatment,no obvious adverse reaction in the two groups occurred. Conclusion Guizhi Fuzi Decoction combined with external application of herbal medicine exerts certain effects for the treatment of cold-damp blockage type of gouty arthritis by relieving the clinical symptoms and decreasing the BUA level.