沈氏生地红藤汤治疗湿热蕴结型急性痛风性关节炎的临床观察

Clinical observation on Shen’s Shengdi Hongteng Decoction in treatment of acute gouty arthritis of dampness-heat accumulation type

目的观察沈丕安名老中医自拟方生地红藤汤治疗急性痛风性关节炎的临床疗效。方法将60例急性痛风性关节炎患者随机分为治疗组和对照组,每组30例。对照组予塞来昔布胶囊口服,治疗组在对照组治疗基础上加用生地红藤汤。两组疗程均为1周,观察两组临床疗效,比较两组关节疼痛、肿胀改善情况及红细胞沉降率(ESR)、C反应蛋白(CRP)、血尿酸(UA)及炎症因子(IL-1β、TNF-α)的变化情况。结果治疗组、对照组总有效率分别为90.0%、76.7%;组间临床疗效比较,治疗组优于对照组(P<0.05)。治疗前后组内比较,两组VAS评分及肿胀评分均降低(P<0.05);组间治疗后比较,治疗组VAS评分及肿胀评分均低于对照组(P<0.05)。治疗前后组内比较,两组ESR、CRP、UA、IL-1β、TNF-α水平差异均有统计学意义(P<0.05);组间治疗后比较,治疗组ESR、CRP、UA、IL-1β、TNF-α水平与对照组比较差异均有统计学意义(P<0.05)。结论生地红藤汤对痛风性关节炎有良好的镇痛、消炎作用,同时可降低血尿酸水平。

Objective To observe the clinical efficacy of Shengdi Hongteng Decoction formulated by Shen Pian(a famous veteran teran doctor of TCM) in the treatment of acute gouty arthritis. Methods 60 patients with acute gouty arthritis were randomly assigned into treatment group and control group, 30 patients in each group. The control group was given Celebrex capsules, and the treatment group was administered Celebrex capsules and Shengdi Hongteng Decoction. The two groups were treated for 1 week. Clinical efficacy was observed. Improvement in pain and swelling of joints, and changes in erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), serum uric acid(UA) and inflammatory cytokines(IL-1β and TNF-α) were compared. Results The total effective rate was 90.0% and 76.7% in the treatment group and the control group, respectively. The clinical efficacy in the treatment group was superior to that in the control group(P<0.05). VAS and swelling scores decreased in both groups after treatment(P<0.05). After treatment, VAS and swelling scores were lower in the treatment group than in the control group(P<0.05). There were significant differences in the levels of ESR, CRP, UA, IL-1β and TNF-α in the two groups before and after treatment(P<0.05). After treatment, there were significant differences in the levels of ESR, CRP, UA, IL-1β and TNF-α between the treatment group and the control group(P<0.05). Conclusion Shengdi Hongteng Decoction has good analgesic and anti-inflammatory effect on gouty arthritis, and lowers the level of uric acid in serum.